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
This just published in the American Journal of Managed Care (AJMC) detailing our collective experience treating high-risk patients with COVID19 A growing body of research, as well as first-hand accounts from clinicians on the ground, indicate that a significant percentage of patients with chronic wounds have delayed preventative and emergent wound care during the COVID-19 […]Read More Managing the Surge: Delayed Chronic Wound Care During COVID-19 @AJMC_Journal @USC @USC_vascular @ALPSlimb @APMA @SVS #ActAgainstAmputation
From our long-time friend Charles Liu via Wired Magazine (and Dr. Brandy Schillace) exploring the outer limits of neuroplasticity via the very real immediate-term promise of vagus nerve stimulation.Read More A Stroke Study by @USC / @RanchoRehab Prof. Charles Liu Reveals the Future of Human Augmentation @Wired @NeurosurgeryUSC
Just published this past week by our collective Chongqing/Singapore/and local LA squad. Diabetic foot ulcer (DFU) is one of the most serious and alarming diabetic complications, which often leads to high amputation rates in diabetic patients. Machine learning is a part of the field of artificial intelligence, which can automatically learn models from data and […]Read More An explainable machine learning model for predicting in‐hospital amputation rate of patients with diabetic foot ulcer
A key Taiwanese nationwide study suggests that focusing on quality can improve outcomes. See for yourself: A nationwide cohort investigation on pay-for-performance and major adverse limb events in patients with diabetes A nationwide cohort investigation on pay-for-performance and major adverse limb events in patients with diabetes Highlights The nationwide population-base investigation unlinked vascular benefit of […]Read More Pay For Performance Reduces Incident Ulceration, Amputation, Death in the Diabetic Foot: Nationwide Study
Important work from Sicco Bus, et al. published in BMJ Diabetes This RCT (DIATEMP) suggests that it’s not enough just to know that you’ve a preulcerative hot spot– but you need to do something about it. In this case, patients were told to reduce activity. Effectiveness of at-home skin temperature monitoring in reducing the incidence […]Read More Thermometry reduces risk for reucleration in remission– in patients who reduce their activity
Yet more data to support the contention that different matrices are deleteriously and similarly affected by this silent sinister syndrome Proportion and severity of periodontitis and correlation of periodontal inflamed surface area with glycemic status in type 2 diabetic neuropathy patients with and without diabetic foot Background The association between diabetic neuropathy with and without […]Read More Diabetic Foot in Mouth Disease?
A great review from Queensland that should help put some of the confusing M1-M2 phenotype story into sharper relief. Skin Wound Healing: Normal Macrophage Function and Macrophage Dysfunction in Diabetic Wounds Abstract: Macrophages play a prominent role in wound healing. In the early stages, they promote inflammation and remove pathogens, wound debris, and cells that […]Read More Mixed up Macrophages: M1/M2 Dysregulation in Diabetic Foot Ulcers
Superb work from our long-time SALSAmigo, Prof. Luigi Uccioli and his team led by Meloni and coworkers. This confirms previous work by our team that there is indeed foot level as well as a much higher rate of revascularization failure in “RDF” patients compared to their “DF” counterparts.Read More More evidence for “renal foot” angiographic findings and outcomes
This via Gretchen Reynolds and the NYT. Many of the tools and technologies we’ve pined over (and worked on) over the years are coming to fruition in a variety of ways!Read More Is an Exoskeleton Suit in Your Future? #WearableRobots
VIA Keck School News The USC Limb Preservation Program has been awarded an 18-month, $1.43 million grant from the Department of Defense to support an innovative wound-healing program. The group will be studying the effects of stimulating the spleen in people with catastrophic tissue loss to promote the release of anti-inflammatory cells and cytokines. The […]Read More @USC Limb Preservation Program gets $1.43 million Dept. of Defense grant @KeckMedUSC