Wound classification systems - why no neuropathy?

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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. Is there one that incorporates neuropathy that I haven't found? Or a reason why not?

 

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!)

 

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?

 

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).

 

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.

 

Paul
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.

Regards
Jill

 

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?

 

Yes neuropathy, edema, area. wound healing phase, an other variables are pretty important. I hope this paper could provide additional information.

A Checklist System to Score Healing Progress of Diabetic Foot Ulcers
cheers