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Wound classification systems - why no neuropathy?

Discussion in 'Diabetic Foot & Wound Management' started by Paul_UK, May 7, 2010.

  1. Paul_UK

    Paul_UK Active Member

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    Is there a reason why wound classification systems, such as the Texas System, don't incorporate neuropathy in them? Ive been doing some reading, albeit not a huge amount, but all the systems out there dont seem to include it. :confused: Is there one that incorporates neuropathy that I haven't found? Or a reason why not?
  2. charlie70

    charlie70 Active Member

    The Texas system has been updated to the TexaN system: basically, if neuropathy is a factor then you stick a big capital "N" at the end of the code.

    e.g. A3N

    Genius, no?

    (Pity they didn't think of it eariler!)
  3. Paul_UK

    Paul_UK Active Member

    Thanks, ill look into the new "TexaN" system. But it doesnt really incorporate neuropathy, just kinder sticks it on the end as an after thought. Would it be possible to develop a system that includes neuropathy in the same way as ischaemia/infection?
  4. Craig Payne

    Craig Payne Moderator

    Hopefully no one reading this get confused between the Texas diabetic foot classification (which does include neuropathy) and the Texas wound classification system (which originally did not).
  5. Admin2

    Admin2 Administrator Staff Member

  6. Paul_UK

    Paul_UK Active Member

    Craig - I was unaware there was a specific Texas Diabetic Classification. We are only using, what appears the old, Texas Classification without neuropathy hence my question. I will have a look at both the new TexaN and Texas diabetic classifications.
  7. Jill

    Jill Member

    the classification system PEDIS developed by William Jeffcoate and Colleagues also includes neuropathy
    PEDIS stands for P (perfusion), E (extent/size), D (depth of tissue loss), I (infection) and S (sensation). There are levels of 1 to 4 for each of these factors.
    (Schaper NC. International ulcer classification for research purposes by the International Working Group on the Diabetic Foot. Proceedings of the 4th International Symposium on the Diabetic Foot. Diab Metab Res Rev. 1998) or www.iwgdf.org
    A paper by Abbas et al in Diabetic Medicine compares PEDIS with S(AD)SAD, Meggit and Wagner and Univeristy of Texas systems
    Diabetic Medicine 2008 25:2;134-137 Comparison of four systems of classification of diabetic foot ulcers in Tanzania.
    There is an earlier paper by Armstrong and Peters (2001) Classification of wounds of the diabetic foot Current Diabetes Reports 1;3;233-238

    I have to say that I thought one of the faults of the UT system was that it did not include neuropathy.

  8. Paul_UK

    Paul_UK Active Member

    Many thanks Jill, thats given me some more to look in to.

    My thoughts as well but it looks as if they have adapted it so neuropathy is now included. There appears to be a lot of systems out there, does this mean that none of them meet all the needs?
  9. ferminmdj

    ferminmdj Welcome New Poster


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