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DOI: 10.1055/a-2500-1472
Diabetic Foot Syndrome
The DDG clinical practice guidelines are updated regularly during the second half of the calendar year. Please ensure that you read and cite the respective current version.
UPDATES TO CONTENT AND DIFFERENT RECOMMENDATIONS COMPARED TO THE PREVIOUS YEAR’S VERSION
Change 1:
The previous ("Shoe care and risk classifications for diabetic foot syndrome and associated neuro-angio-arthropathies") has been replaced by a completely revised version and supplemented by an “Instructions for provision of shoes for diabetic foot syndrome” as 2.
Change 2:
In [Tab. 4] (“Clinical classification of foot infections”), the nomenclature of PEDIS grades 3 and 4 in the presence of osteomyelitis has been adapted to the original publication.
|
Clinical manifestation of infection |
Severity of infection |
PEDIS classification |
|---|---|---|
|
Wound without suppuration or signs of inflammation |
Not infected |
1 |
|
Presence of ≥2 signs of inflammation (suppuration, redness, (pressure) pain, warmth or sclerosis), but each sign of inflammation ≤2 cm around the ulcer; infection is limited to the skin or superficial subcutaneous tissue; no other local complications or systemic disease |
Mild |
2 |
|
Infection (as above) in a patient who is systemically healthy and metabolically stable, but exhibits ≥1 of the following characteristics: Signs of inflammation which extend >2 cm around the ulcer, lymphangitis, spread under the superficial fascia, abscess in deep tissue, necrosis and extends to muscle, tendon, joint or bone |
Moderate |
3 |
|
Infection with osteomyelitis |
Add "O" |
|
|
Infection in a patient with systemic signs of infection or unstable circulation (e. g., fever, chills, tachycardia, hypotension, confusion, vomiting, leukocytosis, acidosis, severe hyperglycaemia or azotaemia) |
Severe |
4 |
|
Infection with osteomyelitis |
Add "O" |
Note: The presence of critical ischaemia shifts the severity of the infection (in terms of prognosis) towards "severe" but may reduce the clinical signs of infection. PEDIS: “Perfusion”, “Extent/Size”, “Depth/tissue loss”, “Infection” and “Sensation”.
Publikationsverlauf
Artikel online veröffentlicht:
30. Juli 2025
© 2025. Thieme. All rights reserved.
Georg Thieme Verlag KG
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References
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