Wagner developed a classification for diabetic foot ulcers associated with vascular disease.
Appearance of Wound
Grade
no open lesion; preulcerative change, bony deformity, or healed ulcer
0
superficial ulcer, not involving subcutaneous tissue
1
deep ulcer; wound penetrating into subcutaneous tissue, with possible exposure of tendon, ligament, joint capsule, or bone
2
osteitis, abscess or osteomyelitis
3
gangrene involving one or more digits or the forefoot
4
gangrene involving the entire foot; requires foot amputation or disarticulation
5
NOTE: There is no grading for a diabetic patient with a perfectly normal foot.
Limitations:
• While the classification covers the entire spectrum of diabetic foot changes, it does involve mixed and overlapping pathologic processes (ulceration, infection, ischemia).
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