Cath Lab Digest

   Overall costs of limb preservation and salvage not only include those direct healthcare dollars but also involve the socioeconomic and psychosocial consequences of chronic ulcerations and amputations on patients and their families. For further involvement, there are numerous local and national organizations such as “Save A Leg, Save A Life,” that are dedicated to the team approach to limb salvage. Additionally, annual conferences such as the Diabetic Limb Salvage conference (www.dlsconference.com) are aimed at further development of the team approach to limb preservation and salvage.

   Dr. Pupp is a Fellow of the American College of Foot and Ankle Surgeons. He is the Director of the Foot and Ankle Clinic at Oakland Regional Hospital in Southfield, Mich. He is also a member of the Residency Training Committee at Providence Hospital in Southfield, Mich.

   Dr. Scholl is a PGY-3 surgical resident at Providence Hospital in Southfield, Mich.

   Dr. Steinberg is an Assistant Professor in the Department of Plastic Surgery at the Georgetown University School of Medicine in Washington, D.C. He is a Fellow of the American College of Foot and Ankle Surgeons.

References:

1. Gibson T, Bagalman E, Wang S, et al. Podiatrist care and likelihood of amputation or hospitalization for patients with diabetes and foot ulcer. Late breaking abstract poster presentation, American Diabetes Association’s Scientific Sessions, June 2010, Orlando, FL. Diabetes 2010; 59(suppl1).
2. Singh N, Armstrong DG, Lipsky BA. Preventing foot ulcers in patients with diabetes. JAMA Jan 12 2005; 293(2):217-228.
3. Izumi Y, et al. Risk of re-amputation in diabetic patients, stratified by limb and level of amputation: a 10-year observation. Diabetes Care 2006; 29(3):566-70.
4. Ziegler-Graham K. Estimating the prevalence of limb loss in the United States–2005-2050. Arch Physical Med Rehab 2008; 89(3):422-439.
5. Adler AI, et al. Lower extremity amputation in diabetics: independent effects of PVD, sensory neuropathy and foot ulcers. Diabetes Care 1999; 22(7):1029-35.
6. National Limb Loss Information Center. Available at http://www.amputee-coalition.org/nllic_about.html
7. Aulivola B, Hile CN, Hamdan AD, et al. Major lower extremity amputation:outcome of a modern series. Arch Surg 2004; 139(4):395-399.