Resembles laceration, puncture, or blister with round or oblong shape.

May be necrotic, pink, or pale with well-defined smooth edges.

Periwound often presents with callus.

Origin and development have several components.

Thirty-two unique casual pathways for developing foot ulcers.²

Major common pathways involve pressure/trauma, ischemia/hypoxia, infection, cellular failure, and chronic inflammation.

12.5% individuals with diabetes will develop lower extremity ulceration.³

Basic history, including state of health, record of diabetic complications, shoe problems, pain in extremity, medications, glycated hemoglobin level.

Risk factor assessment involving absence of protective sensation due to peripheral neuropathy, vascular insufficiency, structural deformities/callus formation, autonomic neuropathy, limited joint mobility, long duration of diabetes, long history of smoking, poor glucose control, obesity, impaired vision, past history, increased age, male gender, poor footwear.

The Wagner scale for foot wound classification based on depth and presence of osteomyelitis and gangrene is the most widely accepted classification scheme⁴ (FIG 1) but does not address the critically important parameters of ischemia and infection.