Wagner Classification of Diabetic Foot Ulcers
Grade 0: No ulcer in a high risk foot.
Grade 1: Superficial ulcer involving the full skin thickness but not underlying tissues.
Grade 2: Deep ulcer, penetrating down to ligaments and muscle, but no bone involvement or abscess formation.
Grade 3: Deep ulcer with cellulitis or abscess formation, often with osteomyelitis.
Grade 4: Localized gangrene.
Grade 5: Extensive gangrene involving the whole foot.
University of Texas Wound Classification System of Diabetic Foot Ulcers
Grade I-A: non-infected, non-ischemic superficial ulceration
Grade I-B: infected, non-ischemic superficial ulceration
Grade I-C: ischemic, non-infected superficial ulceration
Grade I-D: ischemic and infected superficial ulceration
Grade II-A: non-infected, non-ischemic ulcer that penetrates to capsule or bone
Grade II-B: infected, non-ischemic ulcer that penetrates to capsule or bone
Grade II-C: ischemic, non-infected ulcer that penetrates to capsule or bone
Grade II-D: ischemic and infected ulcer that penetrates to capsule or bone
Grade III-A: non-infected, non-ischemic ulcer that penetrates to bone or a deep abscess
Grade III-B: infected, non-ischemic ulcer that penetrates to bone or a deep abscess
Grade III-C: ischemic, non-infected ulcer that penetrates to bone or a deep abscess
Grade III-D: ischemic and infected ulcer that penetrates to bone or a deep abscess
References:
- Armstrong DG, Lavery LA, Harkless LB. Validation of a diabetic wound classification system. The contribution of depth, infection, and ischemia to risk of amputation. Diabetes Care. 1998 May;21(5):855-9. [Medline]
- Oyibo SO, Jude EB, Tarawneh I, Nguyen HC, Harkless LB, Boulton AJ. A comparison of two diabetic foot ulcer classification systems: the Wagner and the University of Texas wound classification systems. Diabetes Care. 2001 Jan;24(1):84-8. [Medline]
- Wagner FW: Supplement: algorithms of foot care. In The Diabetic Foot. 3 rd ed. Levin ME, O’Neal LW, Eds. St. Louis, MO, CV. Mosby, 1983, p. 291–302
- Lavery LA, Armstrong DG, Vela SA, Quebedeaux TL, Fleischli JG. Practical criteria for screening patients at high risk for diabetic foot ulceration. Arch Intern Med. 1998 Jan 26;158(2):157-62. [Medline]
Created: April 13, 2006