New insights in diabetic foot infection

Table 1 International consensus on the diabetic foot classification of foot wound infections (adapted from reference [17])

Grade 1	No symptoms, no signs of infection
Grade 2	Lesion only involving the skin (no subcutaneous tissue lesion or systemic disorders) with at least two of the following signs:
	Local warmth
	Erythema > 0.5 cm - 2 cm around the ulcer
	Local tenderness or pain
	Local swelling or induration
	Purulent discharge (thick, opaque to white or sanguineous secretion)
	Other causes of inflammation of the skin must be eliminated (for example: trauma, gout, acute Charcot foot, fracture, thrombosis, venous stasis)
Grade 3	Erythema > 2 cm and one of the findings described above
	or
	Infection involving structures beneath the skin and subcutaneous tissue, such as deep abscess, lymphangitis, osteomyelitis, septic arthritis or fasciitis
	There must not be any systemic inflammatory response (see Grade 4)
Grade 4	Regardless of the local infection, in the presence of systemic signs corresponding to at least two of the following characteristics:
	Temperature > 39°C or < 36°C
	Pulse > 90 bpm
	Respiratory rate > 20/min
	PaCO2 < 32 mmHg
	Leukocytes > 12 000 or < 4 000/mm3
	10% of immature leukocytes