Why SINBAD? Describing diabetic foot ulcers in a Barbados population

ABSTRACT

OBJECTIVE: Here, we report on the characterization of diabetic foot ulcers in a Barbados population using the SINBAD ulcer classification system. SUBJECTS AND METHODS: Sixty-five case participants were seen and 73 ulcers presented. All ulcers were categorized upon examination using the SINBAD classification scheme Site, Ischaemia, Neuropathy, Bacterial infection, Area, Depth. The individual category scores were summed to create a SINBAD score with a range of 0–6.Results were compiled and analysis performed using Stata SE 12.1 (Stata Corporation). RESULTS: Mean age of the participants was 56.75 (± 9.03SD) years and more were men (53.4%). The mean diabetes duration was 15.25 (± 9.84 SD) years. Three SINBAD scores (1, 2 and 3) shared the majority of the ulcers at 26.0% each. The next highest was SINBAD score 0 at 15.1% of the ulcers, followed by the SINBAD score 4at 6.9%. None of the ulcers seen in the participants (0%)registered a SINBAD score of 5 or 6. The majority of the ulcers were neuropathic (61.64% vs 38.36%), larger than 1cm2 (63.01% vs 36.99%), free of bacterial infection(95.89% vs 4.11%) and confined to the skin and subcutaneous tissue (100% vs 0%). CONCLUSION: The SINBAD ulcer classification score indicates the risk of a foot wound failing to heal, with scores of three and above having a significantly increased time to heal and being classified as complicated. In the current study, 67% of the ulcers seen were scored below the threshold of a SINBAD score of 3.