Why SINBAD? Describing diabetic foot ulcers in a Barbados population

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.