Dr. Lavery's presentation addresses an overview of the incidence and etiology of foot ulcers in diabetes and discusses several current classification systems that are used to describe lower extremity wounds. Shea's classification system for decubitus ulcers is reviewed, as well as the four tiered system endorsed by the National Pressure Ulcer Advisory Panel. Meggitt-Wagner's six level classification system is discussed. Most residents and wound care experts are most familiar with this system. It is used as a method of communicating the risk or severity of the wound to other caregivers. Dr. Lavery also developed his own classification system at the University of Texas Health Science Center in San Antonio. He published this classification system with Dr. David Armstrong (another Great Texan) in the Journal of Foot and Ankle Surgery, 1996 and in the Diabetes Care Journal, 1998. In addition to grading by depth, Dr. Lavery also stages wounds according to key risk factors. Theoretically, we would expect that there should be increasing risk and perhaps increasing level of amputation as the grade and stages of the wound increase. Dr. Lavery's new classification system not only helps standardize communication of wound stages, but can also be utilized as a more accurate predictor of wound outcomes.