Wound Classifications

UT DFU Classification


Grade



Stage

0
1
2
3
A
Pre-ulcerative lesions
No skin break
Superficial wound
No penetration
Wound penetrating tendon or capsule
Wound penetrating bone or joint
B
With infection
With infection
With infection
With infection
C
With ischemia
With ischemia
With ischemia
With ischemia
D
With infection and ischemia
With infection and ischemia
With infection and ischemia
With infection and ischemia
B for Bug, C for Circulation!
Two for Tendon
UT DFU Treatments
  1. A ➝ offloading, imaging to rule out osteo, reappt 1-2 months
  2. B ➝ A + debridement, Rx topicals +/- systemic antibiotics
  3. C ➝ A + vascular consult
  4. D ➝ C + medical management

NPUAP Pressure Ulcer

Stage
Description
Stage I
Non-blanchable erythema of intact skin
Stage II
Partial thickness skin loss; ulcer extends down to epidermis and/or dermis
Stage III
Full thickness skin loss; ulcer extends down to subcutaneous fat and fascia
Stage IV
Full thickness skin loss with extensive destruction and tissue necrosis; ulcer extends down to muscle, bone, tendon, or joint capsule

Wagner

Grade
Description
Treatment
Grade 0
Skin intact but bony deformities lead to "foot at risk"
Shoe modifications with serial exams
Grade 1
Superficial ulcer
Office debridement and contact casting
Grade 2
Deeper, full thickness extension
Operative formal debridement and contact casting
Grade 3
Deep abscess formation or osteomyelitis
Operative formal debridement and contact casting
Grade 4
Partial Gangrene of forefoot
Local vs. larger amputation
Grade 5
Extensive Gangrene
Amputation