Signs of infection require to be considered such as development of grey or yellow tissue, purulent discharge, unpleasant smell, sinus, undermined edges and exposure of bone or tendon.Identification of diabetic foot in medical databases, such as commercial claims and prescription data, is complicated by the lack of a specific ICD-9 code for diabetic foot and variation in coding practices. The following codes indicate ulcer of the lower limb or foot:
707.1 Ulcer of lower limbs, except pressure ulcer
707.14 Ulcer of heel and midfoot
707.15 Ulcer of other part of foot
707.19 Ulcer of other part of lower limbOne or more codes, in combination with a current or prior diagnosis of diabetes may be sufficient to conclude diabetic foot:

250.0 Diabetes Mellitus
250.8 Diabetes with other specified manifestations

Classification
Diabetic foot ulcer is a complication of diabetes. Diabetic foot ulcers are classified as either neuropathic, neuroischaemic or ischaemic.Doctors also use the Wagner Grades to describe the severity of an ulcer. The purpose of the Wagner Grades is to allow specialists to better monitor and treat diabetic foot ulcers. This grading system classifies Diabetic foot ulcers using numbers, from 0 to 5. Wagner Grades 0 through 5 are as follows:
0. No diabetic foot ulcer is present, but there is a high risk of developing one. 1. A surface ulcer involves full skin thickness, but does not yet involve the underlying tissues. 2. A deep ulcer penetrates past the surface, down to the ligaments and muscle. There is no abscess or bone involved yet. 3.
Diabetic foot ulcers develop their own, distinctive microbiota. Investigations into characterizing and identifying the phyla, genera and species of nonpathogenic bacteria or other microorganisms populating these ulcers may help identify one group of microbiota that promotes healing.The recent advances in epigenetic modifications, with special focus on aberrant macrophage polarisation is giving increasing evidences that epigenetic modifications might play a vital role in changing the treatment of diabetic foot ulcer in the near future. References


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