Comparison of shid and wagner wound classifications for assessing quality of life in patients with diabetic foot ulcers
DOI: https://doi.org/10.56922/mhc.v4i6.2336
Diabetic Foot Ulcer Wagner Classification SHID Quality of Life Scoping Review
Abstract
Background: Diabetic Foot Ulcer (DFU) is a chronic complication of diabetes mellitus that significantly affects patients’ quality of life. Several wound classification systems are used to assess DFU severity, including the Wagner and SHID classifications. However, evidence comparing the application of these classifications in evaluating quality of life (QoL) among DFU patients has not been comprehensively mapped.
Purpose: To map and compare existing evidence regarding the use of SHID and Wagner wound classifications in evaluating quality of life in patients with diabetic foot ulcer.
Method: A scoping review was conducted following the Arksey and O’Malley framework. Literature searches were performed in electronic databases (PubMed and Google Scholar) for studies published within the last five years. Eligible articles were analyzed using descriptive and thematic approaches.
Results: Most studies applied the Wagner classification as the primary clinical assessment tool, while SHID was reported to provide a more comprehensive depiction of wound conditions.
Conclusion: A consistent association between wound severity and decreased quality of life was identified, although direct integration of both classifications with QoL instruments remains limited.
Keywords: Diabetic Foot Ulcer; Wagner Classification; SHID; Quality of Life; Scoping Review.
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References
Ahmad, J. (2016). The diabetic foot. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 10(1), 48-60.
Amrullah, S., Pratama, S. F., Agustini, F., Khairillah, Y. N., & Saun, A. U. (2024). The relationship between infection severity, wound categorization, and foot care in type 2 diabetes mellitus patients with recurring diabetic foot ulcers. The Medical Journal of Malaysia, 79(1), 60-67.
Barker, T. H., Stone, J. C., Sears, K., Klugar, M., Tufanaru, C., Leonardi-Bee, J., & Munn, Z. (2023). The revised JBI critical appraisal tool for the assessment of risk of bias for randomized controlled trials. JBI evidence synthesis, 21(3), 494-506.
Dias, Â., Ferreira, G., Vilaça, M., & Pereira, M. G. (2022). Quality of life in patients with diabetic foot ulcers: a cross-sectional study. Advances in skin & wound care, 35(12), 661-668.
Geravand, F., Nasli-Esfahani, E., Montazer, M., Jalalzadeh, M., & Azadbakht, L. (2025). The association between the quality and quantity of carbohydrate intake and the size, depth, and Wagner grade of diabetic foot ulcers in patients with type 2 diabetes. PLoS One, 20(6), e0323537.
Gul, A., Basit, A., Ali, S. M., Ahmadani, M. Y., & Miyan, Z. (2016). Role of wound classification in predicting the outcome of diabetic foot ulcer. JPMA. The Journal of the Pakistan Medical Association, 56(10), 444.
Jais, S., Pratama, K., Fahrain, J., Junaidi, J., Kardiatun, T., & Kawuryan, U. (2022). The SHID wound classification system for diabetic foot ulcer patients: a validity study. Journal of Medicine and Life, 15(10), 1224.
Jalilian, M., & Shiri, S. (2022). The reliability of the Wagner Scale for evaluation the diabetic wounds: A literature review. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 16(1), 102369.
Kumar, H. (2021). Evaluation and management of diabetic foot according to wagner’s classification (Master's thesis, Rajiv Gandhi University of Health Sciences (India)).
Monteiro‐Soares, M., Boyko, E. J., Jeffcoate, W., Mills, J. L., Russell, D., Morbach, S., & Game, F. (2020). Diabetic foot ulcer classifications: a critical review. Diabetes/metabolism research and reviews, 36, e3272.
Monteiro‐Soares, M., Hamilton, E. J., Russell, D. A., Srisawasdi, G., Boyko, E. J., Mills, J. L., & Game, F. (2024). Classification of foot ulcers in people with diabetes: a systematic review. Diabetes/Metabolism Research and Reviews, 40(3), e3645.
Munawwarah, M., Khansa, A. S., Oktariani, M., & Amir, T. L. (2023). Hubungan Grade Luka Terhadap Quality Of Life (Qol) Pada Diabetic Foot Ulcer (DFU). Jurnal Fisioterapi dan Rehabilitasi, 7(2), 170-176.
Niță, O., Arhire, L. I., Mihalache, L., Popa, A. D., Niță, G., Gherasim, A., & Graur, M. (2023). Evaluating classification systems of diabetic foot ulcer severity: a 12-year retrospective study on factors impacting survival. In Healthcare (Vol. 11, No. 14, p. 2077). MDPI.
Oe, M., Saad, S. S., Jais, S., & Sugama, J. (2024). Impact of foot ulcer‐related factors on quality of life in patients with diabetes: prospective observational study. International Wound Journal, 21(5), e14895.
Peters, M. D., Godfrey, C., McInerney, P., Munn, Z., Tricco, A. C., Khalil, H., & Munn, Z. (2020). JBI manual for evidence synthesis. JBI manual for evidence synthesis, 406-451.
Pratama, K., Suyanto, S., Bhakti, W. K., & Jais, S. (2025). Comparison of the accuracy of two wound classification systems for diabetic foot ulcer healing. Jurnal Keperawatan Padjadja-ran, 13(3), 303-310.
Qomariyanti, K., Sauriasari, R., & Sartika, R. A. D. (2024). Diabetic Foot Ulcers: Impact on Quality of Life and Instruments for Its Measurement. Borneo Journal of Pharmacy, 7(2), 215-223.
Sachin, V. (2016). Clinical Evaluation and Management of Diabetic Foot According to Wagner’s Classification (Master's thesis, Rajiv Gandhi University of Health Sciences (India)).
Steel, A. (2024). Relationship between depression, quality of life and foot ulcer healing rates in type 2 diabetic (T2D) patients (Doctoral dissertation, RMIT University).
Suriadi, H., & Imran, A. D. (2021). Reliability study of a new wound classification system for patients with diabetes. Cinical Pract, 18(4), 1672-1677.
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