In the last issue of The Diabetic Foot (2(4): 123–31), a new classification for diabetic foot lesions, S(AD) SAD, was proposed (Macfarlane and Jeffcoate, 1999). This had five key elements: size (area and depth), sepsis, arteriopathy, and denervation. The key problems in defining such a classification were examined.
The proposed classification was designed for the purposes of audit and research – with the main aim being to identify populations of similar lesions, which could then be subjected to prospective study (possibly multicentre). It could nevertheless be adapted for the purposes of routine clinical management. It was suggested that each lesion could be graded on a scale of 0 to 3 using criteria that were either quantitative or qualitative (see Table 1).
