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J Pak Med Assoc. 2006 Oct;56(10):444-7.

Role of wound classification in predicting the outcome of diabetic foot ulcer.

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Baqai Institute of Diabetology and Endocrinology, Karachi.



To compare the effectiveness of Wagner and University of Texas (UT) classification systems of diabetic foot ulcers in directing appropriate therapy and possibly predicting outcomes.


A total of 383 patients with foot ulcer were seen. Details of socio-demographic and clinical profiles of 200 patients were completely available. Patients were assessed and classified into different grades and stages according to Wagner's and UT classification systems. Their duration of healing was recorded. The outcome endpoints were defined as complete healing, major or minor amputations, or expired.


Out of the 200 subjects, 65% were males and 35% were females. Mean age in males was 53.04 +/- 10.33 years and in females was 51.14 +/- 9.94 years. Average duration of treatment in males was 109.68 +/- 82.26 days and in females was 85.10 +/- 61.97 days. Forty five percent of the subjects had neuropathic ulcers. Median healing time increased with increase in Wagner grade and UT grade and stage. The higher the UT grade and stage at the time of presentation, the less the chances of ulcer to heal within the study period.


Our study has shown that grading and staging of diabetic foot ulcer affects and predicts the outcome. Amputation rates increase with increase in grade. Addition of stage to grade in UT classification helps further on assessing the severity of wound at the time of presentation and shows better association with the outcome.

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