Evaluation and Management of Diabetic Foot According to Wagner's Classification

Abstract

^{ABSTRACT Background: Diabetic foot is a very common complication of diabetes mellitus and requires proper management. Wagner’s classification is the most widely utilized grading system for lesions of the diabetic foot. Objectives: To evaluate the outcome of management for the different lesions of diabetic foot according to Wagner's classification. Methods: the study was conducted in the surgical unit of Baghdad Teaching Hospital, between October 2007 and October 2008. One hundred patients, with diabetic foot disease, were included in the study. Patients were grouped into six groups corresponding to Wagner grading system. Wound debridement was done and the outcome measures were wound healing or amputations (limited or lower limb amputations) Results: fifty four patients (54%) were males and forty six(46%) were females. Common age group was above 60 years, two patients had grade 0, fourteen grade 1, twenty five with grade 2, thirty with grade 3, twenty three with grade 4 and six with grade 5 lesions. Twelve patients (12%) were managed conservatively with antibiotics alone; forty one (41%) had incision drainage and debridement while twenty one had ray amputations and twenty two (22%) major limb amputations. Staphylococcus aureus was the commonest organism isolated. Conclusion: The majority of the diabetic foot lesions were in grade 2 to 4. Lesser grade lesions responded well to conservative treatment with antibiotics and surgical debridement while those with higher grades needed amputations. Keywords: Diabetic foot diseases, Wagner’s classification, Lower limb amputations.}