[Debatable questions in diabetic foot syndrome classification].

Area of Science:

• Podiatry
• Vascular Surgery
• Endocrinology

Background:

• Diabetic foot syndrome (DFS) poses a significant clinical challenge.
• Existing classifications may not fully capture the diverse pathology of DFS.
• Effective treatment relies on accurate disease categorization.

Purpose of the Study:

• To review and propose an updated classification system for diabetic foot syndrome.
• To identify distinct clinical and pathological forms of DFS.
• To introduce a new classification for ischemic DFS based on hemodynamic parameters.

Main Methods:

• Retrospective analysis of 705 patients treated for diabetic foot syndrome.
• Clinical and pathological feature assessment to define DFS subtypes.
• Evaluation of micro- and macrogemodynamic criteria for ischemia classification.

Main Results:

• Identified three primary forms of diabetic foot syndrome: neuropathic, neuroischemic, and ischemic.
• Developed a novel classification for ischemic diabetic foot syndrome.
• The proposed ischemia classification incorporates reliable micro- and macrogemodynamic criteria.

Conclusions:

• The current study highlights the need for revised diabetic foot syndrome classifications.
• The proposed neuropathic, neuroischemic, and ischemic forms offer a refined approach to DFS.
• The new ischemia classification provides valuable hemodynamic criteria for clinical decision-making in DFS management.