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 | 8,990 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

Evaluating And Refining The Team Approach To Limb Salvage

Guy R. Pupp, DPM, and Desiree Scholl, DPM | 13,906 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.

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 | 35,768 reads | 0 comments | 08/03/2008

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

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

By Guy R. Pupp, DPM, and Peter M. Wilusz, DPM | 11,507 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.

Limb Salvage And The Charcot Foot: What The Evidence Shows

Guy Pupp, DPM, FACFAS, and Robert Koivunen, DPM | 30,787 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.

Can Endovascular Atherectomy Be Beneficial In Diabetic Limb Salvage?

By Peter Wilusz, DPM, and Guy Pupp, DPM | 18,074 reads | 0 comments | 11/03/2006

     The non-traumatic lower extremity amputation rate among people with diabetes mellitus has increased 38 percent from 1992 to 2002.1 The number of amputations has increased from 99,552 in 2000 to 110,000 in 2002.2 To appreciate this statistic, this is more than double the number of amputations on U.S. soldiers from the Civil War through Vietnam.3      Peripheral arterial disease (PAD) is largely undiagnosed.

Emphasizing The Multidisciplinary Approach To Diabetic Limb Salvage

Melissa Adams, DPM, and John S. Steinberg, DPM | 13,816 reads | 0 comments | 10/29/2008

   The prevalence of individuals with diabetes continues to rise. The disease now affects nearly 24 million Americans or 7.8 percent of the population of the United States.1 Consequently, the demand for diabetic foot care continues to increase and this is exemplified by the one-year incidence of newly occurring ulcerations in patients with diabetes ranging from 1 to 2.6 percent. 2

Examining The Role Of NPWT In Limb Salvage

Marie Keplinger, DPM, and John S. Steinberg, DPM | 13,187 reads | 0 comments | 11/23/2009

   Diabetic foot ulcerations are a significant public health concern and cause an increasingly heavy demand on our healthcare systems. Diabetic foot infections cause more than 300,000 admissions to hospitals each year, leading to approximately 92,000 amputations.1 The resulting wounds require intensive local wound care and are slow to heal, resulting in prolonged disability and hospitalization.

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 | 20,964 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.

Cheering On The Champions Of Limb Salvage

Kathleen Satterfield DPM FACFAOM | 3,918 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.