Active ulceration (pictures below) is defined by The International Working Group on the Diabetic Foot 2005 (IWGDF), as:
‘a full thickness wound, i.e. a wound penetrating through the dermis, below the ankle in a diabetic patient, irrespective of duration’.
NICE guideline [NG19]: Diabetic foot problems: prevention and management: 1.5 Diabetic foot ulcer recommend the SINBAD (site, ischaemia, neuropathy, bacterial infection, area and depth) or the TEXAS scale is used to classify a diabetic foot ulcer.
If during the screening process you discover the patient has a foot ulcer the patient should be referred without delay for treatment/management by an experienced podiatrist who is part of a multidisciplinary foot team/service.