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420 Cardio Diabetes Medicine 2017

Table : 1: Neuropathy versus Ischemic ulcer

Wagner Classification of diabetic foot ulcers
Wagner classification is based on depth and infec-
tion and has 6 grades. However this is not inter
connected and hence ulcer with infection in the su-
perficial ulcer will not be included in the classification
as shown in Tab 2. (3)

The differentiating features of each ulcer are shown in ta-
Figure: 2(a),(b),(c) - Diabetic Peripheral neuropathy caus- ble 1.
ing Foot ulcer. Characteristic Neuropathic Ischemic Ulcers
Ulcers
Staging and Classification of Diabetic Foot Patients age Younger(fifth to Older (seventh to
Ulcer: sixth decades) eighth decades)
• Staging and classification are important for Pedal deformities Hammer or claw None
toes, Charcot
• Assume the etiology deformity
• Predict this prognosis Skin Warm with good Cool, often red
colour
• Choose appropriate treatment
Ulcer features Wet with drain- Dry black eschar,
• Monitor program age, often locat- often located on
• Serve as a form of communication ed on pressure dorsal surface of
points of planter feet and toes
There are numerous classifications of Diabetic foot surface
ulcer. Based on the etiology the diabetic foot ulcers Pulses Intact Diminished to
are classified as absent
1. Neuropathic ulcer Pain Often absent Often painful
2. Neuro Ischemic ulcer

GCDC 2017