As regards the posting on "toe and flow" of a few days ago, we are working on an editorial that we plan to submit that works to compare the work of pushing the patient up the perfusion/healing curve to the mythical Sisyphus-- all alone in Hades pushing a rock up the hill, only to have... Continue Reading →
Diabetes Causes More Amputations then Landmines: A Call To Arms to Save Limbs
Some years ago, we compared diabetes-related amputations to cancer in terms of 5 year mortality. Now, a no less compelling comparison has emerged. The scourge of unexploded ordinance-- particularly landimines-- has been evident since at least the end of WWII. Literally hundreds of non-governmental organizations and celebrities have rallied around this entirely preventable problem in... Continue Reading →
Marker for Heart Attack Risk May Also Predict Bone Infection in Diabetes: Researchers
The same test now frequently used to assess risk for heart disease may now help prevent amputations according to researchers at Rosalind Franklin University of Medicine and Science in Chicago and the University of Arizona. "The results of this study, led by Dr. Adam Fleischer, were somewhat surprising to us", noted David G. Armstrong, Professor... Continue Reading →
The Toe and Flow: Structure of an Effective Amputation Prevention Team
The core theme of our team at SALSA has been "team". What my friend and co-director Joe Mills and I have found in participating in and developing amputation prevention initiatives in North America and around the world is that the "irreducible minimum" to this team involves a "toe team" (someone taking care of the foot... Continue Reading →
MRSA, Superbugs and SALSA: Where do we go from here?
With the ever increasing rise in prevalence of "superbugs" and methicillin-resistant Staphylococcal species in hospitals, clinics and public/private places around the world, it seems that both clinicians and their patients have taken a significant interest in this area. Recently, we developed a series of lectures on this topic it is available here. Enjoy.
Now taking requests
In putting this blog together, we have surprisingly already been contacted with requests from clinicians and people with diabetes. To that end, we would formally announce that we are happy to expound on any issue related to diabetes, wound healing, and amputation prevention put out there. To that end, as per request, here is the... Continue Reading →
Admixture of Calcium Sulfate Pellets
This week, we at SALSA have some patients who have a certain degree of bone involvement in their wounds that might benefit from locally implanting a high degree of antibiotics. This again reminded us of the requests we often received for how to mix medical-grade calcium sulfate with various classes of antibiotics. Tobramycin, Gentamicin and... Continue Reading →
Rapid Response Diabetic Foot Team Skill Set
In the work we have been doing with the Infectious Diseases Society of America (IDSA) along with our own work at SALSA, we have proposed the following key skill set for any "rapid response team" dedicated to amputation prevention: Ability to perform site-appropriate culture technique Ability to perform vascular work-upAbility to perform revascularization, as necessary Ability to perform... Continue Reading →
Health Care Service and Outcomes Among an Estimated 6.7 Million Ambulatory Care Diabetic Foot Cases in the U.S.
This from our @UofA / @BCM, UTSouthwestern and Oklahoma SALSA team. 6.7 million diabetic foot ulcers, 785 million diabetes-related outpatient visits and 5.5 billion visits overall suggest that diabetic foot ulcers are common, complex, and costly. Compare this frequently silent and sinister problem to CHF, MI, stroke. OBJECTIVE: To evaluate ambulatory clinical cases of diabetic foot... Continue Reading →
Prevention = Remission: How One Word Can Change Everything
This abstract is from an upcoming JAPMA manuscript from Joe Mills and me. We have been using this terminology in our clinic for some time and believe it truly makes a difference. Here's to measuring that effect! We credit our friend and colleague Jeff Robbins with simultaneously working on this subject as well and for... Continue Reading →