Wound classification
The IWGDF recommends studies of diabetic foot ulcers should use one of the standard classification systems to facilitate communication between healthcare providers, provide information about the healing potential of an ulcer and help guide management decisions. (3) Many classifications have been devised and the TEXAS Classification is used in Wales. It has been chosen for its ease of use, while still providing sufficient reliability in different clinical settings.
The TEXAS classification is based on the depth of the ulcer and the presence of infection and/or ischaemia, requiring a thorough clinical examination of the wound state. Results provide a summary of the state of the ulcer and indicate whether urgent intervention is required.
Texas foot ulcer classification
| Ulcer Grade (depth) | |||||
|---|---|---|---|---|---|
| Ulcer stage | 0 | I | II | III | |
| A | Pre / postulverative lesion completely epithelialised | Superficial lesion, not involving tendon, capsule or bone | Wound penetrating to tendon or capsule | Wound penetrating to bone or joint | |
| B | Infection | Infection | Infection | Infection | |
| C | Ischaemia | Ischaemia | Ischaemia | Ischaemia | |
| D | Infection and ischaemia | Infection and ischaemia | Infection and ischaemia | Infection and ischaemia | |
From Armstring D, Lavery LA & Harkless LB (1998) Validation of a diabetic wound classification system.
Diabetes Care 21(5):855 - 859.
