The Wagner classification system for diabetic foot ulcerations is likely the most common grading system used to classify diabetic foot ulcerations at treatment. The classification scheme is based upon the depth of penetration, the presence of infection and the extent of the infection. The classification system is as follows:
Wagner Ulcer Classification System
| Grade | Lesion |
|---|---|
|
0 |
No open lesions; may have deformity or cellulitis |
|
1 |
Superficial diabetic ulcer (partial or full thickness) |
|
2 |
Ulcer extension to ligament, tendon, joint capsule, or deep fascia without abscess or osteomyelitis |
|
3 |
Deep ulcer with abscess, osteomyelitis, or joint sepsis |
|
4 |
Gangrene localized to portion of forefoot or heel |
|
5 |
Extensive gangrenous involvement of the entire foot |
Although this is a reasonable system for classification and developing a treatment plan it does have its limitations. The most commonly sighted complaint about this classification system is that it does not account for other factors contributing to ulcer pathology. Failure to account for ischemia and infection are the two most commonly cited features missing from this classification system.
This is an interesting articles to read to understand the basic underpinnings of how we classify ulcerations. Due to it’s age a digital copy could not be found but the reference to the article is below and it’s well worth reading at least once.
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