Signs of deterioration

• Colour of ulcer bed changes

• Matt surface develops over ulcer bed

• Dimensions of ulcer become static or increase

• Ulcer becomes moist with increased discharge

• Local swelling develops or increases

• Foot becomes painful

• Malodour develops

• Ulcer becomes undermined.

In the long term, it should be remembered that patients with neuropathic feet may eventually develop ischaemia, and the classification should be repeated at every annual review.

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