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

• Published in: Jornal vascular brasileiro Vol. 19; p. e20190070
• Main Authors: Cerqueira, Lorena de Oliveira, Duarte, Eliud Garcia, Barros, André Luis de Souza, Cerqueira, José Roberto, de Araújo, Walter Júnior Boim
• Format: Journal Article
• Language: English
• Published: Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV) 08-05-2020
• Subjects: Review
• DOI: 10.1590/1677-5449.190070
• EISSN: 1677-7301
• ISSN: 1677-5449

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.