Table 1.
Classification of diabetic foot infections
| GRADE 1 | No symptoms or signs of infection |
| GRADE 2 | Infection involving the skin and the subcutaneous tissue only (without involvement of deeper tissues and without systemic signs as described below). At least two of the following signs are present: |
| •Local swelling or induration | |
| •Erythema >0·5–2 cm around the ulcer | |
| •Local tenderness or pain | |
| •Local warmth | |
| •Purulent discharge (thick, opaque to white secretion). Other causes of an inflammatory response of the skin should be excluded (e.g. trauma, gout, acute Charcot neuro‐osteoarthropathy, fracture, thrombosis and venous stasis) | |
| GRADE 3 | Erythema >2 cm plus one of the signs described above (swelling, tenderness, warmth, discharge) OR |
| Infection involving structures deeper than skin and subcutaneous tissues such as abscess, osteomyelitis, septic arthritis and fasciitis | |
| No systemic inflammatory response signs as described below | |
| GRADE 4 | Any foot infection with the following signs of a systemic inflammatory response syndrome (SIRS). This response is manifested by two or more of the following conditions: |
| •Temperature >38°C or <36°C | |
| •Heart rate >90 beats/minute | |
| •Respiratory rate >20 breaths/minute | |
| •PaCO2 <32 mmHg | |
| •White blood cell count >12·000 or <4·000/mm3 | |
| •10% immature (band) forms |
Adapted from (17) with permission from IDF Consultative Section on the Diabetic Foot/IWGDF. Copyright © 2003, IDF Consultative Section on the Diabetic Foot/IWGDF. All rights reserved.