The Rutherford classification for chronic limb ischaemia Grade 3, Category 6 describes:
- A Major tissue loss — gangrene extending above the transmetatarsal level, non-salvageable foot ✓
- B Rest pain with intact skin
- C Minor tissue loss — non-healing ulcer or minor gangrene limited to the toes
- D Severe claudication with ankle-brachial index <0.5
Correct answer: A. Major tissue loss — gangrene extending above the transmetatarsal level, non-salvageable foot
Explanation
The Rutherford classification uses Grades 0–III with Categories 0–6. Category 5 (Grade III) represents minor tissue loss (non-healing ulcer, focal gangrene limited to digits). Category 6 (Grade III) represents major tissue loss with gangrene extending above the transmetatarsal level, indicating a non-salvageable foot requiring major amputation. Rest pain without tissue loss is Category 4 (Grade II). This classification guides revascularisation urgency and amputation level decisions.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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Written and medically reviewed by the StethoPrep medical team.