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What Does a Wagner Grade 5 Look Like?

Updated: 3 days ago

What Is a Wagner Grade 5 Diabetic Foot Ulcer?


Wagner Grade 5 diabetic foot ulcers represent the most severe classification in the Wagner Ulcer Grade Scale. This stage is marked by extensive gangrene involving the entire foot, often accompanied by deep infection, tissue necrosis, and systemic risk.


Unlike Grade 4 ulcers, which are limited to part of the foot, Grade 5 ulcers indicate full-foot involvement with widespread tissue death. At this advanced stage, limb salvage is rarely possible. Below-the-knee amputation is commonly required to protect the patient's life and prevent systemic complications such as sepsis or multi-organ failure.


Why Wagner Grade 5 Often Requires Amputation


With progressive infection, loss of blood flow, and irreversible necrosis, Wagner Grade 5 ulcers often leave no viable tissue for healing. In many cases, amputation becomes the only option to prevent life-threatening outcomes. Delaying surgery in such cases can increase the risk of systemic infection and organ damage.


Contributing Factors to Wagner Grade 5 Progression


Common contributing factors include:


  • Poor glycemic control

  • Severe peripheral arterial disease

  • Chronic or untreated infections

  • Delayed or inadequate wound care interventions


These cases serve as a critical reminder of why early intervention, routine foot inspections, and ongoing care coordination are essential in diabetic wound management.


Life After Amputation: What Patients Can Expect


Following amputation, patients often require multidisciplinary support including:


  • Post-operative wound care

  • Physical rehabilitation

  • Prosthetic evaluation and training

  • Mental health support


With coordinated care, many patients are able to regain mobility and achieve a high quality of life, but the recovery process requires time, resources, and a committed support system.


Wagner Grade 5 Ulcer Examples [Graphic Images Below]


The images below provide real-world clinical examples of Wagner Grade 5 ulcers, illustrating the severity of disease progression and the urgent need for preventative strategies in diabetic foot care.


Diabetic foot showing full-thickness necrosis and gangrene across the forefoot and toes, consistent with Wagner Grade 5 ulceration.
Advanced diabetic foot ulcer with large necrotic area, deep tissue involvement, and early signs of wet gangrene along the lateral plantar surface
Severe diabetic gangrene extending up the lower leg with blackened necrotic tissue and skin sloughing, indicating systemic tissue death typical of Wagner Grade 5.
Dorsal foot wound with moist gangrene, heavy infection, and yellow-black slough, demonstrating a late-stage Wagner Grade 5 diabetic foot ulcer.

How Shared Health Services Supports Diabetic Limb Preservation


At Shared Health Services (SHS), we work with hospitals and wound care providers to prevent advanced outcomes like Wagner Grade 5 ulcers. Our team equips partners with the clinical tools, documentation workflows, and compliance strategies needed to intervene early and treat effectively.


With more than 25 years of experience in wound care and hyperbaric program development, SHS supports durable service lines that help teams manage complex wounds, improve patient outcomes, and reduce avoidable amputations.


Our role is to support your team with proven strategies and clinical expertise — the success is yours to own.


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