Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/1677-5449.190070
Jornal Vascular Brasileiro
Review Article

Classificação WifI: o novo sistema de classificação da Society for Vascular Surgery para membros inferiores ameaçados, uma revisão de literatura

WIfI classification: the Society for Vascular Surgery lower extremity threatened limb classification system, a literature review

Lorena de Oliveira Cerqueira; Eliud Garcia Duarte Júnior; André Luis de Souza Barros; José Roberto Cerqueira; Walter Júnior Boim de Araújo

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Resumo

Resumo: A Society for Vascular Surgery propôs nova classificação para o membro inferior ameaçado, baseada nos três principais fatores influenciadores do risco de amputação do membro: ferida (Wound, W), isquemia (Ischemia, I) e infecção do pé (foot Infection, fI): a classificação WIfI. Esta abrange também os diabéticos, anteriormente excluídos do conceito de isquemia crítica do membro devido a seu quadro clínico complexo. O objetivo da classificação era fornecer estratificação de risco precisa e precoce ao paciente com membro inferior ameaçado; auxiliar no manejo clínico, permitindo comparar terapias alternativas; e predizer o risco de amputação em 1 ano e a necessidade de revascularização. O objetivo deste estudo é reunir os principais pontos abordados sobre a classificação WIfI no meio científico. A maior parte dos estudos de validação da classificação demonstram sua associação à predição de salvamento do membro, eventos de reintervenção, amputação e estenose, taxas de amputação maior e menor, sobrevida livre de amputação, e cicatrização de feridas.

Palavras-chave

pé diabético, úlcera do pé, isquemia, infecção, amputação, mortalidade

Abstract

The Society for Vascular Surgery has proposed a new classification system for the threatened lower limb, based on the three main factors that have an impact on limb amputation risk: Wound (W), Ischemia (I) and foot Infection (“fI”) - the WIfI classification. The system also covers diabetic patients, previously excluded from the concept of critical limb ischemia because of their complex clinical condition. The classification’s purpose is to provide accurate and early risk stratification for patients with threatened lower limbs; assisting with clinical management, enabling comparison of alternative therapies; and predicting risk of amputation at 1 year and the need for limb revascularization. The objective of this study is to collect together the main points about the WIfI classification that have been discussed in the scientific literature. Most of the studies conducted for validation of this classification system prove its association with factors related to limb salvage, such as amputation rates, amputation-free survival, prediction of reintervention, amputation, and stenosis (RAS) events, and wound healing.

Keywords

diabetic foot; foot ulcer; ischemia; infection; amputation; mortality

References

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