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This study aims to assess the complete healing or healing progress of foot ulcer within 1 year Where the patients will be classified according to foot arch state together with the angiosome theory and the WIFI clinical stage to reflect the the necessity of inclusion of foot arch state together with the angiosome theory within the WIFI classification to enhance the predictability of wound healing and decision making
Patients will be classified according to their WIFi stages into 3 groups and each group will be furtherly classified according to the patient's angiography of foot arch (whether by CT angiography or direct angiography) into:
Type 1: patent foot arch Type 2: partially occluded foot arch which is divided into whether Type 2a: patent dorsal tributary of foot arch Type 2b: patent lateral tributary of foot arch Type 3: totally occluded foot arch is divided into whether. Type 3a: totally occluded foot arch with anterior tibial artery inflow. Type 3b: totally occluded foot arch with posterior tibial artery inflow.
During follow-up assessments, wound is classified to be within: anterior tibial artery, posterior tibial artery or both territories.
Wound healing states are often classified based on the progression of the healing process into each of the following categories such as:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| WIFI stage 1 with type 1 foot arch | |||
| WIFI stage 2 with type 1 foot arch | |||
| WIFI stage 3 with type 1 foot arch | |||
| WIFI stage 1 with type 2a foot arch | |||
| WIFI stage 2 with type 2a foot arch | |||
| WIFI stage 3 with type 2a foot arch | |||
| WIFI stage 1 with type 2b foot arch | |||
| WIFI stage 2 with type 2b foot arch | |||
| WIFI stage 3 with type 2b foot arch | |||
| WIFI stage 1 with type 3a foot arch |
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| Measure | Description | Time Frame |
|---|---|---|
| Complete Healing | Wound closure with the restoration of tissue integrity and absence of signs of infection. | 2,4,6 months |
| Partial Healing: | significant improvement but not complete closure; may involve change in wound size and improved tissue viability. | 2,4,6 months |
| Worsening | change in wound size or signs of infection which may necessitates performing major amputation. . | 2,4,6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Occurrence of Complication | Rates of procedure- and device-related adverse events during revasularization | within 30 days of the procedure |
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Inclusion Criteria:
Exclusion Criteria:
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patients walking in or referred to the out-patient clinic at Ain Shams University Specialized Hospitals or El-Demerdash University Hospitals with symptoms of diabetic foot ulcer or gangrene.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ain Shams University | Cairo | Egypt |
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| WIFI stage 2 with type 3a foot arch |
| WIFI stage 3 with type 3a foot arch |
| WIFI stage 1 with type 3b foot arch |
| WIFI stage 2 with type 3b foot arch |
| WIFI stage 3 with type 3b foot arch |
| ID | Term |
|---|---|
| D000089802 | Chronic Limb-Threatening Ischemia |
| D017719 | Diabetic Foot |
| D014652 | Vascular Diseases |
| ID | Term |
|---|---|
| D058729 | Peripheral Arterial Disease |
| D050197 | Atherosclerosis |
| D001161 | Arteriosclerosis |
| D001157 | Arterial Occlusive Diseases |
| D002318 | Cardiovascular Diseases |
| D016491 | Peripheral Vascular Diseases |
| D002908 | Chronic Disease |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D007511 | Ischemia |
| D003925 | Diabetic Angiopathies |
| D016523 | Foot Ulcer |
| D007871 | Leg Ulcer |
| D012883 | Skin Ulcer |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D048909 | Diabetes Complications |
| D003920 | Diabetes Mellitus |
| D004700 | Endocrine System Diseases |
| D003929 | Diabetic Neuropathies |
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