{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T02:27:26Z","timestamp":1777861646044,"version":"3.51.4"},"reference-count":23,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>There is limited high\u2010quality data on the factors that contribute to limb loss in patients with diabetes\u2010related foot disease (DFD) in New Zealand and Australia. Furthermore, wound, ischaemia and foot infection (WIfI) staging has not been validated in the Australasian cohort. The aim of this study was to (1) report on the presentation, management and outcomes of DFD (wound healing, major limb amputation [MLA], amputation\u2010free survival [AFS] and mortality at 1\u2010year), and (2) validate the association of WIfI stage on outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was an observational prospective study of patients with DFD and a wound at three centres in New Zealand and Australia from 2020 to 2022. Data on presentation, management, amputation and mortality at 1\u2010year was collected. Outcomes were stratified by presenting WIfI stage. Wound healing and survival were assessed with Kaplan\u2013Meier curves, time\u2010to\u2010healing with Fine\u2010Gray competing risks, AFS with logistic regression and survival with Cox proportional hazards.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Two hundred and seventy\u2010six patients (384 limbs) were recruited, with WIfI stage 1 (47.9%), 2 (21.1%), 3 (19.5%) and 4 (12.5%). At 1\u2010year, 71.4% of wounds healed, with WIfI stage associated with healing,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001. At 1\u2010year 16.6% of limbs had underwent a MLA, with the proportion increasing by WIfI stage. Poorer AFS was observed with increasing WIfI. Mortality at 1\u2010year increased with WIfI stage,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study reports on the presentation, management and outcomes from DFD in New Zealand and Australia. WIfI staging appropriately classifies patients with DFD and correlates with healing, MLA, AFS and survival at 1\u2010year.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ans.70577","type":"journal-article","created":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T05:45:08Z","timestamp":1773294308000},"page":"873-880","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Australia and\n                    <scp>N<\/scp>\n                    ew\n                    <scp>Z<\/scp>\n                    ealand Diabetic and Ischaemic Foot Outcomes Study (\n                    <scp>ANZDIFOS<\/scp>\n                    )"],"prefix":"10.1111","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6330-2810","authenticated-orcid":false,"given":"Odette","family":"Hart","sequence":"first","affiliation":[{"name":"Department of Vascular and Endovascular Surgery Waikato Hospital  Hamilton New Zealand"},{"name":"Department of Surgery, Faculty of Medical and Health Sciences University of Auckland  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8645-514X","authenticated-orcid":false,"given":"Philip","family":"Allan","sequence":"additional","affiliation":[{"name":"Department of Vascular and Endovascular Surgery Waikato Hospital  Hamilton New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shirley","family":"Jansen","sequence":"additional","affiliation":[{"name":"School of Population Health Curtin University  Perth Western Australia Australia"},{"name":"Surgery Division, Faculty of Health and Medical Sciences The University of Western Australia  Perth Western Australia Australia"},{"name":"Department of Vascular and Endovascular Surgery Sir Charles Gairdner Hospital  Perth Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6258-5997","authenticated-orcid":false,"given":"Robert","family":"Fitridge","sequence":"additional","affiliation":[{"name":"Discipline of Surgery The University of Adelaide  Adelaide South Australia Australia"},{"name":"Department of Vascular Surgery Royal Adelaide Hospital  Adelaide South Australia Australia"},{"name":"Basil Hetzel Institute for Translational Health Research, the Queen Elizabeth Hospital  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claire","family":"Murray","sequence":"additional","affiliation":[{"name":"Department of Vascular and Endovascular Surgery Sir Charles Gairdner Hospital  Perth Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mendel","family":"Baba","sequence":"additional","affiliation":[{"name":"Department of Podiatry Sir Charles Gairdner Osborne Park Healthcare Group  Perth Western Australia Australia"},{"name":"Heart and Vascular Research Institute  Perth Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4533-6320","authenticated-orcid":false,"given":"Prue","family":"Cowled","sequence":"additional","affiliation":[{"name":"Discipline of Surgery The University of Adelaide  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0027-3095","authenticated-orcid":false,"given":"Neil","family":"McMillan","sequence":"additional","affiliation":[{"name":"Discipline of Surgery The University of Adelaide  Adelaide South Australia Australia"},{"name":"Department of Vascular Surgery Royal Adelaide Hospital  Adelaide South Australia Australia"},{"name":"Basil Hetzel Institute for Translational Health Research, the Queen Elizabeth Hospital  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4921-8433","authenticated-orcid":false,"given":"Manar","family":"Khashram","sequence":"additional","affiliation":[{"name":"Department of Vascular and Endovascular Surgery Waikato Hospital  Hamilton New Zealand"},{"name":"Department of Surgery, Faculty of Medical and Health Sciences University of Auckland  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,3,11]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.2337\/dci22-0043"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)67698-2"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1615439"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/ans.15079"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2016.03.421"},{"key":"e_1_2_9_7_1","unstructured":"M.Monteiro\u2010Soares D.Russell andE. 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