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Thermography-Assisted Grading in Wagner Classification: A New Approach for Diabetic Foot Assessment. A

Víctor Manuel Loza-González1, Mario Aurelio Martínez-Jiménez2, Alejandra Ortiz Dosal3,4

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Infrared thermography can objectively assess diabetic foot complications. A temperature difference threshold of -2.6°C accurately predicts patient outcomes, aiding in wound clinic evaluations.

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Area of Science:

  • Medical imaging
  • Biomedical engineering
  • Diabetes mellitus research

Background:

  • Diabetic foot is a severe diabetes complication impacting patient quality of life.
  • The Wagner classification system is a traditional method for grading diabetic foot severity.
  • Clinical assessment of diabetic foot can be subjective and prone to bias.

Purpose of the Study:

  • To establish the thermographic patterns associated with each grade of the Wagner classification system for diabetic foot.
  • To explore thermography's potential to reduce subjectivity in diabetic foot evaluation.

Main Methods:

  • Infrared thermography was used to capture temperature data from 66 diabetic foot patients.
  • Temperature differences (ΔT) between affected and unaffected first toes were analyzed.
  • Thermographic patterns were correlated with the Wagner classification grades.

Main Results:

  • Positive ΔT values were observed in early Wagner grades (0-2), indicating inflammation.
  • Negative ΔT values were noted in later Wagner grades (3-5), suggesting compromised circulation.
  • A ΔT threshold of -2.6°C predicted amputation versus conservative management with over 95% accuracy.

Conclusions:

  • Thermography shows promise as an objective tool for evaluating diabetic foot ulcers.
  • This technology can aid wound clinics in patient assessment and outcome prediction.
  • Infrared thermography offers a quantitative method to complement clinical judgment in diabetic foot care.