Is Limb Salvage Practical In Patients With Diabetes And Renal Failure?

By Jessica Kaylor, BA, and John S. Steinberg, DPM


1. Sanchez LA, Goldsmith J, Rivers SP, Panetta TF, Wengerter KR, Veith FJ. Limb salvage surgery in end stage renal disease: is it worthwhile? J Cardiovasc Surg (Torino). 1992 May-Jun;33(3):344-8.
2. Lawrence A. Foot care education in renal patients with diabetes. EDTNA ERCA J. 2004 Jul-Sep;30(3):153-6. Review.
3. Lim TS, Finlayson A, Thorpe JM, Sieunarine K, Mwipatayi BP, Brady A, Abbas M, Angel D. Outcomes of a contemporary amputation series. ANZ J Surg. 2006 May;76(5):300-5.
4. Georgopoulos S, Filis K, Vourliotakis G, Bakoyannis C, Papapetrou A, Klonaris C, Papalambros E, Bastounis E. Lower extremity bypass procedures in diabetic patients with end-stage renal disease: is it worthwhile? Nephron Clin Pract. 2005;99(2):c37-41. Epub 2004 Dec 21.
5. O'Hare A, Johansen K. Lower-extremity peripheral arterial disease among patients with end-stage renal disease. J Am Soc Nephrol. 2001 Dec;12(12):2838-47. Review.
6. Boufi M, Ghaffari P, Allaire E, Fessi H, Ronco P, Vayssairat M. Foot gangrene in patients with end-stage renal disease: a case control study. Angiology. 2006 May-Jun;57(3):355-61.
7. Koch M, Trapp R, Kulas W, Grabensee B. Critical limb ischaemia as a main cause of death in patients with end-stage renal disease: a single-centre study. Nephrol Dial Transplant. 2004 Oct;19(10):2547-52. Epub 2004 Jul 20.
8. Simsir SA, Cabellon A, Kohlman-Trigoboff D, Smith BM. Factors influencing limb salvage and survival after amputation and revascularization in patients with end-stage renal disease. Am J Surg. 1995 Aug;170(2):113-7.
9. Edwards JM, Taylor LM Jr, Porter JM. Limb salvage in end-stage renal disease (ESRD). Comparison of modern results in patients with and without ESRD. Arch Surg. 1988 Sep;123(9):1164-8.
10. O’Hare AM, Sidawy AN, Feinglass J, Merine KM, Daley J, Khuri S, Henderson WG, Johansen KL. Influence of renal insufficiency on limb loss and mortality after initial lower extremity surgical revascularization. J Vasc Surg. 2004 Apr;39(4):709-16.
11. Reddan DN, Marcus RJ, Owen WF Jr, Szczech LA, Landwehr DM. Long-term outcomes of revascularization for peripheral vascular disease in end-stage renal disease patients. Am J Kidney Dis. 2001 Jul;38(1):57-63.
12. Larsson J, Apelqvist J, Agardh CD, Stenstrom A. Decreasing incidence of major amputation in diabetic patients: a consequence of a multidisciplinary foot care team approach? Diabet Med. 1995 Sep;12(9):770-6.
13. Edmonds M. Diabetic Foot Ulcers: Practical Treatment Recommendations. Drugs. 2006;66(7):913-929.
14. Miyajima S, Shirai A, Yamamoto S, Okada N, Matsushita T. Risk factors for major limb amputations in diabetic foot gangrene patients. Diabetes Res Clin Pract. 2006 Mar;71(3):272-9. Epub 2005 Aug 31.
15. Stone PA, Back MR, Armstrong PA, Flaherty SK, Keeling WB, Johnson BL, Shames ML, Bandyk DF. Midfoot amputations expand limb salvage rates for diabetic foot infections. Ann Vasc Surg. 2005 Nov;19(6):805-11.
16. Faglia E, Clerici G, Caminiti M, Quarantiello A, Gino M, Morabito A. The role of early surgical debridement and revascularization in patients with diabetes and deep foot space abscess: retrospective review of 106 patients with diabetes. J Foot Ankle Surg. 2006 Jul-Aug;45(4):220-6.
17. Deery HG 2nd, Sangeorzan JA. Saving the diabetic foot with special reference to the patient with chronic renal failure. Infect Dis Clin North Am. 2001 Sep;15(3):953-81. Review.
18. Korzets A, Ori Y, Rathaus M, Plotnik N, Baytner S, Gafter U, Isakov E. Lower extremity amputations in chronically dialysed patients: a 10 year study. Isr Med Assoc J. 2003 Jul;5(7):501-5.
19. Johnson BL, Glickman MH, Bandyk DF, Esses GE. Failure of foot salvage in patients with end-stage renal disease after surgical revascularization. J Vasc Surg. 1995 Sep;22(3):280-5; discussion 285-6.
20. Attinger CE, Ducic I, Neville RF, Abbruzzese MR, Gomes M, Sidawy AN. The relative roles of aggressive wound care versus revascularization in salvage of the threatened lower extremity in the renal failure diabetic patient. Plast Reconstr Surg. 2002 Apr 1;109(4):1281-90; discussion 1291-2.
21. El Sakka K, Fassiadis N, Gambhir RP, Halawa M, Zayed H, Doxford M, Greensitt C, Edmonds M, Rashid H. An integrated care pathway to save the critically ischaemic diabetic foot. Int J Clin Pract. 2006 Jun;60(6):667-9.



Podiatrists and Wound Care Specialists.
Over the past 40 years, Diapulse Wound Treatment System has proved repeatedly it completely heals Diabetic Wounds, much faster than conventional wound treatment. It also restores circulation to extremeties that have circulatory, and edema problems, caused by Diabetes. And finally, and most importantly, it many cases it PREVENTS amputation of extremeties, resulting from Diabetes. Diapulse is still very much around, and still extremely viable, but evidently, many of the younger Doctors and Nurses have either never heard of, forgot about, or thought this incredible modality was no longer available. It's FDA approved, and extremely inexpensive to have a unit in your practice, hospital or wound care center.
If you'd like to know more, please contact me:
John Ulrich
Texas area Diapulse Technology Consultant
Diapulse Corporation

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