Sakitamiwa Classification

| Feature | | Modified Sakita-Miwa | Forrest Classification | | :--- | :--- | :--- | :--- | | Primary Purpose | Staging the natural history of an ulcer's healing process | Adapted version for specific contexts (e.g., post-band ligation ulcers) | Assessing the risk of re-bleeding from an ulcer | | Key Focus | Presence of fibrin slough, regenerating epithelium, scarring | Often customized definitions, but based on the core A-H-S framework | Presence and type of stigmata of recent hemorrhage (e.g., active bleeding, visible vessel, clot) | | Main Application | Assessing ulcer activity, healing, and completeness of mucosal repair | Research or specialized clinical scenarios (e.g., variceal banding ulcers) | Emergency and acute management of upper GI bleeding | | Stages | A1, A2, H1, H2, S1, S2 (6 stages) | Varies; often focuses on healing stages (e.g., H1, H2, S1) | Ia (spurting), Ib (oozing), IIa (visible vessel), IIb (adherent clot), IIc (flat spot), III (clean base) |

The core architecture of the Sakita-Miwa classification relies on a highly scannable, logical progression of tissue repair. Each of the three main stages is split into two sub-stages (1 and 2) to pinpoint the exact state of the wound. sakitamiwa classification