Sims et al proposed a foot lesion grading system for a patient with diabetes. This is an expansion of the system reported by Wagner. The authors are from Pennsylvania State University.
Patient selection: diabetic
Parameters:
(1) skin lesion
(2) infection
(3) gangrene
Skin Lesion
Infection
Gangrene
Grade
none
none
absent
0
yes
dense callus
absent
1
preulcer
absent
2
superficial ulcer (partial thickness)
absent
3
full thickness but not into tendon, bone, joint or ligament
absent
4
full thickness into tendon, bone, joint or ligament
