Australian guideline on wound classification of diabetes-related foot ulcers: part of the 2021 Australian evidence-based guidelines for diabetes-related foot disease

Abstract Background Wound classification systems are useful tools to characterise diabetes-related foot ulcers (DFU) and are utilised for the purpose of clinical assessment, to promote effective communication between health professionals, and to support clinical audit and benchmarking. Australian gu...

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Autores principales:	Emma J. Hamilton, Joanna Scheepers, Hayley Ryan, Byron M. Perrin, James Charles, Jane Cheney, Stephen M. Twigg, on behalf of the Australian Diabetes-related Foot Disease Guidelines & Pathways Project
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Wound classification Guidelines Adapt Adopt Diabetes-related foot ulcers Diseases of the musculoskeletal system RC925-935
Acceso en línea:	https://doaj.org/article/7c4ea1eb79ae458a8b710b484af92051
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spelling	oai:doaj.org-article:7c4ea1eb79ae458a8b710b484af920512021-12-05T12:04:10ZAustralian guideline on wound classification of diabetes-related foot ulcers: part of the 2021 Australian evidence-based guidelines for diabetes-related foot disease10.1186/s13047-021-00503-61757-1146https://doaj.org/article/7c4ea1eb79ae458a8b710b484af920512021-12-01T00:00:00Zhttps://doi.org/10.1186/s13047-021-00503-6https://doaj.org/toc/1757-1146Abstract Background Wound classification systems are useful tools to characterise diabetes-related foot ulcers (DFU) and are utilised for the purpose of clinical assessment, to promote effective communication between health professionals, and to support clinical audit and benchmarking. Australian guidelines regarding wound classification in patients with DFU are outdated. We aimed to adapt existing international guidelines for wound classification to develop new evidence-based Australian guidelines for wound classification in people with diabetes and DFU. Methods Recommended NHRMC procedures were followed to adapt suitable International Working Group on the Diabetic Foot (IWGDF) guidelines on wound classification to the Australian health context. Five IWGDF wound classification recommendations were evaluated and assessed according to the ADAPTE and GRADE systems. We compared our judgements with IWGDF judgements to decide if recommendations should be adopted, adapted or excluded in an Australian context. We re-evaluated the quality of evidence and strength of recommendation ratings, provided justifications for the recommendation and outlined any special considerations for implementation, subgroups, monitoring and future research in an Australian setting. Results After the five recommendations from the IWGDF 2019 guidelines on the classification of DFUs were evaluated by the panel, two were adopted and three were adapted to be more suitable for Australia. The main reasons for adapting, were to align the recommendations to existing Australian standards of care, especially in specialist settings, to maintain consistency with existing recommendations for documentation, audit and benchmarking and to be more appropriate, acceptable and applicable to an Australian context. In Australia, we recommend the use of the SINBAD system as a minimum standard to document the characteristics of a DFU for the purposes of communication among health professionals and for regional/national/international audit. In contrast to the IWGDF who recommend against usage, in Australia we recommend caution in the use of existing wound classification systems to provide an individual prognosis for a person with diabetes and a foot ulcer. Conclusions We have developed new guidelines for wound classification for people with diabetes and a foot ulcer that are appropriate and applicable for use across diverse care settings and geographical locations in Australia.Emma J. HamiltonJoanna ScheepersHayley RyanByron M. PerrinJames CharlesJane CheneyStephen M. Twiggon behalf of the Australian Diabetes-related Foot Disease Guidelines & Pathways ProjectBMCarticleWound classificationGuidelinesAdaptAdoptDiabetes-related foot ulcersDiseases of the musculoskeletal systemRC925-935ENJournal of Foot and Ankle Research, Vol 14, Iss 1, Pp 1-15 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Wound classification Guidelines Adapt Adopt Diabetes-related foot ulcers Diseases of the musculoskeletal system RC925-935
spellingShingle	Wound classification Guidelines Adapt Adopt Diabetes-related foot ulcers Diseases of the musculoskeletal system RC925-935 Emma J. Hamilton Joanna Scheepers Hayley Ryan Byron M. Perrin James Charles Jane Cheney Stephen M. Twigg on behalf of the Australian Diabetes-related Foot Disease Guidelines & Pathways Project Australian guideline on wound classification of diabetes-related foot ulcers: part of the 2021 Australian evidence-based guidelines for diabetes-related foot disease
description	Abstract Background Wound classification systems are useful tools to characterise diabetes-related foot ulcers (DFU) and are utilised for the purpose of clinical assessment, to promote effective communication between health professionals, and to support clinical audit and benchmarking. Australian guidelines regarding wound classification in patients with DFU are outdated. We aimed to adapt existing international guidelines for wound classification to develop new evidence-based Australian guidelines for wound classification in people with diabetes and DFU. Methods Recommended NHRMC procedures were followed to adapt suitable International Working Group on the Diabetic Foot (IWGDF) guidelines on wound classification to the Australian health context. Five IWGDF wound classification recommendations were evaluated and assessed according to the ADAPTE and GRADE systems. We compared our judgements with IWGDF judgements to decide if recommendations should be adopted, adapted or excluded in an Australian context. We re-evaluated the quality of evidence and strength of recommendation ratings, provided justifications for the recommendation and outlined any special considerations for implementation, subgroups, monitoring and future research in an Australian setting. Results After the five recommendations from the IWGDF 2019 guidelines on the classification of DFUs were evaluated by the panel, two were adopted and three were adapted to be more suitable for Australia. The main reasons for adapting, were to align the recommendations to existing Australian standards of care, especially in specialist settings, to maintain consistency with existing recommendations for documentation, audit and benchmarking and to be more appropriate, acceptable and applicable to an Australian context. In Australia, we recommend the use of the SINBAD system as a minimum standard to document the characteristics of a DFU for the purposes of communication among health professionals and for regional/national/international audit. In contrast to the IWGDF who recommend against usage, in Australia we recommend caution in the use of existing wound classification systems to provide an individual prognosis for a person with diabetes and a foot ulcer. Conclusions We have developed new guidelines for wound classification for people with diabetes and a foot ulcer that are appropriate and applicable for use across diverse care settings and geographical locations in Australia.
format	article
author	Emma J. Hamilton Joanna Scheepers Hayley Ryan Byron M. Perrin James Charles Jane Cheney Stephen M. Twigg on behalf of the Australian Diabetes-related Foot Disease Guidelines & Pathways Project
author_facet	Emma J. Hamilton Joanna Scheepers Hayley Ryan Byron M. Perrin James Charles Jane Cheney Stephen M. Twigg on behalf of the Australian Diabetes-related Foot Disease Guidelines & Pathways Project
author_sort	Emma J. Hamilton
title	Australian guideline on wound classification of diabetes-related foot ulcers: part of the 2021 Australian evidence-based guidelines for diabetes-related foot disease
title_short	Australian guideline on wound classification of diabetes-related foot ulcers: part of the 2021 Australian evidence-based guidelines for diabetes-related foot disease
title_full	Australian guideline on wound classification of diabetes-related foot ulcers: part of the 2021 Australian evidence-based guidelines for diabetes-related foot disease
title_fullStr	Australian guideline on wound classification of diabetes-related foot ulcers: part of the 2021 Australian evidence-based guidelines for diabetes-related foot disease
title_full_unstemmed	Australian guideline on wound classification of diabetes-related foot ulcers: part of the 2021 Australian evidence-based guidelines for diabetes-related foot disease
title_sort	australian guideline on wound classification of diabetes-related foot ulcers: part of the 2021 australian evidence-based guidelines for diabetes-related foot disease
publisher	BMC
publishDate	2021
url	https://doaj.org/article/7c4ea1eb79ae458a8b710b484af92051
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Australian guideline on wound classification of diabetes-related foot ulcers: part of the 2021 Australian evidence-based guidelines for diabetes-related foot disease

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