Ulcer Classification Systems
Wagner Ulcer Classification
There are several ways that have been devised to classify diabetic ulcers over the years. Perhaps the system most commonly used today is the Wagner system described below:
UTSA Classification System
A new and more comprehensive system has been developed by podiatrists at the University of Texas at San Antonio (abbreviated here as "UTSA").
Wounds in this classification system are graded as follows:
First, the patient's medical condition is graded.
Next, the wound is graded.
So what's the point of all this classification?
Well, it makes it easy for the podiatric physician to accurately discuss both the patient's ulcer and overall medical condition with a colleague, it better differentiates between the types of ulcers, it gives us an idea of the prevalence of the patient's type of wound, and most importantly perhaps, it implies a prognosis for the patient's wound.
For example, the prevalence of each type of wound is listed as the first percentage, and the number percentage of patients in that category who'll go on to have an amputation within 6 months is the second percentage listed:
So now let's return to our example patients above. The first patient classified as 2B represents 7.8% of the diabetic wounds, and the odds of his having an amputation within 6 months is a little more than one out of four. The second patient in our example who was classified as 1C represents 2.8% of diabetic wounds, and there is a one in five chance that the patient will go on to have an amputation within 6 months.
In that diabetic wounds may now be given a prognosis based on their classification, this system represents a major advance in how wounds are considered.