Calculators | Wound Care Evidence-Based Guide

SINBAD Calculator (Diabetic Foot Ulcer)

Six items scored 0–1 each, total 0–6. Used for communication, audit, and prognostic stratification (the basic classification recommended by IWGDF 2023).

S — Site

Forefoot (0 points) Midfoot / hindfoot (1 point)

I — Ischemia

Pedal blood flow intact, at least one palpable pulse (0 points) Clinical evidence of ischemia (1 point)

N — Neuropathy

Protective sensation intact (0 points) Protective sensation lost (1 point)

B — Bacterial infection

No infection (0 points) Infection present (1 point)

A — Area

< 1 cm² (0 points) ≥ 1 cm² (1 point)

D — Depth

Confined to skin / subcutaneous tissue (0 points) Reaching muscle / tendon / bone (1 point)

Source: Monteiro-Soares M, et al. IWGDF 2023 classification update. DOI:10.1002/dmrr.3648

WIfI Calculator (SVS Threatened Limb Classification)

Wound / Ischemia / foot Infection each graded 0–3 → estimates the 1-year amputation-risk stage and benefit of revascularization (SVS 2014).

W — Wound

0: No ulcer, no gangrene 1: Small, shallow ulcer, no gangrene 2: Deep ulcer with exposed bone/joint/tendon ± gangrene limited to toes 3: Extensive deep ulcer or gangrene extending to forefoot/midfoot

I — Ischemia (ABI / toe pressure / TcPO₂, whichever available)

0: ABI ≥ 0.80 (toe pressure/TcPO₂ ≥ 60 mmHg) 1: ABI 0.60–0.79 (40–59 mmHg) 2: ABI 0.40–0.59 (30–39 mmHg) 3: ABI < 0.40 (< 30 mmHg)

fI — foot Infection (IWGDF/IDSA correspondence)

0: No infection 1: Mild (skin/subcutaneous only, erythema ≤ 2 cm) 2: Moderate (erythema > 2 cm or deep structures) 3: Severe (with systemic inflammatory response, SIRS)

Source: Mills JL Sr, et al. SVS WIfI. J Vasc Surg. 2014;59(1):220–234. DOI:10.1016/j.jvs.2013.08.003 (stage lookup summarized from Table 6 of the original article)

University of Texas (UT) Classifier (Diabetic Foot Ulcer)

A 4×4 matrix of depth Grade 0–3 × infection/ischemia Stage A–D (1996). Deeper wounds with infection/ischemia carry higher amputation risk. See Staging & Records, section 4.

Grade — depth (0–3)

Grade 0: pre- or post-ulcerative lesion (intact skin) Grade 1: superficial wound not involving tendon, capsule, or bone Grade 2: penetrating to tendon or joint capsule Grade 3: penetrating to bone or joint

Stage — infection and ischemia (A–D)

Stage A: no infection or ischemia Stage B: with infection Stage C: with ischemia Stage D: with both infection and ischemia

Source: Lavery LA, Armstrong DG, Harkless LB. 1996 (DOI:10.1016/s1067-2516(96)80125-6); Armstrong DG, et al. Diabetes Care 1998;21(5):855–859 (DOI:10.2337/diacare.21.5.855) (validation study: depth and infection/ischemia each increase amputation risk)

Mini Nutritional Assessment (MNA®-SF) Screening

6-item screening tool (max 14 points). For elderly and long-term care patients to quickly screen for malnutrition risk. See Nutrition & Diet for details.

A. Has food intake declined over the past 3 months? (loss of appetite, digestive/chewing/swallowing difficulty)

0 = Severe decrease 1 = Moderate decrease 2 = No change

B. Weight loss during the past 3 months

0 = Loss > 3 kg 1 = Uncertain 2 = Loss 1–3 kg 3 = No loss

C. Mobility

0 = Bedridden or wheelchair-bound 1 = Able to get out of bed/chair but does not go out 2 = Goes out

D. Psychological stress or acute disease in the past 3 months

0 = Yes 2 = No

E. Neuropsychological problems

0 = Severe dementia or depression 1 = Mild dementia 2 = No psychological problems

F. Body Mass Index BMI (kg/m²)

0 = BMI < 19 1 = BMI 19–<21 2 = BMI 21–<23 3 = BMI ≥ 23

Alternative: if BMI cannot be measured, use calf circumference (F2) — 0 = CC < 31 cm, 3 = CC ≥ 31 cm (either one may be used).

Source: Vellas B, et al. J Nutr Health Aging 2006;10:456–465; Rubenstein LZ, et al. J Geront 2001;56A:M366–377; Kaiser MJ, et al. J Nutr Health Aging 2009;13:782–788 (MNA-SF validation)

WIfI / SINBAD / UT / MNA Calculators

SINBAD Calculator (Diabetic Foot Ulcer)

WIfI Calculator (SVS Threatened Limb Classification)

University of Texas (UT) Classifier (Diabetic Foot Ulcer)

Mini Nutritional Assessment (MNA®-SF) Screening