CORELATION OF WAGNER’S DIABETIC ULCER CLASSIFICATION WITH

LOWER EXTREMITIES ISCHEMIA IN DIABETIC FOOT PATIENTS

Tommy Kuswara1,
Marshal2 , Doddy Prabisma Pohan3
1
Surgery Resident Medical Faculty University of Sumatera Utara,
2,3
Thorax Cardiovascular Surgery, General Surgery Department
Medical Faculty University of Sumatera Utara
H.Adam Malik General Hospital Medan

OBJECTIVE : Diabetic foot is infection, ulceration, and/or destruksi inner connective tissue
associated with neuropathy and peripheral vascular disease for lower extremity. The latest
study reported the mortalty rate was 16.7%. This study is for searching corelation of
Wagner’s diabetic ulcer classification with lower extremity ischemia by using ankle brachial
index (ABI) to the diabetic patients.

ABI can be used as a test for peripheral vascular compromise for diabetic foot patients.
From the Papanas study shown that ABI was significantly lower of patient with
microvascular complication than without microvascular complication in DM type-2 patients.
Wagner’s classification is a classification system that widely used for classified
ulceration of diabetic foot. The system provide ulceration grade of diabetic foot from zero to
five. Function of the Wagner’s classification as a method to classified the ulcer by depth and
appeareance of gangrene, osteomyelitis and tissue necrosis.
METHODS : This Study using analitic study with cross sectional method.

RESULT : From 58 Cases, 33 (56.9%) male and 25 (43.1%) female. Age distribution was <
50 years old for 21 (36.2%) patients and ≥50 years old for 37 (63.8%) patients. Mean age is
54.59  9.60 years old. Duration of DM <5 years are 18 (31.0 %) patients and 5 years are 40
(69%) patients. Patients with ABI 1.0-1.4 are 8 (13.8%) patients, 0.9-1.0 are 17 (29.3%), 0.8-
0.9 are 25(43.1%) patients, 0.5-0.8 are 8 (13.8%). Median ABI is 0.86 (min 0.74 max 1.24 ).
CONCLUSION : Correlation analysis result between Wagner’s diabetic ulcer classification
and lower extremity ischaemia show coeficient correlation for 0.41 with p value = 0.001,
indicate that moderate correlation between Wagner’s diabetic ulcer classification and lower
extremity ischaemia (p<0.05).
Keyword : Diabetic foot, Wagner’s Classification, Ischaemia, Ankle-Brachial Index