Скачать или смотреть SVS Guidelines for Patients: WiFi Classification System

#VascularSurgery #LimbPreservation #SVSWIFI #CriticalLimbIschemia #DiabeticFoot #WoundCare #Ischemia #FootInfection #AmputationRisk #Revascularisation

The SVS WIFI (Wound, Ischemia, Foot Infection) classification system is a new tool for assessing complex limb conditions, aiming to empower patients and improve communication with healthcare teams.

*Limitations of Older Systems:*
Previous systems like Critical Limb Ischemia (CLI), defined in 1982, were too narrow.
CLI initially excluded diabetic patients, a major flaw given 50-80% of limb-saving procedure patients now have diabetes.
Older classifications (Fontaine, Rutherford) focused only on severe pain or visible tissue loss, lacking detail on wound severity or infection.
This led to confusion in comparing treatments and understanding disease progression.

*The SVS WIFI System:*
WIFI provides an objective, precise way to classify limb threat, similar to cancer staging, with each factor graded 0 (none) to 3 (severe).
*Wound (W):* Graded by depth and complexity, not just size. W0 (no wound) to W3 (extensive, deep tissue loss or widespread gangrene).
*Ischemia (I):* Blood flow assessed by ABI, toe pressure (critical for diabetics), and TCPO2. I0 (great flow) to I3 (severely reduced flow, often requiring revascularisation).
*Foot Infection (FI):* A major amputation driver. FI0 (no infection) to FI3 (severe, limb- or life-threatening, with systemic signs like fever or rapid heart rate). Severe infection significantly increases amputation risk.

*Clinical Application:*
WIFI combines W, I, and FI scores into four overall clinical stages (Stage 1: very low risk to Stage 4: high risk of amputation within a year).
Higher individual grades generally indicate higher amputation risk and a greater potential benefit from revascularisation.
WIFI scores are dynamic and can be re-evaluated after treatment (e.g., infection control), helping guide next steps and track progress.

*Benefits:*
Provides a clearer, more accurate description of the limb's condition, moving beyond vague terms.
Fosters shared understanding among the care team, leading to more personalised treatment plans and better patient outcomes.
Future developments may include comorbidity indexing and refined arterial classification.