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Diabetic Foot Ulcer — SCE Dermatology MCQ

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ModerateWound HealingDiabetic Foot UlcerSCE Dermatology

A 70-year-old man presents with a chronic non-healing ulcer on his foot. He has type 2 diabetes with HbA1c of 82 mmol/mol. The ulcer is on the plantar surface of the first metatarsal head. Peripheral neuropathy is confirmed on monofilament testing. Pedal pulses are present. What is the most important classification system for diabetic foot ulcers?

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Correct answer: D — Wagner classification or University of Texas classification

The Wagner classification (grades 0-5 based on depth and infection/gangrene) and University of Texas (UT) classification (assessing depth, infection, and ischaemia in a matrix) are the most commonly used systems for diabetic foot ulcers. The UT system is more predictive of outcome as it accounts for both depth and the presence of infection/ischaemia. Management involves multidisciplinary diabetic foot team care, offloading (total contact casting), wound debridement, infection management, glycaemic optimisation, and vascular assessment. NICE NG19 recommends urgent referral to a multidisciplinary diabetic foot team within 24 hours.

Reference: NICE NG19 2019 Diabetic Foot; BAD