Validation of a diabetic foot surgery classification

David G. Armstrong, Lawrence A. Lavery, Robert G. Frykberg, Stephanie C. Wu, Andrew J M Boulton

Research output: Contribution to journalArticlepeer-review

52 Scopus citations


The purpose of this project was to evaluate associations of increasing diabetic foot surgery stage with postoperative outcome. This project, designed as a retrospective cohort model, was conducted at three large, urban referral-based diabetic foot clinics. The investigators abstracted medical records from 180 patients with diabetes, 76.1% male, aged 57.8 ± 11.2 years, falling equally into four classes of a previously reported diabetic foot surgery classification system. These classes included class 1 (elective), class 2 (prophylactic), class 3 (curative) and class 4 (emergency). There was a significant trend towards increasing risk of ulceration/reulceration (χ2trend = 17.8, P = 0.0001), peri-postoperative infection (χ2trend = 96.9, P = 0.0001), all-level amputation (χ2trend = 41.7 P = 0.001) and major amputation (χ2trend = 8.6, P = 0.003), with increasing class of foot surgery. The results of this study suggest that a non vascular foot surgery classification system including variables such as the presence or absence of neuropathy, an open wound and acute infection may be predictive of peri- and postoperative complications. This may assist the surgeon in better identifying risk when determining a rationale for and type of surgery in persons with diabetes.

Original languageEnglish (US)
Pages (from-to)240-246
Number of pages7
JournalInternational Wound Journal
Issue number3
StatePublished - Sep 2006


  • Amputation
  • Classification
  • Risk
  • Surgery
  • Wound

ASJC Scopus subject areas

  • Surgery
  • Dermatology


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