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

Day 1:

Surgical Techniques:
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