Experts At DFCon 2010 To Combat ‘Amputation Tsunami’

David G. Armstrong DPM MD PhD
3/16/10 | 2839 reads | 0 comments
With an amputation performed every 30 seconds due to diabetes-related complications we are dealing with a worldwide amputation tsunami. The Diabetic Foot Global Conference (DFCon 2010) serves as something of an early warning system for doctors worldwide. Read More.

Can An Electrical Stimulation Device Be Part Of A ‘Pacemaker’ In Neuropathic Patients?

David G. Armstrong DPM MD PhD
2/16/10 | 2748 reads | 0 comments
For patients with diabetic and motor neuropathy, an electrical stimulation device, combined with pressure monitoring and thermometry, may be able to act as a “pacemaker” to stimulate the foot. At the Southern Arizona Limb Salvage Alliance (SALSA), we have become increasingly interested in the Walkaide system (Hanger Orthopaedics) and its potential future as a delivery system for extracorporeal nerve and muscle stimulation. The device uses electrical stimulation to improve walking in patients with post-stroke footdrop, according to the company. Read More.

Can Walking Sensors Help Predict The Outcome Of Diabetic Limb Salvage Surgery?

David G. Armstrong DPM MD PhD
1/25/10 | 2496 reads | 0 comments
In the past, surgery designed to heal wounds or reduce the risk for development of wounds in people with diabetes has been haphazard. A recently published pilot study in Gait & Posture suggests strongly that we can work toward predicting success preoperatively.1 See Read More.

A Closer Look At The Plantar Fat Pad In People With Diabetes

David G. Armstrong DPM MD PhD
12/21/09 | 3751 reads | 0 comments
At the Southern Arizona Limb Salvage Alliance (SALSA), we have been fascinated with a recent paper by our colleagues Hsu and co-workers from the Chang Gung Memorial Hospital and National Taiwan University Hospital. These authors suggest that the plantar fat pad -- that specialized fat that exists on the sole of every one of us -- may undergo changes in people with diabetes. To make a long story short, fewer small “microchambers” of fat make it less cushy and more susceptible to ulceration. We invite you to give the work a read. See Read More.

A Closer Look At The Roles Of Advanced Therapies Within The Wound Healing Spectrum

David G. Armstrong DPM MD PhD
11/24/09 | 2441 reads | 0 comments
There has been a consistent request for some clarity on where various classes of wound healing modalities may fit along a timeline. Rather than adhere to a "one size fits all" concept, more clinicians have moved toward a multimodal approach. However, there is a variety of questions when it comes to optimal use of these modalities to help ensure optimal outcomes. Read More.

Can Teams Trump Technology When It Comes To Optimal Care For High-Risk Patients?

David G. Armstrong DPM MD PhD
11/3/09 | 2336 reads | 0 comments
Can teams trump technology in the new healthcare debate? I ask this question because I continuously see many patients referred to the Southern Arizona Limb Salvage Alliance (SALSA) who have been relegated to amputation. This is not because they have not had access to technology. In fact, most have had extensive work done by well-intentioned clinicians. What frustrates me, and I know my SALSA partners agree as well, is the lack of access to a team. Read More.

Current SALSA Research Efforts To Preserve The Pedal Peninsula

David G. Armstrong DPM MD PhD
10/2/09 | 3786 reads | 0 comments
Greetings from the Southern Arizona Limb Salvage Alliance (SALSA). Joseph Mills, MD, and I recently did an interview with one of our professional magazines and we were reflecting on the unique nature of the diabetic foot. The diabetic foot is at the end of what I refer to as an “anatomic peninsula.” For that reason, the diabetic foot is hostage to the supply from the “anatomic mainland.” Read More.

Wound Chemotherapy: Can It Help Facilitate Optimal Outcomes?

David G. Armstrong DPM MD PhD
8/18/09 | 2932 reads | 0 comments
At the Southern Arizona Limb Salvage Alliance (SALSA), we are frequently saddled with the most complex patients (and wounds) I have worked with in my career. Our "Toe and Flow" philosophy has been evolving to develop what we call “wound chemotherapy.” Lately, we have been very active in modifying many of the techniques first described by Wim Fleischmann, MD, PhD, and others to provide active matrix management (negative pressure wound therapy) with other chemotherapeutic tools (i.e. antimicrobials/antiseptics, analgesics, etc.) to manipulate the wound environment. Read More.

SALSAisms: Lingo From The University Of Arizona's "Toe And Flow" Service

David G. Armstrong DPM MD PhD
7/14/09 | 3686 reads | 1 comments
On our "toe and flow" service at the Southern Arizona Limb Salvage Alliance (SALSA), we often operate in close quarters. This has led to many appellations for and colloquialisms used by various team members. Here is a partial (and running) list: 1. Toe Bless Oblige: The obligation to improve foot care 2. Podshine 3. Der DopplerGanger: Referring to one's vascular partner 4. Sir I-Pod: International podiatrist 5. PodCaster 6. Toe Mechanic 7. Podiatric physician extender: Given to our vascular surgical team Read More.