Ulcers in diabetic foot are one of the most common focal pathology that affects more than 15% of ... more Ulcers in diabetic foot are one of the most common focal pathology that affects more than 15% of the patients in their lifetime. Loss of sensation in foot and biomechanical factors play essential role in it's causation. One of the most common modality of management of diabetic foot ulcer is offloading. The offloading can be mechanical or surgical. This article aims at providing a new descriptive classification for surgical offloading for the first time and it is an extension of Amit Jain's SCC classification.
Diabetic foot ulcers are common in clinical practice and they are often difficult to treat, espec... more Diabetic foot ulcers are common in clinical practice and they are often difficult to treat, especially the plantar ulcers which are common in patients with neuropathy. One modality of treatment that is important is offloading of the foot. There are distinct offloading methods used in clinical practice in different parts of the world. In this article, author suggest a practical offloading ladder approach for diabetic foot ulcers
Wounds are extremely common in clinical practice and they include diabetic foot
wounds, venous u... more Wounds are extremely common in clinical practice and they include diabetic foot wounds, venous ulcers, burns, traumatic wounds, etc. These wounds occur frequently in daily life and needs to be managed appropriately otherwise they can lead to complications. Numerous wound dressings/products are available in Industry with each having merits and demerits. Often, it is also difficult to understand their usage and mechanisms of action. The primary author extended his ‘SCC’ classification series to wound dressings wherein one can categorize them into 3 type’s namely simple, complex, and complicated wound dressings. This article aims to discuss this new classification of wound dressings.
The number of diabetic foot complications is rising globally due to the increased incidence of di... more The number of diabetic foot complications is rising globally due to the increased incidence of diabetes. Various research, guidelines, and practices in managing diabetic foot are being adopted from the West. In the majority of Asian and African countries, where a large population with diabetes exists, the diabetic foot is often neglected. Geographic differences in diabetic foot disorders, as well as in podiatric surgeon practices, are noticeable. Infectious diseases like cellulitis, abscesses of leg, and necrotizing fasciitis, etc. are known to affect the diabetic lower limbs. When there are relatively few trained and certified podiatric surgeons and diabetic limb salvage specialist, there are also very few research studies on these diseases, particularly in many developing countries, including India. The author, as a practicing diabetic limb salvage sub-specialist, presents a new staging system for cellulitis in diabetic lower limb for the first time. This simple staging system is likely to help standardize the practice of diabetic lower limb salvage worldwide. By including photographic cases in this article, surgeons and specialists will hopefully better understand the new staging system. This will enable them to diagnose dreaded infections like necrotizing fasciitis more confidently in their diabetic lower limb salvage practice.
Charcot foot (CF) is an uncommon, but a dreaded, complication of diabetic foot. The incidence of ... more Charcot foot (CF) is an uncommon, but a dreaded, complication of diabetic foot. The incidence of both CF and diabetes is increasing worldwide. Most of the data on CF is from developed countries, and there is hardly any data from the Indian subcontinent, which harbors the largest number of diabetics in the world. The reason is because there are approximately only a dozen qualified podiatric surgeons, or dedicated expert diabetic foot surgeons, in the country who specifically treat this condition. This article aims to share an experience from the largest, and currently the best known diabetic limb salvage center in the country. It is also the only one of its kind. This center encounters at least one CF every week. Most of the patients (66%) have chronic CF. Nearly 43% of the patients have an identifiable precipitating factor leading to the foot deformity. Around 62% of the patients have a mixed pattern of joint involvement, with Pattern III being the most common single pattern of joint involved. The most interesting finding in the study is the association of peripheral vascular disease (PVD) with chronic CF, which is very rarely described. There was no major amputation in any of our patients, since there is a strict attempt to salvage every foot.
Acute Necrotizing Pancreatitis is a rare complication of leptospirosis and this association carri... more Acute Necrotizing Pancreatitis is a rare complication of leptospirosis and this association carries a high mortality rate. Only few cases have been reported in literature. We hereby report one such case we encountered.
Numerous new concepts have been laid down in field of diabetic foot over past few years. The aim ... more Numerous new concepts have been laid down in field of diabetic foot over past few years. The aim of this article is to review and add information on various different triangles in diabetic foot exclusively as well as triangles that can be applied in diabetic foot specialty from other specialty field. The purpose of these triangles ranges from being simple teaching models to providing guidance in treatment. Some triangles in diabetic foot can be multipurpose. The triangles in diabetic foot are newer concepts and we hereby describe some of the newly proposed named and unnamed triangles, acquaintance of which would help the clinicians in their practice and academic knowledge.
Plantar ulcerations are quite common in foot of diabetic patient and majority of them are neuropa... more Plantar ulcerations are quite common in foot of diabetic patient and majority of them are neuropathic. In view of these ulcers being located at weight bearing areas, it becomes essential to reduce pressure on wounds to facilitate optimal healing. In spite of knowing the benefits of offloading and also availability of various methods and devices, the practice of offloading has been suboptimal in many regions. This article aims to discuss some of the available offloading methods through a new teaching model, the triangle of offloading.
IAR Journal of Medicine and Surgery Research, 2021
Aim-T o assess the usage of therapeutic offloading in diabetic foot patients in an expert diabeti... more Aim-T o assess the usage of therapeutic offloading in diabetic foot patients in an expert diabetic foot centre and distribute them according to Amit Jain's classification for offloading. Methods and materials-A retrospective audit was conducted at Amit Jain's diabetic foot offloading clinic which is now an eponymous wing under Amit Jain's Institute of Diabetic Foot and Wound Care,
To analyze the occurrence of diabetic foot storm in hospitalized patients with foot complications... more To analyze the occurrence of diabetic foot storm in hospitalized patients with foot complications. Methods and Materials: A retrospective analysis was done from July 2021 to December 2021 at Amit Jain’s Institute of Diabetic foot and wound care, Brindhavvan Areion Hospital, Bengaluru, India
Diabetic foot has always been a complex disease with outcomes of delayed treatment being amputati... more Diabetic foot has always been a complex disease with outcomes of delayed treatment being amputation. Over few decades, one can observe that there have been efforts to simplify the understanding of diabetic foot and also there has been an increased surge in introduction of various new concepts in diabetic foot. There are various distinct acronyms in diabetic foot many of which are popular worldwide and some are recently introduced with each having their own merits and demerits. Apart from rendering it as a easy method to remember, some of the acronyms can even guide treatment in simplified manner so that it can form a protocol in a clinicians practice. This article focuses on various acronyms relevant to diabetic foot including the latest ones.
Aim: To compare pus culture versus tissue culture for bacterial isolates of diabetic foot infecti... more Aim: To compare pus culture versus tissue culture for bacterial isolates of diabetic foot infections through Amit Jain's classification for diabetic foot. Materials and methods: A retrospective comparative analysis was done at Amit Jain's Institute of Diabetic foot and Wound Care, BrindhavvanAreion hospital, Bengaluru. The study period was from Jan 2019 to June 2020. Statistical Analysis was done using SPSS version 25.0 and p value of < 0.05 was considered significant. Results: 42 patients were included in this study. Tissue culture yielded bacteria in 90.5% of cases. Pus culture had multiple growths in 9.5% whereas tissue culture had multiple growths in 16.7%. In both pus and tissue cultures, Gram negative organisms were common compared to Gram positive
Amit Jain's classification of diabetic foot complications is a popular tool that encompasses the ... more Amit Jain's classification of diabetic foot complications is a popular tool that encompasses the common complications seen in the diabetic foot around the world. This classification makes us look at various lesions commonly affecting diabetic foot apart from the foot ulcers that are seen in diabetic patients. Studies have shown that type 1 diabetic foot complications are the most common complications that are encountered in hospitalised patients in developing countries. This article discusses the more common type 2 diabetic foot complications seen in the clinical practice. Type 2 diabetic foot complications are non-infective complications that occur in patients with long-standing diabetes.
Aim. A validation study to analyse diabetic foot osteomyelitis using Amit Jain’s new
classificati... more Aim. A validation study to analyse diabetic foot osteomyelitis using Amit Jain’s new classification for osteomyelitis and predict various related outcomes. Methods and materials. A descriptive retrospective analysis of 28 patients (60.7% male; mean duration of diabetes 16.07 ± 9.8 years) was conducted at Amit Jain’s Institute of Diabetic Foot and Wound Care at Brindhavvan Areion Hospital, Bangalore, India between August 2016 and October 2018. Results. Type 1 diabetic foot osteomyelitis was found in 85.7% of patients; 10.7% had type 3 osteomyelitis. Subtype C was the most common (57%). Ulcer most often caused osteomyelitis (82.1%). Major amputation had occurred in 7.1% of patients and was significantly associated with type 3 osteomyelitis. Conclusion. Type 1, subtype C osteomyelitis was most commonly seen in clinical practice and was usually treated with conservative surgeries. Minor amputations were most frequent in type 1 and 2 osteomyelitis; major amputation was significantly associated with type 3 osteomyelitis. Those who favour purely medical management of osteomyelitis are recommended to prescribe antibiotics alone in subtype A osteomyelitis and in some subtype B patients (without deepseated pus, cellulitis or slough/necrotic tissue). Amit Jain’s classification for diabetic foot osteomyelitis is a simple, easy-to-remember, practical classification that guides treatment and predicts associated outcomes.
Diabetic foot is a known and depressing complication seen in patients with diabetes. If neglected... more Diabetic foot is a known and depressing complication seen in patients with diabetes. If neglected either by patient or clinician, then outcome is obvious and it is amputation. Once a complication sets in, it brings with it many problems that would be difficult for a patient to deal with. Hence, various preventive strategies have come into picture that aimed at decreasing this complication. One such method is by campaigning. This article aims at discussing the 2 terms in diabetic foot that can be used to bring awareness on this dangerous complication of diabetes.
Diabetic foot is a challenging problem for both physicians and health care professionals. However... more Diabetic foot is a challenging problem for both physicians and health care professionals. However, the reward of managing diabetic foot is through preventive strategies rather than treating the established complications. Hence, it becomes essential to adopt such strategies. Diabetic foot storm is the new term coined recently that aimed at bringing awareness regarding problems associated with diabetic foot. This article provides a brief framework to understand the diabetic foot problems, the diabetic foot storm and strategies that can be deployed in preventing the diabetic foot storm. We believe that by adopting simple methods of preventive strategies, the burden of diabetic foot can be decreased to a large extent.
There are numerous scoring system used in different parts of the world and most of them are for d... more There are numerous scoring system used in different parts of the world and most of them are for diabetic foot ulcers only with Amit Jain’s surgical scoring system being the first such scoring for diabetic foot complications. This study aims to validate the Amit Jain’s scoring system in predicting the risk of major amputation in diabetic foot complications. A retrospective analysis was done in Department of General Surgery of Raja Rajeswari medical college, Bengaluru, India. The study period was from January 2018 to December 2019. All the patients who underwent surgeries for diabetic foot complications in our department were included in the study. A total of 47 patients were included in this study. Majority of patients (76.6%) were males 61.7% of patients had diabetes mellitus of less than 10 years duration. Abscess was the most common pathological lesion seen in the foot affecting 36.17%. Most of the patients (59.6%) with diabetic foot complications had Amit Jain’s surgical score of...
Ulcers in diabetic foot are one of the most common focal pathology that affects more than 15% of ... more Ulcers in diabetic foot are one of the most common focal pathology that affects more than 15% of the patients in their lifetime. Loss of sensation in foot and biomechanical factors play essential role in it's causation. One of the most common modality of management of diabetic foot ulcer is offloading. The offloading can be mechanical or surgical. This article aims at providing a new descriptive classification for surgical offloading for the first time and it is an extension of Amit Jain's SCC classification.
Diabetic foot ulcers are common in clinical practice and they are often difficult to treat, espec... more Diabetic foot ulcers are common in clinical practice and they are often difficult to treat, especially the plantar ulcers which are common in patients with neuropathy. One modality of treatment that is important is offloading of the foot. There are distinct offloading methods used in clinical practice in different parts of the world. In this article, author suggest a practical offloading ladder approach for diabetic foot ulcers
Wounds are extremely common in clinical practice and they include diabetic foot
wounds, venous u... more Wounds are extremely common in clinical practice and they include diabetic foot wounds, venous ulcers, burns, traumatic wounds, etc. These wounds occur frequently in daily life and needs to be managed appropriately otherwise they can lead to complications. Numerous wound dressings/products are available in Industry with each having merits and demerits. Often, it is also difficult to understand their usage and mechanisms of action. The primary author extended his ‘SCC’ classification series to wound dressings wherein one can categorize them into 3 type’s namely simple, complex, and complicated wound dressings. This article aims to discuss this new classification of wound dressings.
The number of diabetic foot complications is rising globally due to the increased incidence of di... more The number of diabetic foot complications is rising globally due to the increased incidence of diabetes. Various research, guidelines, and practices in managing diabetic foot are being adopted from the West. In the majority of Asian and African countries, where a large population with diabetes exists, the diabetic foot is often neglected. Geographic differences in diabetic foot disorders, as well as in podiatric surgeon practices, are noticeable. Infectious diseases like cellulitis, abscesses of leg, and necrotizing fasciitis, etc. are known to affect the diabetic lower limbs. When there are relatively few trained and certified podiatric surgeons and diabetic limb salvage specialist, there are also very few research studies on these diseases, particularly in many developing countries, including India. The author, as a practicing diabetic limb salvage sub-specialist, presents a new staging system for cellulitis in diabetic lower limb for the first time. This simple staging system is likely to help standardize the practice of diabetic lower limb salvage worldwide. By including photographic cases in this article, surgeons and specialists will hopefully better understand the new staging system. This will enable them to diagnose dreaded infections like necrotizing fasciitis more confidently in their diabetic lower limb salvage practice.
Charcot foot (CF) is an uncommon, but a dreaded, complication of diabetic foot. The incidence of ... more Charcot foot (CF) is an uncommon, but a dreaded, complication of diabetic foot. The incidence of both CF and diabetes is increasing worldwide. Most of the data on CF is from developed countries, and there is hardly any data from the Indian subcontinent, which harbors the largest number of diabetics in the world. The reason is because there are approximately only a dozen qualified podiatric surgeons, or dedicated expert diabetic foot surgeons, in the country who specifically treat this condition. This article aims to share an experience from the largest, and currently the best known diabetic limb salvage center in the country. It is also the only one of its kind. This center encounters at least one CF every week. Most of the patients (66%) have chronic CF. Nearly 43% of the patients have an identifiable precipitating factor leading to the foot deformity. Around 62% of the patients have a mixed pattern of joint involvement, with Pattern III being the most common single pattern of joint involved. The most interesting finding in the study is the association of peripheral vascular disease (PVD) with chronic CF, which is very rarely described. There was no major amputation in any of our patients, since there is a strict attempt to salvage every foot.
Acute Necrotizing Pancreatitis is a rare complication of leptospirosis and this association carri... more Acute Necrotizing Pancreatitis is a rare complication of leptospirosis and this association carries a high mortality rate. Only few cases have been reported in literature. We hereby report one such case we encountered.
Numerous new concepts have been laid down in field of diabetic foot over past few years. The aim ... more Numerous new concepts have been laid down in field of diabetic foot over past few years. The aim of this article is to review and add information on various different triangles in diabetic foot exclusively as well as triangles that can be applied in diabetic foot specialty from other specialty field. The purpose of these triangles ranges from being simple teaching models to providing guidance in treatment. Some triangles in diabetic foot can be multipurpose. The triangles in diabetic foot are newer concepts and we hereby describe some of the newly proposed named and unnamed triangles, acquaintance of which would help the clinicians in their practice and academic knowledge.
Plantar ulcerations are quite common in foot of diabetic patient and majority of them are neuropa... more Plantar ulcerations are quite common in foot of diabetic patient and majority of them are neuropathic. In view of these ulcers being located at weight bearing areas, it becomes essential to reduce pressure on wounds to facilitate optimal healing. In spite of knowing the benefits of offloading and also availability of various methods and devices, the practice of offloading has been suboptimal in many regions. This article aims to discuss some of the available offloading methods through a new teaching model, the triangle of offloading.
IAR Journal of Medicine and Surgery Research, 2021
Aim-T o assess the usage of therapeutic offloading in diabetic foot patients in an expert diabeti... more Aim-T o assess the usage of therapeutic offloading in diabetic foot patients in an expert diabetic foot centre and distribute them according to Amit Jain's classification for offloading. Methods and materials-A retrospective audit was conducted at Amit Jain's diabetic foot offloading clinic which is now an eponymous wing under Amit Jain's Institute of Diabetic Foot and Wound Care,
To analyze the occurrence of diabetic foot storm in hospitalized patients with foot complications... more To analyze the occurrence of diabetic foot storm in hospitalized patients with foot complications. Methods and Materials: A retrospective analysis was done from July 2021 to December 2021 at Amit Jain’s Institute of Diabetic foot and wound care, Brindhavvan Areion Hospital, Bengaluru, India
Diabetic foot has always been a complex disease with outcomes of delayed treatment being amputati... more Diabetic foot has always been a complex disease with outcomes of delayed treatment being amputation. Over few decades, one can observe that there have been efforts to simplify the understanding of diabetic foot and also there has been an increased surge in introduction of various new concepts in diabetic foot. There are various distinct acronyms in diabetic foot many of which are popular worldwide and some are recently introduced with each having their own merits and demerits. Apart from rendering it as a easy method to remember, some of the acronyms can even guide treatment in simplified manner so that it can form a protocol in a clinicians practice. This article focuses on various acronyms relevant to diabetic foot including the latest ones.
Aim: To compare pus culture versus tissue culture for bacterial isolates of diabetic foot infecti... more Aim: To compare pus culture versus tissue culture for bacterial isolates of diabetic foot infections through Amit Jain's classification for diabetic foot. Materials and methods: A retrospective comparative analysis was done at Amit Jain's Institute of Diabetic foot and Wound Care, BrindhavvanAreion hospital, Bengaluru. The study period was from Jan 2019 to June 2020. Statistical Analysis was done using SPSS version 25.0 and p value of < 0.05 was considered significant. Results: 42 patients were included in this study. Tissue culture yielded bacteria in 90.5% of cases. Pus culture had multiple growths in 9.5% whereas tissue culture had multiple growths in 16.7%. In both pus and tissue cultures, Gram negative organisms were common compared to Gram positive
Amit Jain's classification of diabetic foot complications is a popular tool that encompasses the ... more Amit Jain's classification of diabetic foot complications is a popular tool that encompasses the common complications seen in the diabetic foot around the world. This classification makes us look at various lesions commonly affecting diabetic foot apart from the foot ulcers that are seen in diabetic patients. Studies have shown that type 1 diabetic foot complications are the most common complications that are encountered in hospitalised patients in developing countries. This article discusses the more common type 2 diabetic foot complications seen in the clinical practice. Type 2 diabetic foot complications are non-infective complications that occur in patients with long-standing diabetes.
Aim. A validation study to analyse diabetic foot osteomyelitis using Amit Jain’s new
classificati... more Aim. A validation study to analyse diabetic foot osteomyelitis using Amit Jain’s new classification for osteomyelitis and predict various related outcomes. Methods and materials. A descriptive retrospective analysis of 28 patients (60.7% male; mean duration of diabetes 16.07 ± 9.8 years) was conducted at Amit Jain’s Institute of Diabetic Foot and Wound Care at Brindhavvan Areion Hospital, Bangalore, India between August 2016 and October 2018. Results. Type 1 diabetic foot osteomyelitis was found in 85.7% of patients; 10.7% had type 3 osteomyelitis. Subtype C was the most common (57%). Ulcer most often caused osteomyelitis (82.1%). Major amputation had occurred in 7.1% of patients and was significantly associated with type 3 osteomyelitis. Conclusion. Type 1, subtype C osteomyelitis was most commonly seen in clinical practice and was usually treated with conservative surgeries. Minor amputations were most frequent in type 1 and 2 osteomyelitis; major amputation was significantly associated with type 3 osteomyelitis. Those who favour purely medical management of osteomyelitis are recommended to prescribe antibiotics alone in subtype A osteomyelitis and in some subtype B patients (without deepseated pus, cellulitis or slough/necrotic tissue). Amit Jain’s classification for diabetic foot osteomyelitis is a simple, easy-to-remember, practical classification that guides treatment and predicts associated outcomes.
Diabetic foot is a known and depressing complication seen in patients with diabetes. If neglected... more Diabetic foot is a known and depressing complication seen in patients with diabetes. If neglected either by patient or clinician, then outcome is obvious and it is amputation. Once a complication sets in, it brings with it many problems that would be difficult for a patient to deal with. Hence, various preventive strategies have come into picture that aimed at decreasing this complication. One such method is by campaigning. This article aims at discussing the 2 terms in diabetic foot that can be used to bring awareness on this dangerous complication of diabetes.
Diabetic foot is a challenging problem for both physicians and health care professionals. However... more Diabetic foot is a challenging problem for both physicians and health care professionals. However, the reward of managing diabetic foot is through preventive strategies rather than treating the established complications. Hence, it becomes essential to adopt such strategies. Diabetic foot storm is the new term coined recently that aimed at bringing awareness regarding problems associated with diabetic foot. This article provides a brief framework to understand the diabetic foot problems, the diabetic foot storm and strategies that can be deployed in preventing the diabetic foot storm. We believe that by adopting simple methods of preventive strategies, the burden of diabetic foot can be decreased to a large extent.
There are numerous scoring system used in different parts of the world and most of them are for d... more There are numerous scoring system used in different parts of the world and most of them are for diabetic foot ulcers only with Amit Jain’s surgical scoring system being the first such scoring for diabetic foot complications. This study aims to validate the Amit Jain’s scoring system in predicting the risk of major amputation in diabetic foot complications. A retrospective analysis was done in Department of General Surgery of Raja Rajeswari medical college, Bengaluru, India. The study period was from January 2018 to December 2019. All the patients who underwent surgeries for diabetic foot complications in our department were included in the study. A total of 47 patients were included in this study. Majority of patients (76.6%) were males 61.7% of patients had diabetes mellitus of less than 10 years duration. Abscess was the most common pathological lesion seen in the foot affecting 36.17%. Most of the patients (59.6%) with diabetic foot complications had Amit Jain’s surgical score of...
The Amit Jain’s law of classification states that
“Diabetic foot, a complex disease, is multi-fac... more The Amit Jain’s law of classification states that “Diabetic foot, a complex disease, is multi-factorial, multi-pathological, multianatomical with multi-level involvement and multi-systemic complications requiring multi-disciplinary involvement. Hence, it is impossible for any single classification in diabetic foot to predict the outcome in each and every patient and to guide specific treatment for each patient using a single classification that encompasses many lesions in diabetic foot”. This law encourages professionals to use combination of classification.
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Papers by Amit jain
ulcers which are common in patients with neuropathy. One modality of treatment that is important is offloading of the
foot. There are distinct offloading methods used in clinical practice in different parts of the world. In this article, author
suggest a practical offloading ladder approach for diabetic foot ulcers
wounds, venous ulcers, burns, traumatic wounds, etc. These wounds occur frequently in
daily life and needs to be managed appropriately otherwise they can lead to complications.
Numerous wound dressings/products are available in Industry with each having merits
and demerits. Often, it is also difficult to understand their usage and mechanisms of action.
The primary author extended his ‘SCC’ classification series to wound dressings wherein
one can categorize them into 3 type’s namely simple, complex, and complicated wound
dressings. This article aims to discuss this new classification of wound dressings.
classification for osteomyelitis and predict various related outcomes. Methods and
materials. A descriptive retrospective analysis of 28 patients (60.7% male; mean
duration of diabetes 16.07 ± 9.8 years) was conducted at Amit Jain’s Institute of
Diabetic Foot and Wound Care at Brindhavvan Areion Hospital, Bangalore, India
between August 2016 and October 2018. Results. Type 1 diabetic foot osteomyelitis
was found in 85.7% of patients; 10.7% had type 3 osteomyelitis. Subtype C was the
most common (57%). Ulcer most often caused osteomyelitis (82.1%). Major amputation
had occurred in 7.1% of patients and was significantly associated with type 3
osteomyelitis. Conclusion. Type 1, subtype C osteomyelitis was most commonly
seen in clinical practice and was usually treated with conservative surgeries. Minor
amputations were most frequent in type 1 and 2 osteomyelitis; major amputation
was significantly associated with type 3 osteomyelitis. Those who favour purely
medical management of osteomyelitis are recommended to prescribe antibiotics
alone in subtype A osteomyelitis and in some subtype B patients (without deepseated
pus, cellulitis or slough/necrotic tissue). Amit Jain’s classification for diabetic
foot osteomyelitis is a simple, easy-to-remember, practical classification that guides
treatment and predicts associated outcomes.
ulcers which are common in patients with neuropathy. One modality of treatment that is important is offloading of the
foot. There are distinct offloading methods used in clinical practice in different parts of the world. In this article, author
suggest a practical offloading ladder approach for diabetic foot ulcers
wounds, venous ulcers, burns, traumatic wounds, etc. These wounds occur frequently in
daily life and needs to be managed appropriately otherwise they can lead to complications.
Numerous wound dressings/products are available in Industry with each having merits
and demerits. Often, it is also difficult to understand their usage and mechanisms of action.
The primary author extended his ‘SCC’ classification series to wound dressings wherein
one can categorize them into 3 type’s namely simple, complex, and complicated wound
dressings. This article aims to discuss this new classification of wound dressings.
classification for osteomyelitis and predict various related outcomes. Methods and
materials. A descriptive retrospective analysis of 28 patients (60.7% male; mean
duration of diabetes 16.07 ± 9.8 years) was conducted at Amit Jain’s Institute of
Diabetic Foot and Wound Care at Brindhavvan Areion Hospital, Bangalore, India
between August 2016 and October 2018. Results. Type 1 diabetic foot osteomyelitis
was found in 85.7% of patients; 10.7% had type 3 osteomyelitis. Subtype C was the
most common (57%). Ulcer most often caused osteomyelitis (82.1%). Major amputation
had occurred in 7.1% of patients and was significantly associated with type 3
osteomyelitis. Conclusion. Type 1, subtype C osteomyelitis was most commonly
seen in clinical practice and was usually treated with conservative surgeries. Minor
amputations were most frequent in type 1 and 2 osteomyelitis; major amputation
was significantly associated with type 3 osteomyelitis. Those who favour purely
medical management of osteomyelitis are recommended to prescribe antibiotics
alone in subtype A osteomyelitis and in some subtype B patients (without deepseated
pus, cellulitis or slough/necrotic tissue). Amit Jain’s classification for diabetic
foot osteomyelitis is a simple, easy-to-remember, practical classification that guides
treatment and predicts associated outcomes.
“Diabetic foot, a complex disease, is multi-factorial, multi-pathological, multianatomical
with multi-level involvement and multi-systemic complications
requiring multi-disciplinary involvement. Hence, it is impossible for any single
classification in diabetic foot to predict the outcome in each and every patient
and to guide specific treatment for each patient using a single classification that
encompasses many lesions in diabetic foot”.
This law encourages professionals to use combination of classification.