Diabetic foot ulcers (DFU) are associated with infection, delayed healing, and risk of limb loss, which makes early risk stratification clinically important. A prospective observational study published in Cureus compared the performance of Diabetic Ulcer Severity Score (DUSS), University of Texas (UT) classification, and Site, Ischemia, Neuropathy, Bacterial Infection, Area, and Depth (SINBAD) scoring in predicting clinical outcomes in patients with DFU.

The study included 107 patients aged ≥35 years treated at a tertiary care center over two years. Ulcers were assessed at baseline using DUSS, UT classification, and SINBAD scoring systems. Patients were followed until a definitive outcome, which was categorized as secondary healing, requirement of split-thickness skin grafting (STSG), or lower limb amputation. Non-parametric analysis was performed using the Kruskal-Wallis test, with p<0.05 considered statistically significant.

The mean age was 56.84 ± 12.32 years, and most participants were male (78.3%). Ulcers were most commonly located in the midfoot (42.1%) and forefoot (41.1%). STSG was required in 78.5% of patients, while 16.8% underwent amputation and 4.7% achieved secondary healing.

DUSS and UT classification did not show significant differences across outcome groups. In contrast, SINBAD scores were higher in patients who underwent amputation (median 5, interquartile range [IQR] 4-6) compared with those requiring STSG (median 4, IQR 3-5) or those with secondary healing (median 2, IQR 1-2) (H=8.02; p=0.018).

These findings indicate that SINBAD scoring showed greater discrimination across clinical outcomes and may support risk stratification in patients with DFU.