Author: David G. Armstrong

Dedicated to amputation prevention, wound healing, diabetic foot, biotechnology and the intersection between medical devices and consumer electronics.

A systematic review of outcome reporting for interventions to treat people with diabetic foot ulceration @robhinchliffe1 #ActAgainstAmputation #diabeticfoot

Superb review and recommendations from Dovell and coworkers Background Diabetic foot ulceration (DFU) is a challenging clinical problem that affects up to a quarter of patients with diabetes in their lifetime. An agreed set of outcomes for assessing treatments or interventions for DFU has not previously been considered. The aim of this study was to […]

Read More A systematic review of outcome reporting for interventions to treat people with diabetic foot ulceration @robhinchliffe1 #ActAgainstAmputation #diabeticfoot

A limb is a peninsula and no clinician is an island: Introducing the American Limb Preservation Society (ALPS) @alpslimb @apma @vascularsvs

This manuscript from the founding executive board at the American Limb Preservation Society was published in Foot and Ankle Surgery: Techniques, Reports and Cases (FASTRAC)

Read More A limb is a peninsula and no clinician is an island: Introducing the American Limb Preservation Society (ALPS) @alpslimb @apma @vascularsvs

Opportunities for diabetes and peripheral artery disease-related lower limb amputation prevention in an Appalachian state: A longitudinal analysis @SamanthaMinc @WestVirginiaU @usc_vascular

Opportunities for diabetes and peripheral artery disease-related lower limb amputation prevention in an Appalachian state: A longitudinal analysis Great work from West Virginia’s Sam Minc and coworkers with a little help from us here at USC. SamanthaDanielle MincabStevanBudicDylanThibaultaRanjitaMisradDavid GArmstrongeGordonStephen SmithfLukeMaronea Lower extremity amputation due to peripheral artery disease (PAD) and diabetes (DM) is a life-altering event that identifies disparities in […]

Read More Opportunities for diabetes and peripheral artery disease-related lower limb amputation prevention in an Appalachian state: A longitudinal analysis @SamanthaMinc @WestVirginiaU @usc_vascular

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
Featured

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

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 […]

Read More Impact of repeated remote ischemic conditioning on diabetic foot ulcers

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. […]

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