University of Texas Diabetic Foot Wound Classification
The University of Texas diabetic foot wound classification (Armstrong and colleagues 1998) describes a diabetic foot ulcer on two axes at once.
Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- Depth grade
- Ulcer penetrating to tendon or capsule, without palpable bone
- Complication stage
- Infection - cellulitis, abscess or osteomyelitis
Result: IIB
The tool opens with these values already filled in. Replace them with your own.
What the result means
- Shape
- A TWO-DIMENSIONAL MATRIX: 4 depth grades by 4 complication stages, 16 cells, reported as a PAIR such as 2B or 3D. Never one axis alone.
- Grade 0
- Pre-ulcerative or POST-ulcerative lesion, completely epithelialized. NOT "no problem" - it still carries a stage. A healed ulcer on an ischemic foot is 0C.
- Grade I
- Superficial ulcer, not involving tendon, capsule or bone.
- Grade II
- Ulcer penetrating to tendon or capsule, without palpable bone.
- Grade III
- Ulcer probing to bone.
- Stage A
- No infection and no ischemia.
- Stage B
- Infection - cellulitis, abscess or osteomyelitis.
- Stage C
- Ischemia.
- Stage D
- Both infection and ischemia.
- Why two axes
- The stage adds exactly the two things depth cannot see. Wagner, which this extends, is one-dimensional, so a bare Wagner grade drops that whole axis.
- Ladder
- One published rendering writes grade II as reaching "capsule or bone", which overlaps III. The non-overlapping ladder is used.
- Wagner
- Its grade table is deliberately NOT reproduced - renderings conflict on whether grade 2 involves bone.
- Outcomes
- No percentages are reported; the per-cell figures are single-sourced. Risk rises across BOTH axes, which are read together.
- Scope
- Describes an ulcer. Does not diagnose infection or ischemia, does not decide antibiotics, revascularization or amputation, does not predict an individual outcome.
What you enter
- Depth grade.
- Complication stage.
Full field descriptions
- Depth grade [0 = Pre-ulcerative or post-ulcerative lesion, completely epithelialized; I = Superficial ulcer, not involving tendon, capsule or bone; II = Ulcer penetrating to tendon or capsule, without palpable bone; III = Ulcer probing to bone]. Grade 0 is a pre- or post-ulcerative epithelialized lesion, NOT "no problem".
- Complication stage [A = No infection and no ischemia; B = Infection - cellulitis, abscess or osteomyelitis; C = Ischemia; D = Both infection and ischemia]. This is the axis depth cannot see.
How this is calculated
Armstrong DG, Lavery LA, Harkless LB. Validation of a diabetic wound classification system. The contribution of depth, infection, and ischemia to risk of amputation. Diabetes Care. 1998;21(5):855-859. Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.