Sakitamiwa Classification Jun 2026

The ulcer becomes significantly smaller and shallower. The regenerating epithelium covers more of the base, and the white coating is significantly reduced. 3. Scarring Stage (Stage S) The ulcer has essentially closed, leaving behind a scar.

The regenerative epithelium nearly covers the mucosal break. The ulcer is significantly smaller, and the coating is minimal. 3. Scarring Stage (S) This stage indicates complete or near-complete healing.

In this phase, the ulcer begins to shrink as new tissue (epithelium) starts to regrow. giresearch.ph H1 (Healing 1):

It is commonly used to measure the healing rate of artificial ulcers produced after Endoscopic Submucosal Dissection (ESD). sakitamiwa classification

Clinical trials often use this system to compare the efficacy of different proton pump inhibitors (PPIs) and potassium-competitive acid blockers (P-CABs) in ulcer healing.

The scarring phase marks the successful termination of the open wound, shifting focus toward structural consolidation.

| Resource Level | Minimum required for Stages I–II | For Stages III–IV | |----------------|----------------------------------|------------------| | (clinic) | Tourniquet test, platelet count, urine dipstick | Transfer to district hospital | | Medium (hospital) | Rapid NS1 antigen test, bedside ultrasound for ascites | Complete blood count, ALT, creatinine, chest X-ray | | High (tertiary) | Quantitative RT-PCR for V-score, serum angiopoietin-2 | CT brain, continuous renal replacement therapy | The ulcer becomes significantly smaller and shallower

The red scar fades into a white, fully matured scar, showing long-term healing. Why is this Classification Important?

The Sakita-Miwa system is highly regarded for its precision. It divides the healing process into six distinct categories: 1. Active Stage (A)

: Gastroenterologists use the scale to measure how well an ulcer is responding to proton pump inhibitors (PPIs) or potassium-competitive acid blockers (P-CABs). Complete cure is typically defined when an ulcer successfully reaches the S1 or S2 stage. Scarring Stage (Stage S) The ulcer has essentially

This stage represents the acute phase of the ulcer where the mucosal defect is most prominent.

: The slough has nearly vanished, leaving only a tiny central island of white coating. The ulcer grows noticeably shallower, and the surrounding mucosa starts organizing into a converging, radial pattern of mucosal folds moving toward the healing center. 3. The Scarring Stage (S)