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PEDIS score for diabetic foot ulcers

Multi-axis IWGDF classification of a diabetic foot ulcer by perfusion, extent, depth, infection, and sensation.

PEDIS score for diabetic foot ulcers
Perfusion
Extent/size of the ulcer after debridement
cm²
Depth/tissue loss
Infection
Corresponds to the IDSA/IWGDF diabetic foot infection severity classes (uninfected/mild/moderate/severe).
Sensation
ResultP1 E(not recorded) D1 I1 S1

No high-risk features on this axis-by-axis assessment.

Perfusion
Grade 1
Extent/size
not recorded
Depth/tissue loss
Grade 1
Infection
Grade 1
Sensation
Grade 1

When to use

  • Describing and staging a diabetic foot ulcer along independent, clinically relevant axes for research classification, referral, or handover.
  • The infection grade in particular maps onto the IDSA severity classes and helps guide antibiotic choice and need for hospitalisation.

Formula

Five independent axes, not summed to a single score: Perfusion (grade 1-3), Extent/size (measured wound area in cm²), Depth/tissue loss (grade 1-3), Infection (grade 1-4), and Sensation/loss of protective sensation (grade 1-2).

Pearls and pitfalls

  • Developed by the International Working Group on the Diabetic Foot (IWGDF) explicitly for research classification, not as a single summary score.
  • Infection grading should follow a systematic examination for the local and systemic signs defining each grade, not gestalt.

References

  1. Schaper NC. Diabetic foot ulcer classification system for research purposes: a progress report on criteria for including patients in research studies. Diabetes Metab Res Rev. 2004;20 Suppl 1:S90-95.