Introduction: The National Institute for Health and Care Excellence (NICE) recommends using a standardized system like SINBAD (Site, Ischaemia, Neuropathy, Bacterial infection, Area, Depth) for documenting the severity of diabetic foot ulcers (DFUs). This helps improve clinical management, communication, and comparison of patient outcomes, both locally and internationally. The SINBAD system is valued for its simplicity and practicality in predicting ulcer outcomes, such as the likelihood of healing or the need for amputation. It has been demonstrated that the SINBAD system not only provides a detailed assessment of ulcer characteristics but also allows these features to be combined into an aggregate SINBAD score. This cumulative score is predictive of outcomes, with a score of three or more being associated with a longer time to healing and an increased likelihood of failure to heal. Therefore, patients with higher SINBAD scores often require more intensive care and monitoring, as they are at greater risk for complications, including amputation. 

Objective: We audited the clinical effectiveness of SINBAD in our Diabetic foot clinic, particularly the severity score in predicting amputations.

Methodology: We retrospectively looked at 40 patients from January 2022 to March 2024. After exclusion of patients with painful neuropathy and charcot’s foot, we analyzed the data of 46 patients having diabetic foot ulcer. All patients had scoring as per SINBAD grading.

Results: The data of 40 patients was analyzed. 11 (27.5%) of patients were found to have Sinbad score of ≥3 while 29(72.5%) were found to have Sinbad score of ≤ 2.Out of those patients who have Sinbad score of ≥ 3, 6(54.5%) of patients had amputation while rest of 5(45.%) had their ulcer eventually healed without amputation. Out of those with Sinbad score ≤ 2, only 2(7%) had their amputation while rest of 27(93%) had their ulcer healed without amputation. 75% of amputations were performed in patients having Sinbad score of ≥3.

Conclusions: A SINBAD score of ≥ 3 has been associated with a significantly increased incidence of amputations in patients with diabetic foot ulcers. Given the strong predictive value of this score for amputation risk, it is crucial that these patients undergo swift vascular assessment and, if necessary, prompt vascular intervention. Our MDT meetings facilitate early decision-making on critical issues, including the need for revascularization, advanced wound care, infection management, or surgical interventions. This multidisciplinary approach improves patient outcomes by ensuring that each aspect of care is addressed comprehensively and in a timely manner.