What is the University of Texas (UT) classification system for diabetic foot?

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From the Guidelines

The University of Texas (UT) classification system for diabetic foot is a comprehensive tool that categorizes diabetic foot ulcers based on both depth and the presence of infection or ischemia, using a matrix format with grades 0 to 3 indicating ulcer depth and stages A to D indicating the presence of infection or ischemia. This system is particularly valuable because it provides prognostic information, with higher grades and stages correlating with increased risk of amputation and poorer healing outcomes, as noted in the study by 1. The UT classification system is used to guide appropriate treatment strategies, determine the need for vascular intervention, and estimate healing potential for diabetic foot ulcers. Some of the key points of the UT classification system include:

  • Grades 0 to 3 indicating ulcer depth, with 0 being a pre-ulcerative lesion or healed ulcer, 1 being a superficial wound not involving tendon/capsule/bone, 2 being a wound penetrating to tendon or capsule, and 3 being a wound penetrating to bone or joint.
  • Stages A to D indicating the presence of infection or ischemia, with A being clean wounds, B being non-ischemic infected wounds, C being ischemic non-infected wounds, and D being ischemic infected wounds. The UT classification system has been compared to other classification systems, such as the Wagner and S(AD)/SAD systems, as discussed in the study by 1. However, the UT system is considered a more comprehensive tool for categorizing diabetic foot ulcers, as it takes into account both the depth of the ulcer and the presence of infection or ischemia, as noted in the study by 1. Overall, the UT classification system is a valuable tool for healthcare providers to guide treatment strategies and estimate healing potential for diabetic foot ulcers, as supported by the study by 1.

From the Research

University of Texas Classification System for Diabetic Foot

The University of Texas (UT) classification system for diabetic foot is a clinical classification system that evaluates wound depth, the presence of infection, and peripheral arterial occlusive disease in every category of the wound assessment 2. This system is used to direct appropriate therapy and possibly predict outcome.

Key Components of the UT Classification System

  • The system assesses wound depth, infection, and peripheral arterial occlusive disease
  • It is used to guide treatment and predict outcomes
  • The system is part of a multidisciplinary approach to limb salvage

Comparison with Other Classification Systems

  • The UT classification system is often compared to the Wagner classification system 3, 4, 5
  • The UT system includes both grade and stage to assess the severity of the wound 5
  • The addition of stage to grade in the UT classification helps to better assess the severity of the wound and predict outcomes 5

Clinical Application of the UT Classification System

  • The system is used to classify diabetic foot ulcers and guide treatment 2, 4
  • It is part of a comprehensive approach to managing diabetic foot ulcers, including pressure relief, sharp debridement, and management of underlying infection and ischemia 4
  • The system can be used in conjunction with other treatment principles, such as the STAGE principles and the TIME principles 3

Predicting Outcomes with the UT Classification System

  • The UT classification system can be used to predict outcomes, including healing time and amputation rates 5
  • Higher grades and stages are associated with longer healing times and increased amputation rates 5

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Classification of diabetic foot wounds.

The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons, 1996

Research

Diabetic foot ulcers: pathogenesis and management.

American family physician, 2002

Research

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

JPMA. The Journal of the Pakistan Medical Association, 2006

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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