Related Experiment Video
Updated: Aug 20, 2025
04:09
Prospective, Randomized, and Controlled Study of a Human Umbilical Cord Mesenchymal Stem Cell Injection for Treating Diabetic Foot Ulcers
Published on: March 3, 2023
3.0K
The SHID wound classification system for diabetic foot ulcer patients: a validity study
Suriadi Jais1, Kharisma Pratama1, Jery Fahrain1
1Department of Medical Surgical Nursing, Sekolah Tinggi Ilmu Keperawatan Muhammadiyah Pontianak, Pontianak, Indonesia.
Journal of Medicine and Life
|November 24, 2022
Summary
The new SHID (Suriadi, Haryanto, Imran dan Defa) wound classification system shows excellent predictive validity for diabetic foot ulcers, outperforming the Wagner and TU systems in Indonesia. This tool aids in better patient outcomes.
Area of Science:
- Podiatry
- Dermatology
- Clinical Nursing
Background:
- Diabetic foot ulcers (DFUs) pose a significant global health challenge, necessitating accurate classification systems for effective management.
- Existing wound classification systems, such as the Wagner and Texas University (TU) systems, have limitations in predicting DFU outcomes.
- The Suriadi, Haryanto, Imran dan Defa (SHID) system is a novel classification tool developed to improve DFU assessment.
Purpose of the Study:
- To evaluate and compare the predictive validity of the SHID wound classification system against the TU and Wagner systems in Indonesian patients with diabetic foot ulcers.
- To determine which classification system demonstrates superior accuracy in predicting DFU progression and outcomes.
Main Methods:
- A prospective cohort study was conducted involving 111 patients with diabetic foot ulcers at a wound clinic in Indonesia.
- Patients' wounds were assessed using the SHID, TU, and Wagner classification systems by postgraduate nursing students.
- Wound outcomes were observed over a 4-week period to assess the predictive accuracy of each system.
Main Results:
- The SHID system demonstrated high sensitivity (74%) and specificity (97%), with an Area Under the Curve (AUC) of 0.90 and a Youden index of 0.72%.
- The TU system showed sensitivity of 77% and specificity of 92% (AUC: 0.85, Youden index: 0.70%).
- The Wagner system had sensitivity of 84% and specificity of 71% (AUC: 0.86, Youden index: 0.55%), indicating lower predictive performance compared to SHID and TU.
- The SHID tool yielded the highest AUC and Youden Index values, suggesting superior predictive capability.
Conclusions:
- The SHID wound classification system exhibits strong predictive validity for diabetic foot ulcers in the Indonesian context, surpassing the Wagner system.
- All evaluated systems are valuable for identifying diabetic foot ulcers, but SHID offers enhanced accuracy for predicting outcomes.
- The findings support the adoption of the SHID system for improved management and prediction of outcomes in diabetic foot ulcer patients.
Keywords:
ABI – ankle brachial indexAUC – area under the curveCI – confidence intervalDFU – diabetic foot ulcerPEDIS – Perfusion, Extent, Depth, Infection, and SensationRN – registered nurseROC – receiver operating characteristicSHIDSHID – Suriadi, Haryanto, Imran, DefaSINBAD – Site, Ischemia, Neuropathy, Bacterial Infection and DepthTU – Texas Universitypredictive validitywound classification
Related Concept Videos
01:26Peripheral Artery Disease IV: Nursing Management
22
The nursing management of a patient with peripheral artery disease (PAD) begins with a thorough assessment of the patient’s health history and clinical manifestations.AssessmentHealth History: Evaluate the patient’s history of hypertension, hyperlipidemia, family history of cardiovascular issues, and lifestyle factors such as dietary patterns, smoking, and physical activity.Physical Examination:Assess the affected extremity for decreased or absent peripheral pulses,...
22
01:21Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
24
Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
24
01:27Assessment of the Cardiovascular System III: Palpation
440
Palpation involves feeling the body to evaluate texture, size, consistency, and tenderness for assessing cardiovascular health. The following steps are organized in a head-to-toe order:
Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above...
Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above...
440
01:23Peripheral Artery Disease V: Postoperative Nursing Management
17
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
17