On diabetic foot, wound healing, amputation prevention, and the merger of consumer tech with medical devices
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!
Read More SALSA’s Diabetic Foot Ulcer Flowchart to help #ActAgainstAmputationThere have been early peeks at the role of using lactobacillus and other kinder and gentler species to battle more hostile ones in chronic wounds. Now a new manuscript from Italian colleagues Venosi and coworkers provides tantalizing new peeks into the metabolomic profile of a patient treated with topical probiotics. Enjoy. Infected chronic ischemic wound […]
Read More Treating locally infected wounds with topical probiotics? Finally.Fascinating and very plausible data from Liu and coworkers fits well with previous works from our group and others. Background: One of the main causes for foot ulcers in diabetics is an excessive, constant load on the foot which over time leads to ischemia. The aim of this study is to explore whether vibration preconditioning […]
Read More Vibration Preconditioning as a Method to Reduce Hyperemia Responses to Plantar Pressure-Induced IschemiaThis great release from the folks at Microsoft Azure detailing efforts by our Rancho team to develop next-gen technologies like Smart Boots to help people navigate their world a little better Continuous patient monitoring is one of the newest and most innovative applications of the Internet of Things (IoT) in healthcare. Real-time patient data is […]
Read More Doctors @RanchoRehab Aim to Reduce Diabetes-Related Amputation with @Microsoft @AzureImportant work from Ignacia Fuentes, Andrew South and team beginning with EB but possibly with even wider applicability. Impaired wound healing complicates a wide range of diseases and represents a major cost to healthcare systems. Here we describe the use of discarded wound dressings as a novel, cost effective, accessible, and non-invasive method of isolating […]
Read More Cells from discarded dressings differentiate chronic from acute wounds @SciReports #WoundHealing #Diagnostics #TheragnosticsThis interview and wide ranging discussion of David G. Armstrong was just posted to the podcast Doctorpedia. David Armstrong, DPM, MD, PhD Podiatric Surgeon Professor of Surgery at the University of Southern California Keck School of Medicine Founder and co-Director of the Southwestern Academic Limb Salvage Alliance (SALSA) Founder and co-chair of the International Diabetic […]
Read More The Gift of Pain– and much more– an interview with David G. Armstrong on the Doctorpedia PodcastWork from Polish colleagues Barc and coworkers report promise with a novel gene therapy approach. Critical leg ischemia (CLI) complicated by diabetes mellitus (DM), which is a very common and dangerous disease, represents the ultimate stage of peripheral arterial disease. Patients are treated with antiplatelet drugs, statins and limb revascularization, but a significant number of […]
Read More Double VEGF/HGF Gene Therapy in Critical Limb Ischemia Complicated by Diabetes Mellitus | SpringerLinkComprehensive work from Meshkin and coworkers from Georgetown evaluating 36,037 people undergoing major amputation Abstract Chronic wounds that lead to major lower extremity amputation have immense consequences on quality of life, and ultimately, mortality. However, mortality rates after lower extremity amputation for a chronic wound are broad within the literature and have escaped precise definition. […]
Read More Pooled mortality rates following below knee amputation were 33.7%, 51.5%, 53%, 64.4%, and 80% at 1-, 2-, 3-, 5- and 10-year follow-up, respectivelyThis excellent work from Le and coworkers strongly suggests that using a point of care diagnostic device (Moleculight) can identify elevated bacterial load and influence medical decision making. Objective:Â High bacterial load contributes to chronicity of wounds and is diagnosed based on assessment of clinical signs and symptoms (CSS) of infection, but these characteristics are poor […]
Read More Diagnostic Accuracy of Point-of-Care Fluorescence Imaging for the Detection of Bacterial Burden in WoundsThis is the thesis behind an interesting gait analysis study from Amemiya and coworkers Bottom line: An effective intervention for preventing callus formation for the first MTH would involve assisting the push-off foot motion using rocker-sole footwear or gait training. For the second and fifth MTHs, wearing appropriate size footwear would be effective.
Read More What gait factors cause calluses under the neuropathic foot and what can we do to change it?
