Diagnosis
8
Figure 4. SVS WIfI Clinical Limb Stage
Based on estimated risk of amputation at one year
Ischemia – 0 Ischemia – 1 Ischemia –2 Ischemia – 3
W–0 1 1 2 3 1 2 3 4 2 2 3 4 2 3 3 4
W–1 1 1 2 3 1 2 3 4 2 3 4 4 3 3 4 4
W–2 2 2 3 4 3 3 4 4 3 4 4 4 4 4 4 4
W–3 3 3 4 4 4 4 4 4 4 4 4 4 4 4 4 4
f I-0 f I-1 f I-2 f I-3 f I-0 f I-1 f I-2 f I-3 f I-0 f I-1 f I-2 f I-3 f I-0 f I-1 f I-2 f I-3
KEY: I = Ischemia W = Wound f I = foot Infection
Clinical Stage 1 or Very low risk
Clinical Stage 2 or Low risk
Clinical Stage 3 or Moderate risk
Clinical Stage 4 or High risk
Clinical Stage 5 = Unsalvageable limb
Premises:
a. Increase in wound class increases risk of amputation (based on WIf I, PEDIS, UT and
other wound classification systems)
b. PAD and infection are synergistic (Eurodiale); infected wound + PAD increases
likelihood revasularization will be needed to heal wound
c. Infection 3 category (systemic/metabolic instability): moderate to high-risk of
amputation regardless of other factors (validated IDSA infection guidelines)
