Does Your Hospital Have A DRRAFT?

David G. Armstrong DPM MD PhD

In the ongoing collaboration between the Infectious Diseases Society of America (IDSA) ( and the Southern Arizona Limb Salvage Alliance (SALSA) (, we have proposed the following key skill set for any multidisciplinary team dedicated to amputation prevention.

We refer to this team as the Diabetic Rapid Response Acute Foot Team (DRRAFT). Here are the key skills for such a team.

1. The ability to perform hemodynamic and anatomic vascular assessment with revascularization as necessary.

2. The ability to perform a neurologic workup.

3. The ability to perform site-specific culture technique.

4. The ability to do a wound assessment and appropriate staging/grading of infection and ischemia.

5. The ability to perform site-specific bedside and intraoperative incision and debridement.

6. The ability to initiate and modify culture-specific and patient-appropriate antibiotic therapy.

7. The ability to perform appropriate postoperative monitoring to reduce risks of re-ulceration and infection.

The manuscript outlining these skills was recently published in the online edition of the plastic surgery journal ePlasty (

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