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Wagner Classification of Diabetic Foot Ulcers

Monday, January 3rd, 2011 

Diabetes type II related complications such as diabetic foot ulcers are worldwide health problems. The improvement in prevention and cure techniques and increased efficiency in patient care cannot be overstated. The foot ulcers are a consequence of vascular abnormalities, peripheral neuropathy, and impaired immune system and delayed healing process, all product of long standing high glucose levels in the body.

Various classification techniques or systems are devised in order to encompass the majority of aspects of ulcers, which in turn has a major impact on the overall treatment strategies and the process of healing. The basic elements in the handling of ulcers anywhere on the body are: the size, depth, infection, ischemia and presence of neuropathy. The main purpose of any classification of these ulcers is to decrease the morbidity and mortality. Timely intervention with topical agents such as Wound-Be-Gone® , after asking the physicians also assists in hindering the infection and facilitating healing process.
Wagner’s classification is the most widely used grading system of diabetic foot disease. The Wagner system evaluates the ulcer depth with the focus on accompanying osteomyelitis or gangrene or both. There is another method of classification called the University of Texas (UT) method of wound classification. This method assesses the ulcer depth along with the manifestation of infection and clinical signs of lower extremities ischemia. Both these grading systems are easy to understand and follow and both are highly appraised by the health care professionals all around the world.

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 tendon.
Grade II-B: infected, non-ischemic ulcer that penetrates to capsule or tendon.
Grade II-C: ischemic, non-infected ulcer that penetrates to capsule or tendon.
Grade II-D: ischemic and infected ulcer that penetrates to capsule or tendon.

Grade III-A: non-infected, non-ischemic ulcer that penetrates to bone or joint.
Grade III-B: infected, non-ischemic ulcer that penetrates to bone or joint.
Grade III-C: ischemic, non-infected ulcer that penetrates to bone or joint.
Grade III-D: ischemic and infected ulcer that penetrates to bone or joint.

The most substantial point is no matter what the grade; the overall outcome depends upon the stage of the disease. Increasing the stage leads to decreased healing which in turn enhances the possibility of amputations. Early detection of any of the developing sore and prompt treatment to restore the foot in perfect healthy condition can save lots of time, money and undue stress. Using Wound-Be-Gone®gel early in the process just when a sore starts or the skin starts getting dried up, can help restore and heal and can avert the development of an ulcer altogether.

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