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Economic Value of Podiatric Surgery when Added to A Vascular Surgery Program #ActAgainstAmputation #ToeandFlow @vascularsvs @alpslimb @apma

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
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A Free, Comprehensive Limb Preservation Owner’s Manual For Patients (and their docs) From @NealBarshes @BCM_Surgery – in 10 Languages

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
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SALSA’s Diabetic Foot Ulcer Flowchart to help #ActAgainstAmputation

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
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How to build and certify a center of excellence for limb preservation @ALPSlimb @VascularSVS @APMA @USC @KeckMedUSC #ToeFlowandGo

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

Development of a prediction model for foot ulcer recurrence in people with diabetes using easy-to-obtain clinical variables #Remission #DiabeticFoot #UlcerFreeDays #Thermometry

Here is important work from our long-time Dutch friends and colleagues. Bottom line: there are now key factors that can be inputted into models to predict (and therefore reduce) risk for reulceration in patients in diabetic foot remission. This is the first multivariate model we’ve seen include use of personal thermometry. Wouter B Aan de […]

Read More Development of a prediction model for foot ulcer recurrence in people with diabetes using easy-to-obtain clinical variables #Remission #DiabeticFoot #UlcerFreeDays #Thermometry

Observed impact of skin substitutes in lower extremity diabetic ulcers: lessons from the Medicare Database (2015-2018)

Summary: This study from our combined team suggests that use of advanced therapies for treatment of lower extremity wounds was associated with significant reductions in major and minor amputation, ED use, and hospital readmission compared with similarly matched patients not receiving advanced therapy. Objective: To evaluate large propensity-matched cohorts to assess outcomes in patients receiving advanced […]

Read More Observed impact of skin substitutes in lower extremity diabetic ulcers: lessons from the Medicare Database (2015-2018)

Immediate Effects of Weight-Bearing Calf Stretching on Ankle Dorsiflexion Range of Motion and Plantar Pressure During Gait in Patients with Diabetes Mellitus

Terrific work by our colleagues from Kobe, Tokyo, Nara and Osaka, respectively! High plantar pressure is a risk factor for diabetic foot ulcers, and it is known that restriction of ankle dorsiflexion range of motion (ROM) causes high plantar pressure. Stretching is a non-invasive and general means to improve ROM; however, the effect of stretching […]

Read More Immediate Effects of Weight-Bearing Calf Stretching on Ankle Dorsiflexion Range of Motion and Plantar Pressure During Gait in Patients with Diabetes Mellitus

Impact of repeated remote ischemic conditioning on diabetic foot ulcers

This open label, single-arm study from Regulski and coworkers continues the data supporting potential use of this safe, simple intervention Patients with a diabetic foot ulcer (DFU) suffer disabilities and are at increased riskfor lower extremity amputation. Current standard of care includes debridement, topi-cal antibiotics, and weight off-loading—still resulting in low rates of healing. Previoussmall-scale […]

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Stratification of Microvascular Disease Severity in the Foot Using Spatial Frequency Domain Imaging

Work from our combined UofA and USC team with our colleagues at Modulim. Samuel Jett 1, Mallory R Thompson 2, Shubhangi Awasthi 2, David J Cuccia 1, Tze-Woei Tan 2, David G Armstrong 3, Amaan Mazhar 1, Craig C Weinkauf 2 Background: Microvascular disease (MVD) describes systemic changes in the small vessels (~100 um diameter) that impair tissue oxygenation and perfusion. MVD is a common but poorly monitored complication of diabetes. […]

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Materials and Cytokines in the Healing of Diabetic Foot Ulcers

Important deep dive from Kim and coworkers published in Advanced Therapeutics Diabetes affects an increasing number of patients, and is associated with sustained and chronic inflammation. Complications arising from diabetes, including hypoxia, neuropathy, hyperglycemia, and ischemia that contribute to a delayed and reduced healing response result in chronic slow healing wounds. Here, key differences in […]

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Nerve damage in diabetes

This series from the Guardian and BMJ reviews practical best practices for care of people with diabetes, including care of the feet.——- To see this story with its related links on the guardian.co.uk site, go to http://www.guardian.co.uk/lifeandstyle/besttreatments/diabetes-type-1-nerve-damage-in-diabetes Nerve damage in diabetesWednesday January 7 2009BMJ Group Over time, high levels of glucose (sugar) in your blood […]

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