A Focus on Amputation Level: Factors Preventing Length Preservation in the National Inpatient Sample

Great work by Fan et al from Georgetown. Bottom line: rural v. urban and revascularization again show a significant effect on amputation level. Abstract Background: Diabetic lower-extremity disease is the primary driver of mortality in patients with diabetes. Amputations at the forefoot or ankle preserve limb length, increase function, and, ultimately, reduce deconditioning and mortality... Continue Reading →

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.... Continue Reading →

Wound healing with “spray-on” autologous skin grafting (ReCell) compared with standard care in patients with large diabetes-related foot wounds: an open-label randomised controlled trial – PubMed

There is an urgent need for interventions that improve healing time, prevent amputations and recurrent ulceration in patients with diabetes-related foot wounds. In this randomised, open-label trial, participants were randomised to receive an application of non-cultured autologous skin cells ("spray- … — Read on pubmed.ncbi.nlm.nih.gov/34156758/ There was no difference in healing between active and control... Continue Reading →

Design of a partially virtual diabetic service improves access to care and education and reduces amputation incidence @diabetesrc @ALPSlimb

Important work from the Devon NHS trust, UK. Service user and community clinician design of a partially virtual diabetic service improves access to care and education and reduces amputation incidence Significance of this studyWhat is already known about this subject? ► Quality outcome framework, education and multi- disciplinary secondary care have improved services for diabetes... Continue Reading →

Outcomes after Emergency Admission with a Diabetic Foot Attack Indicate a High Rate of Healing and Limb Salvage But Increased Mortality

Timely work from our SALSAmigos at King's. Aim The diabetic foot attack (DFA) is perhaps the most devastating form of diabetic foot infection, presenting with rapidly progressive skin and tissue necrosis, threatening both limb and life. However, clinical outcome data in this specific group of patients are not available. Methods Analysis of 106 consecutive patients who underwent emergency hospitalisation... Continue Reading →

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... Continue Reading →

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