Can Angiosome-Based Revascularization Have An Impact In Limb Salvage?

Desmond Bell, DPM, CWS, FACCWS | 32,435 reads | 2 comments | 02/28/2012

This author details the case of a 71-year-old patient who had reperfusion procedures for occlusions at the dorsalis pedis and posterior tibial arteries, and subsequently had transmetatarsal and below-knee amputations.

Here one can see an ischemic ulcer in a patient with diabetes. The authors say the endovascular approach to the ischemic diabetic foot has lead to a 96 percent one-year limb salvage rate at their institution. (Photo courtesy of Jonathan Moore, DPM, and Pa

Have Endovascular Advances Reinvented Limb Salvage Expectations?

By Francesco Serino, MD, and Yimei Cao, MD | 8,930 reads | 0 comments | 09/03/2008

In the early 1980s, LoGerfo opened the window of limb salvage in critical stages of diabetic atherosclerosis by fighting the misconception of microangiopathy that had previously prevented attempts to bypass arterial lesions in diabetic foot.1 He produced evidence that revascularization of distal diabetic arterial occlusions can be successful. This evidence in turn gave a fundamental push to expand and improve techniques of distal bypass.2,3

Here one can see a non-healing ulceration in a male patient with peripheral vascular disease, diabetes and Charcot arthropathy. (Photos courtesy of Intermountain LDS Hyperbaric Medicine Department)

Is There A Role For HBO In Limb Salvage?

By Harriet W. Hopf, MD, and Caroline E. Fife, MD | 35,581 reads | 0 comments | 08/03/2008

   There are 15 million people in the United States with diabetes mellitus, half of whom are undiagnosed.

Cheering On The Champions Of Limb Salvage

Kathleen Satterfield DPM FACFAOM | 3,902 reads | 0 comments | 08/10/2010

Podiatry Today’s recent poll showed that not all of our colleagues are happy with their career choice (see Among those are several podiatrists, who are now nearing retirement and were not fortunate enough to have gotten residency programs years ago. They have not been able to practice to the fullest extent of their potential and they feel that they were cheated out of what they could have done.

How To Form A Diabetic Limb Salvage Team

Manish Bharara, PhD, Christy L. Scimeca, DPM, Timothy K. Fisher, DPM, Heather R. Kimbriel, BS, Joseph L. Mills, MD, and David G. Armstrong, DPM, PhD, MD | 20,667 reads | 0 comments | 05/20/2010

Given the potential risk of amputation among people with diabetes, multidisciplinary teams are critical to facilitate timely diagnostic assessment and appropriate interventions. Accordingly, these authors review the literature on multidisciplinary care for this high-risk patient population and share insights from their experience on the vital skill sets needed to facilitate improved patient outcomes.

Evaluating And Refining The Team Approach To Limb Salvage

Guy R. Pupp, DPM, and Desiree Scholl, DPM | 13,809 reads | 0 comments | 09/22/2010

Recent data suggests that three visits to a podiatrist prior to development of an ulceration correlates with better overall outcomes with fewer hospitalizations and decreased associated healthcare costs for patients with diabetes.1 As the incidence of diabetes continues to rise among the general population, this study reinforces the value of the podiatric physician within the community and the overall realm of public health.

Limb Salvage And The Charcot Foot: What The Evidence Shows

Guy Pupp, DPM, FACFAS, and Robert Koivunen, DPM | 29,885 reads | 0 comments | 02/23/2011

Treating Charcot foot deformities can be quite challenging. Accordingly, these authors discuss the etiology and diagnostic keys with this condition, weigh in on various surgical options, and share emerging perspectives on fixation and the potential of orthobiologics in facilitating limb salvage.

Rethinking Proper Patient Selection For Limb Salvage Interventions

By Ronald A. Sage, DPM | 10,760 reads | 0 comments | 08/03/2006

   Reducing the number of lower extremity amputations is a goal for all clinicians caring for patients with diabetes. In spite of this, the numbers of limb-threatening infections and subsequent amputations continue to rise each year. While medical and surgical interventions are frequently successful in facilitating limb salvage in patients facing amputation, failures in limb salvage attempts do occur. These failures result in multiple trips to the operating room, significant potential morbidity and prolonged disability.

External Fixation: Is It The Answer For Diabetic Limb Salvage?

By Guy R. Pupp, DPM, and Peter M. Wilusz, DPM | 11,376 reads | 0 comments | 07/03/2004

There has been a six-fold increase in diabetes mellitus over the last four decades in the United States.1 Indeed, 798,000 new diabetic patients are diagnosed each year in the U.S.2,3 The statistics are particularly disturbing when it comes to lower extremity amputation among people with diabetes.

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

By Jessica Kaylor, BA, and John S. Steinberg, DPM | 21,032 reads | 1 comments | 03/03/2007

      Although the patient with diabetes and renal failure presents serious challenges to the limb salvage team, there is evidence and argument to support aggressive treatment and attempted limb salvage in a multidisciplinary clinical environment. An abundance of medical literature discusses the separate wound care challenges posed by diabetes and renal failure.       Less work has been done, however, to identify proper treatment and salvage techniques for patients who suffer from both maladies.