Important data from Naren Patel et al at the University of Arizona’s Southern Arizona Limb Salvage Alliance (SALSA). Bottom line: With equal number of surgeons, podiatry contributed 40% of total wRVUs generated by the entire program in 2019. Here are the granular data in for those of you interested in developing a limb preservation program. […]Read More Economic Value of Podiatric Surgery when Added to A Vascular Surgery Program #ActAgainstAmputation #ToeandFlow @vascularsvs @alpslimb @apma
We can’t say enough about the great and good works of our SALSAmigo, Neil Barshes, the pride of Houston. On his github page, he has published what amounts to a soup-to-nuts owners manual for patients and their clinicians interested in limb preservation. Here it is, reprinted: As an academic vascular surgeon, I work to develop […]Read More A Free, Comprehensive Limb Preservation Owner’s Manual For Patients (and their docs) From @NealBarshes @BCM_Surgery – in 10 Languages
We’ve had many people ask for our generalized flowchart for care. Here it is. As always, these are living documents that change over time. Feel free to improve and pay it forward! Assessment of the Diabetic Foot: Wound, Ischemia and Foot Infection (WIFI) Patient with Diabetic Foot Ulcer (A) Of the 435 million people with […]Read More SALSA’s Diabetic Foot Ulcer Flowchart to help #ActAgainstAmputation
Here is a mashup of two manuscripts recently posted to the blog. While amputation appears to be reducing in OECD states, the risk for mortality secondary to DFU is high and may be getting higher.Read More Decreasing amputation, worldwide…but greater prevalence and mortality from Diabetic Foot Ulcers (DFU)?
Here is the link for the global vascular guidelines. And listed below is section 12 by Rogers and Armstrong detailing methods of developing and certifying a limb preservation unit. We like to think of this as trauma centers for atraumatic wounds/ischemia/infection as described here. Additional information on German and Belgian efforts at limb preservation center […]Read More How to build and certify a center of excellence for limb preservation @ALPSlimb @VascularSVS @APMA @USC @KeckMedUSC #ToeFlowandGo
Great work from our long-time SALSAmigo, Dave Raichlen summarized in this NYT article by Gretchen Reynolds If you are sitting down to read this article, you may be doing your resting wrong, according to a fascinating new study of hunter-gatherer tribespeople and how they idle. The study finds that hunter-gatherers tend to lounge about during the day […]Read More Since sitting is the new smoking, should we be squatting more?
David G. Armstrong, Professor of Surgery and Director of the Limb Preservation Program at Keck School of Medicine of University of Southern California (USC) became the first podiatric surgeon to deliver surgery grand rounds at George Washington University in Washington DC. His lecture, which focused on building limb preservation programs, worldwide, was moderated by Anton […]Read More @USC David G. Armstrong becomes first Podiatric Surgeon to Deliver Surgery Grand Rounds to George Washington University
A terrific review by Rome’s Serini and Calviello Long-chain Omega-3 polyunsaturated fatty acids (Omega-3 PUFAs) are widely recognized as powerful negative regulators of acute inflammation. However, the precise role exerted by these dietary compounds during the healing process is still largely unknown, and there is increasing interest in understanding their specific effects on the implicated […]Read More New Insights on the Effects of Dietary Omega‐3 Fatty Acids on Impaired Skin Healing in DFU and VLU #DiabeticFoot #Wound Healing
A Clinical Study to Evaluate Autofluorescence Imaging of Diabetic Foot Ulcers Using a Novel Artificial Intelligence Enabled Noninvasive Device Great work from our long-time friend and colleague Vijay Viswanathan and coworkers pushing diagnostics and theragnostics forward. Diabetic foot ulcers, with worldwide prevalence ranging from 12%-25%, are an important cause of nontraumatic lower limb amputation. Evidence-based […]Read More A Clinical Study to Evaluate Autofluorescence Imaging of Diabetic Foot Ulcers Using a Novel Artificial Intelligence Enabled Noninvasive Device #ActAgainstAmputation #DiabeticFoot
Yet more information on the role that immunosuppression (including and especially renal replacement) plays on outcomes of diabetic foot infections. This from our friends and colleagues from the Balgrist in Zurich. Ilker Uçkay 1 2 3, Madlaina Schöni 2, Martin C Berli 2, Fabian Niggli 2 3, Emil Noschajew 2, Benjamin A Lipsky 4, Felix W A Waibel 2 We investigated if a chronic, enhanced immunosuppressed condition, beyond the immunodeficiency related […]Read More The association of chronic, enhanced immunosuppression (especially dialysis) with outcomes of diabetic foot infections
Excellent continued efforts in elucidating the role that perturbation of the wound matrix (via NPWT) has on angiogenesis, healing and regeneration. Label‑free quantitative mass spectrometry was used to analyze the differences in the granulation tissue protein expression profiles of patients with diabetic foot ulcers (DFUs) before and after negative‑pressure wound therapy (NPWT) to understand how […]Read More Proteomics changes after negative pressure wound therapy in diabetic foot ulcers
This from our combined Chongqing/Singapore/USC team. This adds additional data pointing to a relationship with glucose, morbidity and mortality in high risk diabetic foot patients. Aims: To evaluate the association of time in range (TIR) with amputation and all-cause mortality in hospitalized patients with diabetic foot ulcers (DFUs) MATERIALS AND METHODS: A retrospective analysis was performed […]Read More From our combined team: Time in Range (TIR) may help to predict amputation and mortality risk #ActAgainstAmputation @USC @USC_Vascular @KeckSchool_USC
USC Professor of Surgery David G. Armstrong became the first podiatric surgeon to keynote a session at the 24th International Conference on Medical Image Computing and Computer Assisted Intervention (MICCAI). Armstrong’s lecture described the toll that diabetes complications take worldwide as well as the role that advances in artificial intelligence, advanced imaging and robotics can […]Read More @USC Armstrong Becomes First Podiatric Surgeon to Keynote Diabetic Foot Grand Challenge at International Computing Imaging Conference in Strasbourg @keckmedusc @usc_vascular @Keckschool_usc #ActAgainstAmputation @alpslimb
Bottom line: much of this reporting from our colleagues at CDC may be explained, thankfully, by the rise in limb-sparing minor amputationsRead More Trends in Nontraumatic Lower-Extremity Amputation Among Privately Insured Adults With Diabetes in the U.S., 2004–2018
Great work by an all-star consensus panel with practical recommendations. Diabetic sensorimotor polyneuropathy (DSPN) affects around one third of people with diabetes and accounts for considerable morbidity, increased risk of mortality, reduced quality of life, and increased health care costs resulting particularly from neuropathic pain and foot ulcers. Painful DSPN is encountered in 13-26% of […]Read More Screening, diagnosis and management of diabetic sensorimotor polyneuropathy in clinical practice: International expert consensus recommendations #Neuropathy #DiabeticFoot #PDN #ActAgainstAmputation