Basic Learning Pathway: Lower Extremity Infection and Limb Preservation

Learning Objectives of this Pathway:

• Understand the perioperative assessment of lower extremity infection
• Understand diagnostic aspects of lower extremity infection diagnosis
• Develop an understanding of lower extremity infection treatment and outcomes

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Day 1:

ACFAS Clinical Sessions:
Strategies in Wound Coverage

Diabetic Surgery – Complete Set

ACFAS Podcasts:

• Team Approach to Diabetic Limb Salvage
• Perioperative Management of the Patient with Renal Disease

JFAS Articles - Perioperative Assessment:

• Wukich et al:  Prevalence of Peripheral Arterial Disease in Patient with Diabetic Charcot Neuroathropathy
• Thorud et al:  Mortality After Nontraumatic Major Amputation Among Patients with Diabetes and Peripheral Vascular Disease:  A Systematic Review
• Attinger et al:  Preoperative Doppler Assessment for Transmetatarsal Amputation
• Caballero and Frykberg:  Diabetic Foot Infections
• Lavery et al:  Classification of Diabetic Foot Wounds
• Armstrong et al:  Leukocytosis is a Poor Indicator of Acute Osteomyelitis of the Foot in Diabetes Mellitus
• Frykberg et al:  Diabetic Foot Disorders:  A Clinical Practice Guideline (2006 Revision)
• Raspovic and Wukich:  Self-Reported Quality of Life and Diabetic Foot Infections
• Yong et al:  The Durability of the Semmes-Weinstein 5.0 Monofilament
  

JFAS Articles - Diagnosis:

• Lavery et al:  Are We Misdiagnosing Diabetic Foot Osteomyelitis?  Is the Gold Standard Gold?
• Sybenga et al:  Diagnosing Osteomyelitis:  A Histology Guide for Pathologists
• Meyr et al:  Statistical Reliability of Bone Biopsy for the Diagnosis of Diabetic Foot Osteomyelitis
• Lavery et al.  Diagnostic Utility of Erythrocyte Sedimentation Rate and C-Reactive Proteinin Osteomyelitis of the Foot in Persons without Diabetes
• Meyr et al:  Level of Agreement with a Multi-Test Approach to the Diagnosis of Diabetic Foot Osteomyelitis
• Ryan et al:  Do SIRS Criteria Predict Clinical Outcomes in Diabetic Skin and Soft Tissue Infections?
• Fujii et al:  Efficacy of Magnetic Resonance Imaging in Diagnosing Diabetic Foot Osteomyelitis in the Presence of Ischemia

JFAS Articles - Treatment:

• Lipsky et al:  Utility of culturing marginal bone in patients undergoing lower limb amputation for infection
• Cates et al:  The Vertical Contour Calcanectomy, an Alternative Approach to Surgical Heel Ulcers:  A Case Series
• Thorud et al:  Reoperative and Reamputation after Transmetatarsal Amputation:  A Systematic Review and Meta-Analysis
• Boffeli et al:  Incidence and Clinical Significance of Heterotopic Ossification after Partial Ray Resection
• Bonanno and Gillies:  Flexor Tenotomy Improves Healing and Prevention of Diabetes-Related Toe Ulcers:  A Systematic Review
• Armstrong et al:  Is Prophylactic Diabetic Foot Surgery Dangerous?
• Fleischer et al:  Post-Treatment Leukocytosis Predicts an Unfavorable Clinical Response in Patient with Moderate to Severe Diabetic Foot Infections
• Nerone et al:  Reamputation after Minor Foot Amputation in Diabetic Patients:  Risk Factors Leading to Limb Loss
• Borkosky and Roukis:  Incidence of Repeat Amputation after Partial First Ray Amputation Associated with Diabetes Mellitus and Peripheral Neuropathy:  An 11-Year Review

The ACFAS learning pathways are a tool to be used by residency directors, fellowship directors and school faculty to aid with didactic learning during the COVID-19 crisis. They are not intended to replace a curriculum, but to supplement student and resident education during this time of need. The learning pathways are divided into basic, intermediate, and advanced categories. Pathways have been organized into specific topics that have a variety of educational materials from the ACFAS On Demand course content. They also include journal articles with links primarily from The Journal of Foot & Ankle Surgery (JFAS).