The scarring phase represents the definitive resolution of active disease and clinical recovery. The thick pathological exudate completely disappears, leaving only a structural signature of the previous wound.
The system is frequently used to monitor the healing of artificial ulcers created after endoscopic submucosal dissection.
Before the widespread adoption of endoscopic staging systems, the clinical description of gastric ulcers was often subjective and varied between different physicians and institutions. This inconsistency made it difficult to accurately track a patient's progress, compare the effectiveness of different treatments, or design meaningful clinical trials. The Sakita-Miwa classification was developed to solve these problems by providing a clear, objective, and universal framework. sakitamiwa classification
The following table outlines the expected endoscopic findings for each of the six stages within the Sakita-Miwa Classification:
It appears to be either:
This stage represents the nadir of mucosal integrity. The body is actively dealing with local tissue destruction.
Thinning of the white exudative coating; a clear zone of red, regenerating epithelium begins to creep inward from the ulcer margins. The scarring phase represents the definitive resolution of
: The resolution phase where mucosal continuity is fully restored.
| 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 | serum angiopoietin-2 | CT brain