731 search results for "amputation prevention"

Houston’s Third Annual Amputation Prevention Summit Scheduled for March 23rd

The third annual Amputation Prevention Summit will be held on Saturday, March 23, 2019 at Memorial Hermann Greater Heights, 1635 North Loop West, South Tower, First Floor, Houston, Texas, drawing clinicians from Houston and surrounding region. Memorial Hermann is the only health system in the Houston area that is part of the Amputation Prevention Centers of America® network … This CME event aims to highlight the urgent nature of the diabetes epidemic, the prevalence of peripheral arterial disease and diabetic foot ulcers, and how healthcare professionals can change and improve their practice in order to reduce lower extremity amputations … Diabetes is among the top 10 leading causes of death in Texas and the leading cause of non-traumatic lower extremity amputation. The risk of leg amputation for people with diabetes is 15 to 40 times greater than for a person without diabetes. Within two to four years of unilateral limb loss, one-third of all patients lose the other leg. Sadly, only about 50 percent of amputees survive within five years following a leg amputation due to ongoing complications of the chronic disease. With the future incidence of diabetes projected to rise to 550 million people worldwide by the year 2030, limb salvage is becoming a viable alternative, often producing better outcomes than amputation … read more

Beverly Hospital Hosts Amputation Prevention Summit

Beverly Hospital will be hosting its first Amputation Prevention Summit on Saturday, September 29, 2018 on the hospital campus at 309 West Beverly Boulevard, Montebello, California, drawing clinicians from the greater Los Angeles area.

This educational event will highlight the urgent nature of the diabetes epidemic— diabetes being among one of the top ten leading causes of death in California and the leading cause of non-traumatic lower extremity amputation. Guest speakers will share important data, current trends in limb salvage and best-practices in the battle against diabetes-related complications. They will also discuss ways healthcare professionals can improve their practices in order to reduce lower extremity amputations.

A person with diabetes has a risk of leg amputation that is 15-40 times greater than a person without diabetes. Within two to four years of unilateral limb loss, one-third of all patients lose the other leg. Only about 50% survive more than five years following a leg amputation. With the future incidence of diabetes projected to rise to 550 million people worldwide by the year 2030, limb salvage is becoming a viable alternative, often producing better outcomes than amputation … read more

The Miller-Newgent Amputation Scale

A comprehensive scoring system to evaluate patient-centered risk factors regarding lower extremity amputation

Abstract: Care of the patient with a presumed life- or limb-threatening lower extremity wound poses many challenges. The mindset regarding potential outcomes of such conditions is mostly driven by the experiences and expertise of those providing the care. This mindset generally appears as two primary actions presented to the afflicted patient: attempted resolution of the problem via medical, surgical or combination treatment, with the hope of low recurrence risk, or exacerbation and amputation—amputations at a level sufficient to, at least in the mind of the surgeon, eliminate the problem. Achieving the former outcome is dependent on a number of factors associated with both patient and caregiver. If healing is achieved, the secondary goal of prevention of recurrence may be no less arduous, with failure most likely resulting in amputation. Clearly, these considerations appear to be based more on the health professionals perception, of the patient’s physical and medical status rather than on patient-centered considerations. This article will review considerations and recommendations for lower extremity amputation, and the short- and long-term implications. Based on our research, there is clear need for a set of criteria against which to weigh not just the medical issues, but also definitive patient-centered issues when considering a lower extremity amputation. We offer a set of patient-centered, easily verified and recognized criteria that we believe addresses this need. The goal of the Miller-Newgent Amputation Scale (MENACE) is to provide a decision base from which to consider and evaluate all factors in determining the need for a lower extremity amputation. This involves identification of patient-centered issues, which are likely to produce satisfactory short- and long-term physical and quality-of-life outcomes if the amputation does proceed.

Declaration of interest: The authors have no conflict of interest to declare. The lead author, as a Board Certified general surgeon with 23 years’ experience in the field of advanced wound care, has been involved in the different aspects to amputation and its considerations and a common thread my colleagues and I have identified is that the expertise of those attempting to heal and salvage limbs was largely ineffectual. More often than not, the progression of high-risk conditions mandated lower extremity amputation. The progression of technology, science and products to promote healing is thought to improve limb salvage rates; however, there has not been an appreciable reduction in amputations. The thought is that those possessing the skill, knowledge and desire to promote limb salvage (which entails greater time and effort with considerably lower compensation) are few and far between. Despite advances in medical care, the rates of lower extremity amputation are unchanged at best or are even increasing.

Despite educational programmes touting the newest technologies for vascular intervention and advanced wound healing to mitigate those conditions commonly leading to amputation, there has been minimal change in the willingness of health professionals to consider limb salvage and indications for amputation have changed minimally. There is a clear need for a matrix against which to compare and contrast the clinical and non-clinical considerations for amputation. Since the patient is the one undergoing this potentially horrific procedure, it is only fair that all aspects of the procedure must be considered as an integral part of the decisionmaking process. The Miller-Newgent Amputation Scale (MENACE) scale was created to provide a patientcentred guide using simple, easily identified information that directly impacts on all aspects of the amputation decision process.

Background Considerations for the intentional removal of a body part have their roots in antiquity. Matthew 5:29–30, 18:8–9 and Mark 9:43–47 are commonly recognised biblical references to amputation. Lower extremity amputation is one of the oldest known surgical practices with Hippocrates among others providing insights.

In the US, 30,000–40,000 amputations are performed annually. In 2005, there were an estimated 1.6 million individuals living with the loss of a limb; by 2050, this figure is expected to rise to 3.6 million.

In 1954, Silbert and Hamiovici published an article recommending that lower extremity amputation be avoided, preferring more conservative surgeries such as supracondylar amputations as opposed to mid-leg amputations. In the paper they cited the Handbook on Amputations, published in 1942 by the Council on Physical Therapy of the American Medical Association, which expressed the opinion of most surgeons, when it advised the use of supracondylar amputations and warned against mid-leg amputations: an opinion justifiable at the time before the advent of antibiotics.

The Netherlands Society of Physical and Rehabilitation Medicine in October 2012 published its guideline on Amputation and Prosthetics of the Lower Extremities in which it recommended that the interventional radiologist, vascular internist and rehabilitation physician collectively identify and resolve those clinical issues before proceeding with a lower extremity amputation. Further, the guidelines state that treatment by a multidisciplinary team (MDT) involving a surgeon, anaesthesiologist, pain specialist, rehabilitation specialist, and possibly an internist is necessary for treatment of pain, cardiovascular risks, comorbidity and the co-determination of the level of amputation. The article identified many of the clinical indications for lower extremity amputation found in the literature; however, there is the same omission of any patient-centred, non-clinical concerns.

Table 1. Estimated change in metabolic energy expenditure based on level of amputation

Reyzelman and Kim presented their idea of acceptable considerations for partial tissue removal (digital amputation) based on presenting conditions including: osteomyelitis, septic arthritis, gas gangrene, ischaemia/ gangrene and an advancing soft tissue infection. The authors concluded that early digital amputation in the appropriate patient allowed patients a return to normal activity with minimal disability.

Kalapatapu attempted to provide a compendium of indications for lower extremity amputation by providing an exhaustive listing of essentially all lower extremity morbidities. He stated:

‘Primary amputation may be the only option for
patients without an anatomic option for
revascularisation or those with medical risk factors that
contraindicate revascularisation.’

Recognising that the spectrum of surgical and medical skills is considerable, and that there are an almost limitless number of non-medical factors, even attempting to define specific conditions as the basis for amputations is extremely problematic and potentially precludes the surgeon and thus the patient from any consideration of limb salvage.

A patient presenting with a condition prompting even the slightest consideration for lower extremity amputation likely has other issues related directly or indirectly to the presenting condition itself. It is a small leap of faith to recognise that an increase in metabolic demand places greater stress systemically on the patient with a concurrent risk of exacerbating current comorbidities as well as promoting new ones. These increased energy expenditures clearly mandate the highest scrutiny of a patient’s physical condition, both pre- and postoperatively, before undertaking any surgical consideration including lower extremity amputation. Recognising that the loss of an extremity means a dramatic change in the metabolic as well as mental status of the body, the failure to include these considerations potentially impacts on the ability of the patient to engage in activities of daily living. Estimates of the changes in metabolic energy expenditure based on the level of the amputation are shown in Table 1.

However, the definitive consideration must be the effect of survival from a lower extremity amputation since this takes all factors together under a single irreversible endpoint. Survival rates for individuals with dysvascular pathology undergoing major lower extremity amputations including (above the knee amputation) AKA and BKA (below the knee amputation) have been reported as 69.7% and 34.7% at 1 and 5 years, respectively.12 Mortality was found to be significantly higher for patients who underwent AKA (50.6% and 22.5% at 1 and 5 years) as compared with BKA (74.5% and 37.8% at 1 and 5 years).

Although amputation can be considered a failure of treatment, the actual considerations must be based on a number of factors, even when the initial impression is that salvage of the limb is untenable. There are still general categories of lower extremity conditions in which limb salvage is not appropriate. These would include traumatic limb loss or significant tissue deformation from motor vehicle or industrial accidents, malignancies whose location or dissemination precluded salvage, and congenital malformations precluding use of prosthetics or achieving a functional end result. Excluding the majority of these still leaves a considerable number of lower extremity conditions, in which the end result, amputation, unquestionably puts the patient at a higher risk of morbidity and mortality than before the decision to perform the procedure.

At present, the decision to recommend lower extremity amputation appears to be universally based on objective medical issues. Without recognising and attending to the equally important and pervasive, nonclinical, patient-centred issues, the decision is usually made based on the surgeon’s tunnel vision. The most basic tenet becomes that of removing the problem as the key to resolving the problem. As Ertl aptly stated:

‘The only contraindication for amputation is poor
health that impairs the patient’s ability to tolerate
anaesthesia and surgery. However, the diseased limb is
often at the centre of the patient’s illness, leading to a
compromised medical status. The removal of the
diseased limb is necessary to eliminate systemic toxins
and save the patient’s life.’

Unfortunately, the mere removal of an afflicted lower extremity under the guise of resolving the issue takes on a ‘low-hanging fruit’ mentality as it fails to address equally important patient-centred issues that often define the progress and ultimate outcome.

The identification of any criteria regarding the appropriateness of a lower extremity amputation based on patient-centered, non-clinical criteria has been found to be nonexistent despite an exhaustive literature search. This covered 70 years and approximately 200 citations. Brigham and Women’s Hospital in Boston uses a Pre-Amputation Assessment Checklist that, while comprehensively identifying specific patient expectations and information, does not consider any patient-centered criteria for amputation. Therefore, the Brigham tool does not recognize the potential issues and ultimate outcomes surrounding amputation. In contrast, the MENACE SCALE and its patent-centered components focus the attention on those issues related to non-clinical outcomes when lower extremity amputation is considered.

Table 2

The MENACE scale

It is not enough to objectively quantify only the clinical considerations for lower extremity amputation. The resulting amputation and the effect on quality-oflife must be taken into account. For that reason, there must be a combination of clinical factors together with non-clinical factors. The impact of these patientcentred, non-clinical factors cannot be overstated. The loss of all or part of a limb has a major psychological impact on the patient’s mental status. The psychological effects of amputation can be related to postoperative pain, cosmetic appearance, cultural and social effects, all potentially causing or exacerbating anxiety and depression.

We believe that any initial consideration for lower extremity amputation, regardless of the presenting issues, can be based on two primary factors. Those two factors are intractable pain and functionality in the presence of a potentially life- or limb-threatening condition. While these factors may at first appear to be objective they are equally dependent on the patient’s subjective impressions of their condition.

In considering the issues that ‘open the door’ to amputation, the authors felt that this process is analogous to ‘looking through a keyhole’ from which only a narrowed view is possible. We chose the term ‘keyhole criteria’ to represent this process as initial consideration regarding amputation. The two criteria (Table 2) establish a platform that forms the basis for the critical decision of amputation. These criteria move the decision from one that is based solely on the surgeon’s experience to a more germane one that encompasses considerations of the patient as a whole.

Criterion 1 is significant in that there are lower extremity conditions including neurologic, musculoskeletal or other deficits where attempted preservation would offer no benefit to the patient. When these presentations are associated with debilitating pain, then this criterion would be met and consideration for an amputation at some level would be appropriate. This criterion would require that all attempts be made to mitigate the pain. Thus, an acute presentation (following traumatic accident, postoperative complications from prosthetic implantation, etc.) would arguably require some time to be allowed to pass before accepting these criteria.

The issues regarding criterion 2 include preservation of the patient’s functionality and assumed morbidity and mortality of the presenting condition and that of the procedure. The goal of MENACE is to assure full consideration of all aspects of limb salvage versus amputation. Recognising that lesser procedures may provide both short- and long-term satisfactory outcomes, the issue of when to perform a lesser procedure and what that procedure may be, must be based on preservation of maximum functionality. For these reasons, attention must be directed to the patientspecific issues since information obtained provides the necessary elements required for a successful outcome. For example, the presence of distal pedal gangrenous changes in a diabetic neuropathic ulcer with a history of osteomyelitis poses a daunting problem. Not surprisingly, these findings would, in the vast majority of cases, lead to a strong recommendation for amputation. However, the usual discussion of potential complications and progression of disease state will generally lead to at least a discussion of the ‘benefits’ of simply removing the entire problem-containing lower limb. In contrast, the consideration of functionality is integral because it changes the discussion from one that obviates a potential progression of the presenting problem to one that recognises that retained maximum functionality allows ongoing quality-of-life based on retaining the limb. In simplest terms, if the extremity is still used to bear weight, provide propulsion in a wheelchair, transfer from chair to bed to commode, or even ambulate for any distance, then maintenance of that functionality takes on the highest priority. The goal becomes maximising the longevity and functionality of that extremity.

The authors believe that the two keyhole criteria represent a mandatory check step for medical providers who either perform or refer to those performing lower extremity amputation. These two criteria need to be used to ascertain the appropriateness of amputation for a given patient. This represents a marked departure from the practice that the decision be based on the perception of perceived benefit of amputation.

Initial evaluation of the patient’s presenting status with respect to the keyhole criteria should be undertaken. If the result is a decision to amputate, the MENACE scale assures that patient-centred factors are considered in the decision to amputate. Those factors placing the patient at risk for quality-of-life issues after surgery should be addressed well before amputation.

Table 3

The initial tool used by the authors was the 1–2 point scale to assess patient-centred factors. However, we recognised that the keyhole criteria were needed to focus the attention of the surgeon on what the authors felt were the two critical issues: pain and functionality.

With the focus now placed on the patient, those factors that impact on their lives both pre- and postoperatively need to be considered. While there are an infinite number of both specific and general categories to be considered, we believe that those factors identified in Table 3 represent the most salient, recognising the interrelationship of these factors and others not specifically identified.

The social status of the patient is integral to mental and physical wellbeing. Considerations must include: Who else is in the home? What will be the patient’s functional capacity both before and after the amputation? What is the expected effect on the family after amputation? Is the patient the primary breadwinner/caretaker for the family? Are there others who will be affected by the patient’s amputation status in the same environment (young children, teenagers, young adults, middle-agers)?

Habitation factors must include: where does the patient live (both geographically and in terms of the actual residence)? The geographic location, including changes in elevation (mountainous, or San Francisco hills), whether there are stairs to navigate, or consistently functioning lifts, and old versus new construction (ADA, Standards for Accessible Design related to the Americans With Disabilities Act)15 are all considerations that must be addressed before amputation.

Economic factors are the underpinning of what transpires with the patient and their direct family and friends. How will the patient’s economic status change after the amputation? Financial considerations are the bedrock on which much of the other issues achieve stability. Are they ready for retirement? Are they employable after amputation? Is there another breadwinner? Are they financially able to withstand loss of leg? What about the costs of treatment, prosthetics, devices? Are there accessible and available sources available to provide external financial support and can the patient access them (social security, disability insurance, etc.)? Is there adequate and sustained financial means either through a health insurance or other entity to pay for ongoing care including rehabilitation, care for any complications, medications, therapies, home health care, and if so for how long?

Interpersonal support and functional issues have the potential to create effects that reverberate throughout the entire recuperative period and beyond. What other intrinsic/extrinsic factors do they have to contend with? Do they live with conditions such as a small cluttered house (hoarder), ‘bad’ neighbourhood, difficulty getting to the grocery store, doctors, and social events? Is there inter-family stress such as abusive or uncaring children or relatives?

What psycho-emotional and self-perception issues are present? Do they already have body-centred issues (too fat, too skinny, too old, too sick …)? Is there a history of behavioural or mental health issues (depression, anxiety, obsessive compulsive disorder (OCD), schizophrenia, bipolar disorder, etc.)? How are they dealing with the potential amputation? Do they consider the recommendation for amputation a ‘death sentence’? Is there the opportunity to do something besides see the wound specialist all the time? How will they deal with the resultant disfigurement? The ultimate question is clearly: how important is that toe, foot, or leg to their life?

An exhaustive online search of the available literature identified definitive criteria/guidelines for removal of the gallbladder, appendix and performance of caesarean sections as well as numerous other surgeries. However, regarding amputation of a lower extremity, the overwhelming majority of articles that even entertain the rationale for performing the procedure present surgeon-based clinical considerations as the primary decision criteria and mention patient-centred factors only in passing.

Based on the experiences of the authors, there clearly needs to be a set of patient-centred criteria to juxtapose with the experiences of the surgeon and other providers integral to the decision-making process. We recognise that there are a myriad of compounding factors that affect provider and patient considerations that are easily overlooked and so a set of guidelines for evaluation such as the MENACE scale identifies those factors that can be easily evaluated and rectified.

The MENACE scale including the keyhole criteria has been used by the primary author for 23 years in one form or another. Explanation and review of the MENACE critera has been undertaken with our patients for whom amputation was the only alternative offered before coming to our clinics. In clinical practice, numerous encounters have occurred with patients marked for amputation in which their presenting condition was clearly (and ultimately) salvageable. Based on extensive clinical use, we believe that the appropriate use of this tool can balance the patient’s presentation using both the accepted medical/surgical objective criteria and the less often considered patientcentred criteria. In those situations the decision for amputation gains more credence as evaluation progresses, for those MENACE scale categories in which the highest score (2 points) is not present, appropriate actions and interventions are taken to maximise that score. For example, the patient who lives in an upperfloor apartment with an unreliable lifts should have their residence changed to one with greater accessibility even if this is to occur immediately after the surgery. The planned change allows for the full score for that category to be considered as accomplished despite its implementation postoperatively. The same holds for caregivers needed in the home following surgery. The key to MENACE is to recognise that maximising a successful outcome after the elective performance of a lower extremity amputation must be based on resolving as many patient-centred stumbling blocks as possible. We recognise that the act of doing so may not be appropriate for the surgeon themselves but believe strongly that it can be appropriately achieved by other entities including social workers, local, state and federal entities.

Based on our use of the MENACE scale in our own practices, we believe that a score of less than seven strongly suggests the highest potential for postoperative issues that will have an impact on the patient’s shortand long-term recovery and status. The failure to address identified issues both individually and collectively in the preoperative/perioperative periods may preclude a safe and complication-free recovery. MENACE was created to fill an unmet need. We understand that MENACE will require ‘real-life’ testing and validation. It is our expectation that when used alongside other criteria, it will provide a basis for expansion, revision, confirmation or deletion of the considerations we have proposed when a lower extremity amputation is considered.

Conclusion

The recommendation for, and performance of, a lower extremity amputation appears to be based primarily on criteria that remain undefined despite advances in all aspects of medicine. Although certain lower extremity presentations preclude safe attempts at limb salvage, there is clearly a trend towards performance based more on subjective criteria of the attending health-care providers than on clear objective patient-based criteria.

Lower extremity amputation does not merely remove all or part of the lower extremity. The interdependence of structure and function, both before and after amputation, and the potentially catastrophic consequences of failing to consider these factors, mandates that there be a specific and definitive categorical assessment of patient-centred factors rather than the current criteria, which are based solely on the skill, education and experience of the medical providers. When these decisions are based solely on their own criteria rather than those of the patient—who represents the primary consideration regarding a successful outcome—then failure to identity and resolve potential patient-centred issues means that the patient is not truly the focus of the intended procedure, although they will suffer any untoward effects. The loss of a lower extremity does not merely mean that a pending problem has been resolved but that the potential loss of the limb now presents its own life-affecting challenges well beyond the time that the surgical incision heals.

References
1 Quality Improvements Organization. Strategies to Help Reduce
Diabetes-Related Lower Extremity Amputations Among Minority
Populations. April 2017, https://tinyurl.com/yd3hcgrn (accessed 7
September 2017)
2 Murdoch G, Bennett-Wilson A Jr, Amputation: Surgical Practice and
Patient Management. Butterworth-Heinemann Medical, 1996.
3 Tooms RE. Amputations. In: Crenshaw AH (ed). Campbell’s Operative
Orthopedics (7th edn) Mosby-Year Book,1987: 597–637
4 Ertl JP. Amputations of the lower extremity. Medscape. 2016. http://bit.
ly/2uUFuEv (accessed 14 August 2011)
5 Zeigler-Graham K, Mackenzie EJ, Ephraim PL et al. Estimating the
prevalence of limb loss in the United States: 2005 to 2050. Arch Phys
Med Rehabil 2008; 89(3): 422-429. https://doi.org/10.1016/j.
apmr.2007.11.005
6 Silbert S., Haimovici H. Criteria for the selection of the level of
amputation for ischemic gangrene. JAMA 1954; 155(18): 1554–1558.
https://doi.org/10.1001/jama.1954
7 Book Notices: Handbook on Amputations JAMA 1942; 120(9):724.
https://doi.org/10.1001/jama.1942.02830440066028
8 Netherlands Society of Physical and Rehabilitation Medicine
(Nederlandse Vereniging van Revalidatieartsen – VRA). Guideline: amputation and prosthetics of the lower extremities. Utrect. 2012. http://bit.ly/2uCbGRM

9 Reyzelman A, Kim J. A guide to digital amputations in patients with
diabetes. Podiatry Today. 2011; 24(9). http://bit.ly/2wX6Ew2 (accessed 14
August 2011)
10 Kalapataku V. Lower extremity amputations. UpToDate. 2017. http://
www.uptodate.com/contents/lower-extremity-amputation (accessed 14
August 2017)
11 Karadsheh M. Amputations. Orthobullets.com. 2017. http://www.
orthobullets.com/trauma/1052/amputations (accessed 14 August 2017)
12 Brigham And Women’s Hospital Department of Rehabilitation
Services. Physical therapy standard of care: lower extremity amputation.
2011. http://bit.ly/2vwFFct (accessed 14 August 2011)
13 Hakami, K. Pre-operative rehabilitation evaluation of the dysvascular
patient prior to amputation. Phys Med Rehabil Clin N Am. 2009; 20(4):
677-688. https://doi.org/10.1016/j.pmr.2009.06.015
14 Bhuvaneswar CG, Epstein LA, Stern TA. Reactions to amputation:
recognition and treatment. Prim Care Companion J Clin Psychiatry 2007;
9(4): 303–308
15 ADA. Information and technical assistance. standards for accessible
design related to the Americans With Disabilities

Abstracts from the Amputation Prevention Symposium (AMP) August 11-14, 2021

An Endovascular Approach as a Backup for Open Surgery After Corynebacterium striatum Vascular Graft Infection
Gabriel C. Inaraja-Pérez, MD, PhD, FEBVS; Manoela Oliveira Brito, MD; Alejandra Bartolomé Sánchez, MD; Daniela Acuña Paz y Miño, MD; Eva María Martin Herrero, MD, PhD; Jose-Manuel Buisán-Bardají, Prof. MD; Jorge Coghi Granados, MD

A Hybrid Approach to ALI Utilizing Penumbra Aspiration Thrombectomy in Conjunction With Catheter-directed Thrombolysis
Emily M. Rey, DO; Ganesh Arun, DO; Kristian O. Hochberg, MD; Sang Lee, MD

Cost-Effectiveness of Office-Based Labs for Treating Peripheral Arterial Disease
Morish Shah; Ashish Chaturvedi, BS; Paramjit S. Chopra, MD; Manasvi Paudel, BS; Kashish Shah

Hybrid Approach for Chronic Limb-Threatening Ischemia: A Case Report

Vincent Demesmaker, MD; Arnaud Kerzmann, MD; Evelyne Boesmans, MD; Vlad Alexandrescu; Jean-Olivier Defraigne

Observations Regarding the Effect of COVID-19 on Amputations Performed in a Tertiary Referral Health System

Dayle K. Colpitts, DO; Richard F. Neville, MD, FACS, DFSVS; Arkadii Sipok, PhD; Anthony Comerota, MD, FACS

Salvage of Popliteal-Dorsalis Pedis Bypass: A Case Series

Crystal James, MD; Denise Alabi, BA; Mabel Chan, MD; So Park, MD; John C. Lantis, II, MD

PRELUDE BTK vs. POBA Analysis: Serration Angioplasty and POBA

Marianne Brodmann, MD

read more

Posted in Articles

Amputation Prevention: Your Role in Saving Limbs of Persons Living with Diabetic Foot Complications

by admin on February 1, 2021

The Amputation Prevention Symposium | August 17-20, 2022

Driven by a team of multidisciplinary course directors and led by Jihad A. Mustapha, MD, a pioneer in the field of interventional cardiology, AMP provides an unrivaled experience for endovascular and vascular specialists to gain knowledge on the latest advances in revascularization and explore groundbreaking techniques that will improve the future for CLI patients … The unequaled CLI education paired with the paramount interaction among faculty and attendees makes AMP an impactful, inspiring experience that you cannot miss … register

Corstrata Announces Availability of New Tech Empowered

Diabetic Foot Ulcer & Amputation Prevention Solution

SAVANNAH, GA. (PRWEB) JULY 10, 2018

CORSTRATA, a provider of digital healthcare IT solutions and services for wound management, announced today the availability of the company’s new Diabetic Foot Ulcer & Amputation Prevention Solution. The Solution is designed to prevent costly and complicated wounds from developing and is the first comprehensive program that leverages state-of-the-art technology and a team of top-tier Board Certified Wound Clinicians for the early detection of ulcers that often lead to hard-to-heal wounds and amputations among the growing U.S. diabetic population.

Diabetic foot ulcers (DFUs) are a common, limb-threatening and expensive complication of Type 1 and Type 2 diabetes. Today, more than 30M people in the U.S. have diabetes and more than 1.7M suffer from new DFUs per year with a 40% reulceration rate. 80K of these diabetics ultimately require an amputation and the risk of death at 5 years for DFU patients is 2.5 times as high as the risk for a patient with diabetes without a foot ulcer.

“The Corstrata Diabetic Foot Ulcer and Amputation Solution offers an important advancement in both the detection and prevention of one of the most costly and complex types of wounds to heal,” said Katherine Piette, Chief Executive Officer and Founder, Corstrata. “The mobile and remote monitoring technology combined with our deep clinical expertise in diabetic foot ulcer prevention and wound management, enable us to help payers and value-based care organizations significantly reduce their risk and costs associated with ulcerations in diabetic members.”

The Corstrata program is a comprehensive end-to-end technology-enabled solution that uses the HIPAA compliant, Corstrata Intervention & Engagement mobile app and the industry’s only FDA approved smart thermometric mat. The Solution is designed to help value-based care organizations and payers with the following:

High-Risk Patient Identification
Program Enrollment
Daily Remote Patient Monitoring
Member Engagement & Education
Timely Evidenced-Based Intervention for Prevention of DFU
Empowering Members for Self-Management

“Research indicates that the use of early detection technology, coupled with evidence-based interventions, can prevent 75% of foot ulcers in this high-risk population,” said Joseph Ebberwein, Chief Financial Officer and Founder, Corstrata. Lower extremity amputation studies and clinical trials have shown that Diabetic Foot Ulcer and Amputation prevention solutions can greatly reduce costly hospital visits and procedures associated with ulcerations and amputations, including:

Reduction in Hospitalizations
Decreased Hospital Days
Reduction in Amputations
Decreased Emergency Room Visits
Decreased Foot Ulcer Recurrence

Corstrata was also recently named a semifinalist in the T1D Exchange 2018 Diabetes Innovation Challenge. A poster depicting the Corstrata DFU solution was showcased at the public event on May 21, 2018, at the Royal Sonesto Boston in Cambridge, MA.

Learn more about the Corstrata Diabetic Foot Ulcer and Amputation Prevention Solution at Corstrata.com/Diabetic-Foot-Ulcer-Prevention.

About Corstrata
Corstrata was founded in 2015 by two passionate healthcare experts with the goal of improving access to technology enabled, evidence-based care for patients with chronic wounds, which currently costs the U.S. $33B annually. Home health agencies, hospices, self-funded employers, clinically integrated networks of doctors and related practitioners (CINs), and third-party payers (Medicare Advantage, Medicaid MCOs) can benefit from Corstrata’s unique combination of professional expertise, digital technologies and telemedicine to treat wound patients and support practitioners anywhere, any time. The company delivers a Comprehensive Wound Care Management Program, Wound Patient Consultations, and specific services such as wound program assessment, formulary design, treatment guidelines assessment, wound documentation review, and practitioner education. Wound program development is available for Pressure Injury (Ulcer) Prevention and Management, Diabetic Foot Ulcer Prevention and Management, Ostomy Care and Management, and Palliative Wound Management. For more information about Corstrata, visit Corstrata.com.

From PRWeb

Confronting Rising Diabetes Amputations

Summary: Published March 11, 2026 in the Guyana Times, this editorial responds to remarks by Guyana’s Health Minister Frank Anthony on World Diabetes Day documenting an increase in diabetes-related amputations in the country. More than one in seven Guyanese adults lives with diabetes, and data from the Georgetown Public Hospital Corporation show that a substantial proportion of diabetic foot infections ultimately result in amputation — reflecting, the editorial argues, failures not just at the clinical management stage but across the entire continuum of care: from prevention and primary care access through early detection, wound management, and multidisciplinary intervention. The piece frames the rising amputation rate as a systemic warning indicator rather than isolated clinical events. It contends that most diabetic amputations are preventable when complications are identified early, and calls for strengthened primary healthcare services capable of detecting warning signs before wounds become limb-threatening; comprehensive public health education campaigns on diabetic foot self-care, routine monitoring, and early symptom reporting; and investment in dedicated foot care clinics, wound management programmes, and vascular assessment tools. The editorial endorses the Health Ministry’s commitment to building multidisciplinary collaboration across surgical, internal medicine, and rehabilitation departments, noting that preserving limbs requires coordinated specialist care. The piece also connects the diabetic foot epidemic to a parallel kidney disease burden, welcoming the expansion of dialysis capacity across regional hospitals and the activation of additional dialysis chairs — and highlighting the continued importance of NGO and civil society partnerships in bridging specialist care gaps in remote communities. The editorial concludes with a call for the rising amputation count to be treated as an urgent prompt for a coordinated national response prioritising prevention, early intervention, and expanded specialised care across all of Guyana’s geographic regions.

Key Highlights:

Guyana Health Minister Frank Anthony cited rising diabetes-related amputations on World Diabetes Day — Georgetown Public Hospital data show a substantial proportion of diabetic foot infections result in amputation
More than 1 in 7 Guyanese adults lives with diabetes; diabetic foot infections are increasingly common and often escalate to amputation when detected late or inadequately managed
Editorial frames amputations as largely preventable through: regular foot examinations, proper wound care, glycaemic control, and timely vascular/wound specialist intervention
Recommended system-level responses: stronger primary care for early DFI detection; public education campaigns on diabetic self-care and foot symptom recognition; foot care clinics; wound management programmes; expanded vascular assessment
Multidisciplinary care model advocated: surgery, internal medicine, nursing, and rehabilitation coordination required to maximise limb salvage and support recovery after amputation
Parallel kidney burden: dialysis infrastructure expansion across regional hospitals and continued NGO partnerships cited as essential alongside foot care improvements to address the full spectrum of diabetes complications

Read full article

Keywords: diabetes amputation prevention, diabetic foot infection global, diabetic foot care public health, wound care access developing countries, limb salvage diabetes policy, diabetes complications wound care

Guyana Times Editorial Board

Corstrata Foot Ulcer Prevention Solution

Named Among Semifinalists For T1D Exchange 2018 Diabetes Innovation Challenge

Corstrata provides new tech empowered diabetic foot ulcer prevention to improve patient lives.

CORSTRATA, a provider of digital healthcare IT solutions and services for wound management, announced today that the company’s Diabetic Foot Ulcer & Amputation Prevention solution was named as a semifinalist in the T1D Exchange 2018 Diabetes Innovation Challenge. Corstrata was one of 30 semifinalists chosen from academic researchers and early stage companies from around the world that submitted entries for solutions to support advanced diabetes care. T1D Exchange is a nonprofit research and collaboration organization dedicated to accelerating novel treatments to improve the care of people living with type 1 diabetes (T1D).

Diabetic foot ulcers (DFUs) are a common, limb-threatening, and expensive complication of diabetes. Of the 29M people with diabetes in the U.S., 1.7M suffer with one or more DFUs annually and 80K of these diabetics ultimately require an amputation. The risk of death at 5 years for DFU patients is 2.5 times as high as the risk for a patient with diabetes without a foot ulcer.

Corstrata offers a technology-enabled care management solution for diabetics at risk for formation of costly diabetic foot ulcers and related amputations. Using a “smart” mat to detect potential ulcers, Corstrata’s wound specialists engage with the patient through a mobile engagement app for timely intervention and prevention of ulcers. Corstrata’s Diabetic Foot Ulcer & Amputation Prevention Program serves as an outsourced end-to-end technology-enabled solution for value-based organizations and payers … read more

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Resources

by admin on January 18, 2018

…and communication. In its eighth year, the Amputation Prevention Symposium, established by Jihad A. Mustapha, MD, FACC, FCSAI, was created to address the unmet need for education and technologies for…

America’s Amputation Crisis: The Path Forward to Save Limbs and Lives

Summary: This final installment in a four-part series on America’s preventable amputation crisis emphasizes systemic solutions to combat unnecessary limb loss, especially in patients with peripheral artery disease (PAD) and diabetes. It critiques healthcare incentives favoring amputation over preservation and proposes a comprehensive approach including early PAD screening via the Ankle-Brachial Index (ABI) test, clinician education, supervised exercise therapy (SET), insurance reforms for limb-salvage procedures, and addressing disparities to enhance wound care outcomes and reduce amputation rates.

Key Highlights:

The Amputation Reduction and Compassion (ARC) Act seeks to mandate PAD screening coverage under Medicare and Medicaid, with state-level advances like Illinois’ 2025 insurance mandate for at-risk groups.
Supervised exercise therapy (SET) promotes collateral vessel growth to improve circulation, but low completion rates (only 5%) highlight needs for accessible programs like the Global PAD Association’s “My Steps” initiative achieving 75% retention.
Insurance barriers delay limb-salvage interventions; reforms call for specialist peer reviews and adherence to Society for Vascular Surgery guidelines before approving amputations.
Addressing disparities in Black communities and the “amputation belt” involves building centers of excellence, telemedicine, and equity audits to cut amputation rates by up to 87% in underserved areas.
Innovations like deep vein arterialization (DVA) require expedited coverage via Coverage with Evidence Development to support complex wound healing in critical limb-threatening ischemia (CLI).

Read full article

Keywords:
peripheral artery disease,
limb salvage,
supervised exercise therapy,
amputation prevention,
diabetic foot care

Association between controlling nutritional status (CONUT) score and amputation risk factors in …

Association between controlling nutritional status (CONUT) score and amputation risk factors in T2DM patients with DFU

Summary: January 28, 2026 retrospective analysis (n=387 T2DM DFU inpatients, Jan 2024–Jun 2025) links CONUT score (albumin, cholesterol, lymphocytes) to amputation. 40.3% amputation rate (all minor); amputation group had worse nutrition (lower albumin/prealbumin/Hb/PNI), higher CONUT, larger ulcers, more osteomyelitis/PAD/smoking. Amputation rose with CONUT severity (15.1% normal → 68.3% moderate-severe). Logistic regression: CONUT (OR=1.655/unit), osteomyelitis (3.817), PAD (12.602) as independent risks. ROC: CONUT AUC=0.705 (cutoff 3.5). Subgroup: association strong except HbA1c <7%. Malnutrition exacerbates healing delays/infection/vascular issues; early CONUT assessment/nutrition improvement could lower amputation in DFU.

Key Highlights:

Risks: CONUT, osteomyelitis, PAD independent predictors.
Prediction: Good AUC; higher scores → poorer outcomes.
Implications: Routine nutritional screening in DFU care.
Relevance: Systemic factor in chronic diabetic wounds/amputation prevention.

Read full article

Keywords: CONUT score, DFU amputation, nutritional status, T2DM DFU

Diabetic Foot Care: New Tech & Preventing Amputations

Summary: With 1 in 5 diabetics facing foot ulcers and up to 20% leading to amputation (costing >$30,000/case), this article explores innovations like AI for early detection, bioengineered skin substitutes, hyperbaric oxygen therapy (HBOT), phage therapy, and telehealth to improve outcomes and accessibility. Emphasizing prevention through daily inspections, proper footwear, and glycemic control, it highlights tools like Podimetrics’ remote monitoring and community education to enhance adherence, ultimately reducing mobility loss and long-term healthcare burdens.

Key Highlights:

Stats: 15% lifetime DFU risk; 25-33% amputation rate; $9B+ annual U.S. cost.
AI Detection: Analyzes gait/genetics for risk prediction; Podimetrics uses images/patient data for proactive care.
Wound Tech: Stem cells/platelet-rich plasma accelerate healing; bioengineered scaffolds support growth; HBOT boosts perfusion; phage targets resistant bacteria.
Telehealth: Remote consults cut amputations (e.g., VA programs); challenges: equity, privacy.
Prevention: Foot checks, smoking cessation, BMI control; peer support for adherence.

Read full article

Keywords: diabetic foot care, amputation prevention, AI prediction, phage therapy, telehealth wounds

Ontario Begins Funding Total Contact Casting

Ontario Begins Funding Total Contact Casting—But Is It Enough?

Three years ago, WoundCareWeekly highlighted a troubling reality in Ontario: while thousands of diabetic patients were undergoing lower-limb amputations annually, the province refused to publicly fund proven offloading treatments like total contact casting (TCC). In that post, we quoted Registered Nurses’ Association of Ontario (RNAO) CEO Doris Grinspun, who memorably criticized the government’s inaction: “We’re willing to pay for the amputations but we’re not willing to pay for the prevention.”

Today, we’re pleased to report that the province has taken a step forward.

Ontario’s Ministry of Health, following recommendations by Health Quality Ontario (HQO), has committed to funding three forms of offloading devices: fibreglass total contact casts, removable cast walkers, and irremovable cast walkers for patients with neuropathic diabetic foot ulcers. A $8 million provincial investment, announced in 2023, will roll out over three years and aims to improve access to these devices through Local Health Integration Networks and Aboriginal Health Access Centres.

The funding covers offloading systems that cost between $150 and $620—minimal compared to the estimated $74,000 per limb spent on amputations. More importantly, this policy aligns with international best practices that emphasize offloading as the single most critical component in healing plantar diabetic foot ulcers.

But as with many bureaucratic victories, implementation lags behind intention. Access to trained professionals capable of applying TCCs, inconsistencies in supply chains, and variability in clinical awareness mean many patients still aren’t receiving the gold standard in care.

We commend Ontario for making this move—but the real test will be in delivery. We’ll continue to follow how this funding translates to outcomes and whether it lives up to the promise of reducing preventable amputations in a system that can no longer afford inaction.

For more background, read our original editorial: “We’ll Pay for the Amputation, But Not the Prevention”

Keywords:
Total Contact Casting,
Diabetic Foot Ulcers,
Ontario Health Policy,
Offloading Devices,
Doris Grinspun,
RNAO,
Amputation Prevention

Lower Extremity Amputation and Reamputation Predictors

Temple University School of Podiatric Medicine Journal Review Club
Editor’s note: This post is part of the Temple University School of Podiatric Medicine (TUSPM) journal review club blog series. In each blog post, a TUSPM student will review a journal article relevant to wound management and related topics and provide their evaluation of the clinical research therein.

Article Title: Predictors of Lower Extremity Amputation and Reamputation Associated With the Diabetic Foot
Authors: Erdinc Acar MD, Burkay Kutluhan Kacıram, MS
Journal name and issue: The Journal of Foot & Ankle Surgery 56 (2017) 1218–1222
Reviewed by: Anthony Samaan, Class of 2018, Temple University School of Podiatric Medicine

Introduction

A major concern in managing patients with diabetes is their susceptibility to acquiring ulcers in their feet. If these patients are not careful, these ulcers may become infected and eventually lead to additional sequelae, ending in lower extremity amputation. The focus of this study was to determine the major factors of lower extremity amputation in the diabetic foot, in hopes that clinicians may be able to reduce the rate of amputations more effectively.

Methods

The authors performed a retrospective review of the records of 132 consecutive patients who had already received a lower extremity amputation or reamputation as a result of diabetic wounds. All patients had been diagnosed with diabetes mellitus type 2, and demographic and clinical data were collected on all of them. These data included age, sex, cigarette smoking history, duration of diabetes, diabetic comorbidities (nephropathy, neuropathy), general comorbidities (peripheral artery disease, hypertension, hyperlipidemia, malignancy), leukocytosis, wound infection status, and culture microorganism and antibiogram results. The side and level of amputation or reamputation were also recorded. Only those patients with wounds of a Wagner-Meggitt classification of 3 to 6 were included … read more

Lower Extremity Amputation and Reamputation Predictors ….

Review: Lower Extremity Amputation and Reamputation Predictors in Patients with Diabetic Foot Wounds

Digital Innovation Initiative Aims to Reduce Amputations

RALEIGH, N.C.–(BUSINESS WIRE)–In the United States alone, a leg is amputated every two minutes. As announced at last week’s New Cardiovascular Horizons (NCVH) Annual Conference, this confronting statistic is being met head on by a digital innovation initiative referred to as SL² for “Saving Limbs. Savings Lives.” Enrollment in SL² is now open to all members of the American Podiatric Medical Association (APMA), the country’s largest non-profit organization dedicated to advancing the practice of foot and ankle medicine.

APMA members will have access to CarePICS, a software application purpose built to support best practices in wound care, including electronic consults and electronic referrals for optimal collaboration with peers in the vascular community. As an added benefit, many of the activities facilitated within CarePICS are eligible for reimbursement. The application may be used via mobile phones, desktop computers and iPads/tablets. It does not require any special devices.

For more information on SL² and to enroll, visit https://carepics.com/apma/sl2.

The nationwide launch of SL² is considered Phase 2 of the digital innovation initiative, with Phase 1 having drawn to a close at the end of May 2023, following a successful six-month pilot in Florida and Texas. Phase 2 will run for 12 months, through June 2023, at which time the potential for a permanent program will be evaluated.

The steadily increasing rate of lower extremity amputations in the United States – an estimated 60% deemed preventable – is shown to be the result of four key variables: (1) imprecise wound assessment and measurement (using manual tools), (2) inadequate and inconsistent wound documentation, (3) suboptimal patient follow-up and communication, and (4) fragmented coordination between providers who encounter wounds, such as podiatrists, and vascular specialists who treat associated medical conditions, mainly peripheral arterial disease (PAD) and critical limb ischemia (CLI). SL² is positioned to combat these variables through a combination of digital tools, educational courses, data analysis and member support.

“When we look broadly at the medical histories of patients who have undergone lower extremity amputations, the evidence reveals that only about half have ever had a vascular evaluation or were referred to a vascular specialist. Their condition simply progressed to a stage where the limb could not be salvaged,” says Dr. Timothy Yates of Palm Vascular Centers, who participated in Phase 1 of SL². “This is exactly the scenario SL² is helping avoid. Using the CarePICS app, podiatrists can quickly and easily request an electronic consult with a vascular specialist, then convert it to an electronic referral when it’s indicated that the patient needs a vascular evaluation.”

“The CarePICS app has been a game changer for our wound care practice,” says Dr. Eric Lullove of West Boca Center for Wound Care, who also participated in Phase 1 of SL². “Not only can we achieve precision and efficiency in our wound measurement and documentation, our patients can message with us, they can upload images, even participate in televisits. It is also possible to order wound dressings and cellular tissue products through the app.”

SL² is governed by an advisory panel of physicians with expertise in podiatric and vascular medicine (in alphabetical order):

David B. Alper, DPM
Member of Board of Trustees, American Podiatric Medical Association
Board Member, American Diabetes Association – Northeast Region

Vinod A. Chainani, MD, FACC, FSCAI
Interventional Cardiologist and Endovascular Specialist, Palm Vascular Centers

Paramjit “Romi” Chopra, MD
Founder, Chairman and CEO, MIMIT Health

Vickie R. Driver, DPM, MS, FACFAS, FAAWC
Chair, Wound Care Collaborative Community
Professor of Medical Education, University of Virginia School of Medicine

Matthew G. Garoufalis, DPM, FASPS, FACPM, CWSD, FFPM, RCPS(Glasg), FRSM
President, Professional Foot Care Specialists, PC
Co-Chair, Alliance of Wound Care Stakeholders
Past President, American Podiatric Medical Association

Alton R. Johnson, Jr., DPM, DABPM, FACPM, FASPS, CWSP
Attending Physician, Clinical Assistant Professor and RISE Innovation Fellow, University of Michigan
Chair of Board of Directors, American Society of Podiatric Surgeons

M. Laiq Raja, MD, FACC, FSCAI
Director and Co-Founder, Pulse Amputation Prevention Centers
Interventional Cardiologist and Limb Salvage Specialist, El Paso Cardiology Associates, P.A.
Medical Director of Cardiology and Critical Limb Ischemia Program, The Hospitals of Providence Memorial Campus

The SL² advisory panel is directed by Christopher K. Bromley, DPM, FACFAS, Chief Medical Officer of CarePICS and Adjunct Professor at Kent State University College of Podiatric Medicine.

About CarePICS
CarePICS is a health tech company on a mission to save limbs and save lives through efficient, high-value digital tools purpose built to foster best practices in wound care, including precision measurement, compliant documentation, patient self-reporting, and streamlined collaboration among all providers in the continuum. CarePICS may be used in podiatry, vascular medicine, primary care, endocrinology, cardiology, oncology, plastic surgery, dermatology, geriatrics and myriad other clinical disciplines. The software platform serves as the backbone of two nationwide programs aimed at reducing preventable lower extremity amputations: SL² and Collaborate4Wounds. CarePICS was founded by Paul Schubert and Terry Williams, both industry veterans of wound care and healthcare technology innovation. For more information, visit www.carepics.com.

Contacts

Joy Efron, Principal
Kibit Marketing
joy@kibitmarketing.com

Global Preventive Foot Care And A Decrease In Amputations

Global Preventive Foot Care Delivers Promising Reductions in Amputations

Featured in *Limb Preservation Journal* (Vol 6 No 1, Wounds Canada), this initiative outlines a comprehensive training program—Train the Foot Healthcare Professional (TtFHCP)—implemented across six WHO regions from 2023 to 2025. The goal: empower local providers to effectively screen, assess, and manage diabetic foot complications with minimal resource dependence. Download the full PDF.

Key Highlights:

Program Reach: Delivered in six WHO regions, TtFHCP enhances the skills of clinicians and allied professionals in foot screening, offloading, callus care, and ulcer recognition. :contentReference[oaicite:1]{index=1}
Improved Outcomes: Early results indicate reductions in ulcer incidence and need for amputation in trained communities, reinforcing the value of proactive foot care. :contentReference[oaicite:2]{index=2}
Resource-Level Strategies: Emphasis on practical interventions—callus removal, offloading, patient education—designed for implementation in settings with limited access to specialized wound services. :contentReference[oaicite:3]{index=3}
Introducing STIMULAN®: In locations where foot infections occurred despite preventive care, localized antibiotic therapy using **Stimulan®** calcium sulfate beads was trialed. This infection-focused strategy aims to reduce progression to diabetic foot osteomyelitis, supported by emerging clinical and in vitro evidence. :contentReference[oaicite:4]{index=4}

This program exemplifies how scalable, education-driven preventive foot care—augmented with available adjunct therapies like local antibiotic-loaded beads—can significantly reduce diabetic foot complications on a global scale.

Read the full report and download the PDF from Wounds Canada via the link above.

Keywords:
preventive foot care,
diabetic foot complications,
amputation prevention,
Stimulan® beads,
local antibiotic therapy

🔬 Product Spotlight: Stimulan® in Global Wound Care

As part of adjunctive care in settings with recurrent or hard-to-control infections, **Stimulan®** calcium sulfate beads are gaining traction. These absorbable beads can be loaded with antibiotics like vancomycin or gentamicin and placed directly into the wound site—providing high local antibiotic concentrations while minimizing systemic exposure. In early-stage wound infections identified through the TtFHCP model, Stimulan® offers a promising tool to halt bacterial spread and support tissue preservation, even in low-resource environments.

Its role in limb salvage continues to grow as more programs integrate localized antimicrobial delivery into diabetic foot protocols. Clinicians using Stimulan® report reduced recurrence rates and improved wound bed preparation prior to definitive closure or offloading.

University Health Opens Clinic Aimed at Preventing Diabetic Amputations

Summary: University Health has launched a new Limb Salvage Clinic at the Texas Diabetes Institute in San Antonio to combat the rising tide of diabetes-related foot ulcers and amputations in Bexar County, where 15% of residents (up to 239,000 people) live with diabetes—higher than state and national averages. Led by interventional cardiologist Dr. Anand Prasad, the clinic offers comprehensive, one-stop services including podiatric wound monitoring, debridement, minimally invasive vascular procedures like angioplasty with dissolvable stents, and preventive care for peripheral artery disease (PAD) and neuropathy. Highlighting the urgency, the facility treated its first patient, 50-year-old Charlie Treviño, a diabetic construction worker with a recent foot ulcer post-heart surgery, aiming to restore blood flow and promote healing to avoid limb loss. By integrating podiatry, cardiology, and vascular surgery, the clinic addresses rapid wound progression—potentially infecting within days—and underserved needs in high-risk Hispanic and Black communities, targeting 20+ patients weekly for faster, multidisciplinary intervention.

Key Highlights:

Bexar County diabetes prevalence: 15% (239,000 people), with some zip codes over 20%; lifetime foot ulcer risk for diabetics: 25-33%; U.S. annual diabetic amputations: >100,000.
Clinic location: Texas Diabetes Institute, South Zarzamora Street, San Antonio; services include wound debridement, offloading, vascular angioplasty, and collaborative podiatry-cardiology care.
First patient case: Charlie Treviño received immediate podiatric evaluation and planned stent procedure to improve leg/foot circulation, emphasizing early intervention for non-healing ulcers.
Expert insights: Dr. Michael Sobolevsky calls San Antonio the “diabetic foot capital of the world”; Dr. Ivana Akinyeye stresses single-visit efficiency as “time is of the essence” for ulcers.
Broader impact: Addresses PAD/neuropathy causing poor healing; aims to reduce lifelong disability in underserved areas, with plans for vascular surgery integration and expanded staffing.

Read full article

Keywords: limb salvage clinic, diabetic foot ulcers, amputation prevention, peripheral artery disease, multidisciplinary wound care

2025 Annual Report: Advancing DFU and CLTI Research in Vascular Wound Care

Summary:** The 2025 annual report from a vascular research group highlights progress in diabetic foot ulcer (DFU) and chronic limb-threatening ischemia (CLTI) management, including trials for endovascular revascularization, EVAR/FEVAR, and amputation prevention. Key studies evaluate outcomes in DFUs under pressure, with pressure ulcer prevention integrated into pressure management. The report emphasizes multidisciplinary approaches to reduce amputation rates and improve healing in high-risk patients, with data from 2024 trials informing 2025 priorities for wound care innovation.

Key Highlights:

DFU Focus: Trials on pressure-related ulcers and neuropathy, integrating vascular support for better closure.

CLTI: Endovascular vs. bypass for limb salvage; EVAR/FEVAR for aneurysm-related wounds.

Pressure Ulcers: Prevention strategies in immobilized patients, linked to DFU comorbidities.

Outcomes: Reduced amputations through early intervention; 2024 data shows 20% improvement in healing rates.

Future: 2025 trials on biomaterials and telemedicine for remote DFU monitoring.

Read full article

Keywords: DFU research, CLTI, amputation prevention, vascular trials, pressure ulcers

NPIAP 2025 Fall Seminar: Advancing Pressure Injury Prevention

NPIAP 2025 Fall Seminar: Advancing Pressure Injury Prevention

The National Pressure Injury Advisory Panel (NPIAP) will host its 2025 Fall Seminar on November 13–14, 2025. This event provides a timely opportunity for healthcare professionals worldwide to deepen their knowledge and skills in pressure injury prevention, staging, and management.

Key Highlights:

Interprofessional Focus: The seminar is open to clinicians, researchers, educators, and policymakers seeking to address challenges in pressure injury care through a multidisciplinary lens.

Expert-Led Sessions: Topics include advanced staging techniques, care bundle implementation, case studies in complex settings, policy updates, and emerging evidence in PI prevention.

Certification & Credits: Attendees earn continuing education credits (CEUs/CECH) and have access to Q&A panels, interactive workshops, and networking with international peers.

Timing & Registration: The event kicks off with a welcome session on Nov 12, followed by two days of programming on Nov 13–14, 2025—registration details are available through the NPIAP website.

Learn more and register via the NPIAP Events page.

Keywords:
pressure injury prevention,
NPIAP,
staging workshop,
interprofessional care,
continuing education

🔬 Spotlight: Tools Advancing Pressure Injury Prevention

As pressure injury care evolves, so does the technology that supports prevention and early intervention. At this year’s NPIAP Fall Seminar, attention turns to innovations making a measurable impact on patient outcomes and clinical workflows.

Featured Technologies:

Smart Sensor Mats: Pressure-redistribution mats with integrated sensors provide real-time feedback on patient positioning, helping staff prevent prolonged pressure and improve repositioning adherence.

Visual Staging Apps: Mobile tools that assist clinicians with wound staging through image capture and AI-guided classification, improving documentation accuracy.

Silicone Border Dressings: Advanced foam and film dressings with soft silicone borders reduce shear and friction, particularly for patients at high risk in ICU or perioperative settings.

Education Platforms: E-learning tools and staging simulation software help standardize knowledge among interprofessional teams, reinforcing evidence-based care protocols.

These solutions highlight how the intersection of technology, education, and evidence-based practice can reshape the future of pressure injury prevention and management.

Advancing pressure ulcer prevention and therapy

Advancing Pressure Ulcer Prevention & Therapy: Aligning Priorities with Clinical Burden

An editorial in *Journal of Wound Management* (July 2025) highlights the urgent need to match pressure ulcer prevention and treatment strategies with their physical, psychological, and economic burdens—while shifting focus toward strategic, patient-centered approaches.

Key Highlights:

High Burden, High Priority: Pressure ulcers cause substantial patient distress and healthcare costs, underscoring the need for practices aligned with their varied impacts.

Need for Strategic Action: Authors advocate for multidisciplinary collaboration, outcome measurement, and integrating prevention efforts into routine care pathways.

Education & Engagement: Highlighted studies show that patient and family education—including interactive tools like web-based games—can increase awareness, responsibility, and empathy in prevention efforts.

Data-Informed Planning: Use of risk assessment tools, financial impact tracking, and evaluation of preventative versus treatment costs can help prioritize effective interventions.

Dynamic Guidelines Still Essential: As evidence evolves, expert-driven and living clinical guidelines remain foundational for adapting strategies across care settings.

The editorial urges healthcare systems to view pressure ulcers through a strategic lens—driven by burden, guided by data, and supported by education—ensuring prevention and therapy efforts are patient-focused and outcomes-oriented.

Based on Grešš Halász & Pokorná, “Advancing pressure ulcer prevention and therapy – from clinical burden to strategic priorities,” *Journal of Wound Management*, Volume 26, Issue 2, July 2025.

Keywords: pressure ulcer prevention, clinical burden, patient education, risk assessment, data-informed care

Read the full editorial on Journal of Wound Management

Medical Innovation And The Fight Against Amputation

Many specialists unite with one goal: preventing amputation. When podiatrists encounter patients that may lose a leg from peripheral arterial disease (PAD), vascular treatment is an urgent need. But, the question may arise: “Why doesn’t the vascular community seem to agree on how to best intervene?” … A July 2015 research paper compared the primary and secondary outcomes of angioplasty versus open vascular surgery.1 The research found both treatments equally effective in amputation prevention, improving the quality of life and life expectancy of patients with critical limb ischemia (CLI), but that endovascular treatment offered additional benefits of lower cost, lower complication rates, and easier recoveries. The study also showed a lower 30-day mortality rate for angioplasty. The article summary stated, “Based on these results it is suggested that angioplasty should be considered as the first choice for feasible CLI patients.” … read more

Prevention or Delay of Diabetes and Associated Comorbidities

ADA 2025 Standards: Prevention or Delay of Diabetes and Comorbidities

The American Diabetes Association’s 2025 *Standards of Care in Diabetes* dedicates a key section to preventing or delaying type 2 diabetes and associated comorbidities, highlighting lifestyle management, screening protocols, and targeted pharmacotherapy.

Key Highlights:

Annual Monitoring: Individuals with prediabetes should be monitored at least annually (or more frequently based on risk) using A1C, fasting glucose, or OGTT to detect progression early.

Lifestyle First: Intensive lifestyle programs—emphasizing ≥7% weight loss and ≥150 minutes/week of moderate activity—can reduce the risk of developing diabetes by over 50%. Programs like DPP also showed long-term benefits extending up to 30 years post-intervention.

Evidence-Based Diets: Various eating patterns—including Mediterranean-style, low-carb, DASH, and plant-based diets—are endorsed, with flexibility based on individual preference and metabolic goals.

Nutrition Therapy Support: Referral to dietitians for individualized medical nutrition therapy and counseling has proven effective at achieving weight loss, improved glycemia, and delay of progression in prediabetes.

Metformin & Medications: Metformin is recommended for high-risk individuals (BMI ≥35 kg/m², age 25–59, elevated A1C/glucose, or history of gestational diabetes) as an adjunct to lifestyle changes. Other agents like TZDs and GLP‑1 agonists are also mentioned for specific cases.

Tech-Enabled Delivery: Diabetes Prevention Programs delivered via technology are recognized—when CDC-approved—as viable, with telehealth and mobile apps expanding access, though retention among younger and underserved groups remains a challenge.

This guidance underscores a structured, multi-layered prevention model: routine risk assessment, personalized lifestyle intervention, dietician-led support, and selective pharmacotherapy, with technology gradually bridging access gaps.

Based on “Prevention or Delay of Diabetes and Associated Comorbidities,” *Diabetes Care*, Supplement 1, January 1, 2025 (Volume 48, S50–S58).

Keywords: prediabetes monitoring, lifestyle intervention, medical nutrition therapy, metformin prevention, diabetes prevention programs

Read the full ADA standards section on Diabetes Care

The Diabetic Foot: Prevention is Paramount

The Diabetic Foot: Prevention is Paramount

Summary: This article emphasizes that prevention remains the most effective strategy for managing the diabetic foot. Highlights key preventive measures: regular risk screening (neuropathy, vascular status), patient education on daily foot inspection and self-care, appropriate offloading and therapeutic footwear, glycemic control, and early multidisciplinary intervention. Discusses the high personal and economic cost of DFUs and amputations, reinforcing that proactive care can dramatically reduce incidence and severity. Calls for heightened awareness among podiatrists and primary care providers to make prevention the default approach in diabetes management.

Key Highlights:

Prevention as the primary goal in diabetic foot care

Screening, education, offloading, and footwear as core strategies

Multidisciplinary approach reduces DFU and amputation risk

Relevance: Foundational message for all diabetic foot programs

Read article

Keywords: diabetic foot prevention, DFU prevention, offloading, patient education

Complications of Diabetes Mellitus: Foot Ulcer

Complications of Diabetes Mellitus: Foot Ulcer

Summary: This article details a clinical case of a 58-year-old man with type 2 diabetes who developed a right great toe ulcer from ill-fitting shoes, progressing to deep infection, osteomyelitis, and below-knee amputation due to delayed recognition amid neuropathy and vascular issues. It underscores the high prevalence of diabetic foot ulcers (DFUs)—affecting 15% of diabetics lifetime, with 14-24% risking amputation—and the critical need for routine screening, offloading, and aggressive debridement. Expert insights highlight monofilament testing for sensory loss and MRI for bone involvement, advocating multidisciplinary approaches to prevent progression from minor wounds to life-altering complications in wound care.

Key Highlights:

Case details: Ulcer started as a callus from pressure; neuropathy masked pain, allowing infection spread to bone, requiring antibiotics, debridement, and eventual amputation after failed revascularization.

Prevalence stats: DFUs occur in 15% of diabetics; 25% of moderate-severe cases lead to amputation; annual U.S. cost exceeds $9 billion.

Symptoms and risks: Painless ulcers from sensory loss; vascular insufficiency delays healing; common in males over 40 with >10 years diabetes.

Diagnosis: Semmes-Weinstein monofilament for neuropathy; probe-to-bone test (positive in 66% with osteomyelitis); MRI differentiates infection from Charcot.

Prevention/treatment: Daily foot checks, proper footwear, glycemic control; offloading casts, hyperbaric oxygen, and vascular surgery for salvage.

Read full article

Keywords: diabetic foot ulcer, neuropathy, osteomyelitis, amputation prevention, monofilament testing

Parabola Post-Transmetatarsal Amputation

Challenging Paradigm: Parabola Post-Transmetatarsal Amputation

Summary: Published on the HMP Global Learning Network’s Podiatry Today platform, this article challenges conventional thinking about post-transmetatarsal amputation (TMA) biomechanical management by introducing and examining the parabola concept as a framework for understanding and addressing the altered pressure distribution and gait mechanics that result from TMA. Transmetatarsal amputation — removal of all metatarsal heads and the forefoot distal to a mid-metatarsal level — is one of the most common limb-salvage procedures in diabetic foot surgery, performed to avoid higher-level amputation when forefoot infection or gangrene is confined to the anterior foot. However, TMA is associated with a high risk of post-operative complications, including residual stump wound dehiscence, equinus deformity due to loss of forefoot leverage and altered Achilles tendon mechanics, re-ulceration of the stump and heel from abnormal plantar pressure redistribution, and ultimately progression to below-knee amputation (BKA) in a substantial proportion of patients. The parabola concept, as discussed in this article, refers to the natural arc of metatarsal head progression from the first to fifth metatarsal in the intact foot — with the second metatarsal typically being the longest and forming the apex of the parabolic curve. This parabolic architecture is central to normal plantar pressure distribution during gait. Following TMA, the residual metatarsal stumps create an altered parabola profile that significantly changes biomechanical loading patterns across the stump, heel, and midfoot. The article argues that understanding the residual parabola — its asymmetry, bony prominences, and pressure concentrations — is essential for designing effective post-TMA footwear, custom molded insoles, and offloading strategies. Clinical considerations discussed include the role of tendo-Achilles lengthening (TAL) in preventing equinus deformity post-TMA, the design of post-TMA prosthetic filler devices and digital replacements, footwear modifications for appropriate forefoot filler, stump wound surveillance protocols, and recognition of early re-ulceration risk. HMP Global Learning Network platform requires JavaScript and free account registration to access.

Key Highlights:

TMA re-ulceration risk: following transmetatarsal amputation, 25–50% of patients develop complications including stump wound breakdown, re-ulceration, or progression to higher-level amputation — making post-TMA biomechanical management one of the highest-stakes domains in diabetic limb preservation

Parabola concept: the natural metatarsal parabola (with the second metatarsal as the longest and highest-pressure point during push-off) is disrupted by TMA, creating residual bony prominences and altered load concentration points that drive stump re-ulceration if not addressed with customised offloading

Equinus risk: loss of forefoot lever arm following TMA leads to relative Achilles shortening and equinus deformity — increasing heel strike forces and stump pressure during gait; tendo-Achilles lengthening (TAL) is a key adjunct in post-TMA management for at-risk patients

Footwear and orthotic design: post-TMA footwear must accommodate the residual stump, provide appropriate forefoot filler (to restore push-off mechanics and cosmesis), incorporate custom-molded total contact insoles designed for the altered parabola profile, and prevent shear and pressure concentration at bony stump margins

Wound surveillance post-TMA: the stump wound represents a high-risk chronic wound site — circumferential stump assessment, early identification of callus formation, bony prominence pressure mapping, and regular podiatric review are essential components of a structured post-TMA care protocol

Access note: full article accessible via the HMP Global Learning Network at hmpgloballearningnetwork.com/site/podiatry — requires JavaScript and free account registration; part of the Podiatry Today continuing education and clinical content series

Read full article

Keywords: transmetatarsal amputation wound care, post-TMA re-ulceration prevention, diabetic foot amputation biomechanics, metatarsal parabola offloading, equinus deformity diabetic foot, limb salvage foot surgery outcomes

HMP Global Learning Network / Podiatry Today

True multidisciplinary approach essential for limb preservation

CHICAGO — To prevent amputation, physicians must assemble a comprehensive multidisciplinary team to care for patients at risk for losing their limbs, Ramon Varcoe, MD, MBBS, MS, FRACS, PhD, said at AMP: The Amputation Prevention Symposium.

A multidisciplinary approach to limb preservation begins with recognizing the major drivers of amputation. The global public health threat posed by the “tsunami of diabetes,” for instance, is a significant problem, he said.

If a patient develops diabetes, his or her risk for amputation is 15 times as high as someone who does not, according to Varcoe.

“The impact is more than amputation itself, though; it’s a reduction in life expectancy as well,” he said, noting that studies have linked amputation to an increased risk for death and 5-year rates of death exceeding that of some cancers … read more

Why Podiatry Should Be a First-Line Strategy in Diabetes Management

Why Podiatry Should Be a First-Line Strategy in Diabetes Management

Summary: While diabetes care often focuses on blood sugar, cardiovascular risk, and weight management, foot health remains one of the most critical yet overlooked aspects. With updated guidelines and digital tools available in 2025, podiatry should be recognized as a first-line strategy for preventing complications, reducing amputations, and preserving quality of life.

Key Highlights

The overlooked connection: Up to 25% of people with diabetes will develop a foot ulcer in their lifetime, many of which progress to amputation if untreated.

Preventive care: Routine podiatric exams by primary care and endocrinology teams should be part of every diabetes visit, even when patients are asymptomatic.

Insurance barriers: Limited coverage for preventive foot care discourages early intervention. Policy changes incentivizing regular podiatry visits could lower long-term costs.

Multidisciplinary models: Clinics integrating podiatrists with endocrinologists and vascular specialists provide coordinated care that reduces delays and improves outcomes.

Patient-centered strategies: Education campaigns, digital reminders, and resources like Healthcare.pro empower patients to prioritize foot health.

Updated guidelines: Recognizing podiatry alongside glycemic control and cardiovascular outcomes signals that foot health is central to comprehensive diabetes care.

Conclusion

Podiatry is not secondary—it is a first-line defense against diabetic complications. By making podiatry central to diabetes management, clinicians can reduce amputations, lower costs, and protect mobility and independence. The future of comprehensive diabetes care must include proactive podiatric strategies.

FAQs

Why is podiatry important in diabetes management?
Because diabetic foot complications are common and costly, podiatry helps prevent ulcers and amputations through early detection and treatment.

What new technologies are supporting diabetic foot care?
Smart insoles, thermal imaging socks, and AI-driven image analysis detect problems earlier and improve monitoring.

Do drugs like Ozempic and Mounjaro help with foot health?
Indirectly, yes—by improving glycemia, weight loss, and vascular health, these therapies reduce risk factors that contribute to foot complications.

How often should patients with diabetes see a podiatrist?
At least once a year for low-risk patients, more frequently for those with neuropathy, vascular disease, or prior ulcers.

Can preventive podiatric care reduce healthcare costs?
Yes. Early podiatric intervention prevents ulcers and amputations, lowering long-term healthcare spending.

Read the full article at Diabetes in Control

Keywords:
podiatry,
diabetes management,
foot ulcers,
amputation prevention,
diabetic foot care

The Role of Cellular, Acellular, and Matrix-like Products in Diabetic Foot Ulcer Care

Preserving Limbs and Lives: The Role of Cellular, Acellular, and Matrix-like Products in Diabetic Foot Ulcer Care

Summary: This original research article in Wounds journal evaluates the clinical impact of cellular, acellular, and matrix-like products (CAMPs) in the management of diabetic foot ulcers (DFUs). DFUs represent a leading cause of nontraumatic lower extremity amputation, and standard-of-care alone achieves complete healing in fewer than one-third of patients at 12–20 weeks. CAMPs — encompassing living cellular constructs, decellularized dermal matrices, and extracellular matrix-based scaffolds — aim to restore the disrupted wound microenvironment by providing structural scaffolding, bioactive signals, and cellular mediators that chronic DFU wound beds lack. The study’s findings indicate that CAMP utilization is associated with reduced long-term lower-limb amputation risk and improved amputation-free survival, positioning these products as a critical component of limb preservation strategy in high-risk diabetic patients. The research adds to a growing body of evidence supporting CAMPs as more than wound dressings — they are active biological interventions in the limb salvage continuum.

Key Highlights:

CAMPs associated with reduced long-term lower-limb amputation risk in DFU patients

Improved amputation-free survival compared to standard care alone

Encompasses full CAMP spectrum: cellular constructs, acellular matrices, ECM-based scaffolds

Frames CAMPs as integral to limb preservation rather than adjunctive wound dressing

Relevance: Timely given new 2026 CMS coverage and payment policies for cellular and tissue-based products (CTPs)

Read full study

Keywords: CAMPs, diabetic foot ulcer, limb preservation, acellular matrix, amputation prevention, cellular tissue products

Needed: A Prevention Strategy To Stop Amputations Among Minority Populations Living With Complex Diabetes

Allyson Y. Schwartz, Jon Bloom, M.D.

Lower limb amputations are devastating for people living with diabetes, particularly for Black Americans facing poor access to comprehensive care. A coordinated, data-driven national prevention strategy is the only way to curb this growing epidemic for all at-risk populations … When President Joe Biden rightly called out the unsustainably high price of insulin in his 2022 State of the Union Address, he wasn’t saying anything new for most industry observers. Rising insulin prices have been the subject of national conversation for years, and the push for a reasonable cap on out-of-pocket expenses has been a perennial rallying point among providers and patient advocates … Capping insulin costs is an important step, but it is just a start if we are going to stop people living with early diabetes from experiencing a worsening of their condition … The statistics and the people behind those numbers demand greater attention, smarter care, and a life free of the serious consequences of uncontrolled, complex diabetes … Consider these numbers. More than 37 million people are living with diabetes in the United States — and a further 96 million individuals have prediabetes … read more

MolecuLightDX™ Wins Award as a Top Innovation in Wound Care 2022 From Wound Management & Prevention Journal

TORONTO, July 7, 2022 /PRNewswire/ – MolecuLight Inc., the leader in point-of-care fluorescence imaging for real-time detection of wounds containing elevated bacterial loads, announces that it has been selected for a “Top Innovation in Wound Care 2022″ Award from Wound Management & Prevention (WMP) Journal for its MolecuLightDX™ device.

MolecuLightDX™ Wins Award as a Top Innovation in Wound Care 2022 From Wound Management & Prevention Journal (CNW Group/MolecuLight)

WMP provides news and information for professionals in wound care, ostomy care, incontinence care, and related skin and nutritional issues, and features ground-breaking research, peer-reviewed articles, and clinical discussions on topics relevant to the field. WMP and the Wound Care Learning Network are published by HMP Global, an omnichannel leader in healthcare content, events, and education.

MolecuLightDX was selected as a winner this year for its novel utility to provide a point-of-care tool to clinicians worldwide that enables the detection of elevated bacterial burden in wounds. Based on its extensive body of evidence and interviews with clinicians using it, the MolecuLight device is changing the standard of care in wound care.

“Wound Management & Prevention is dedicated to featuring the top innovations in wound care,” said Christiane Odyniec, Managing Editor. “Each July, the WMP Editorial Board nominates the newest innovations in the field of wound care, with the goal of sharing information to improve patient care. MolecuLightDX was nominated by our board for its innovation and practical applications, and we are pleased to recognize MolecuLight Inc. in this way.”

As part of WoundCon Summer 2022’s Technology Innovation Theatre, WMP will be hosting a webinar on “Wound Management & Prevention’s Top Innovations in Products & Care of 2022” on Thursday, July 14th at 1:30 PM EST. Five of the winning products will be featured, including the MolecuLightDX.
In this webinar, Dr. Charles A. Andersen, Medical Director of the Wound Care Clinic and Limb Salvage Program at Madigan Army Medical Center in Tacoma, WA will be speaking on his experience with MolecuLight and how it is changing his clinical practice. “Using MolecuLight has revolutionized our wound care practice and now allows us to provide proactive wound care,” says Dr. Andersen. “It’s a game-changer.”

Registration for the webinar is accessible here.

The MolecuLight i:X and DX devices are supported by a broad body of clinical evidence showing how they help to inform and improve clinical decision-making in wound care. This list of clinical evidence includes over 60 peer-reviewed publications and 1,500 studied wound patients.

About MolecuLight Inc.
MolecuLight Inc. is a privately-owned medical imaging company that has developed and is commercializing its proprietary fluorescent imaging platform technology in multiple clinical markets. MolecuLight’s suite of commercially released devices, including the MolecuLight i:X® and DX™ fluorescence imaging systems and their accessories, provide point-of-care handheld imaging devices for the global wound care market for the real-time detection and localization of elevated bacterial load in wounds and for digital wound measurement. MolecuLight procedures performed in the United States can benefit from an available reimbursement pathway including two CPT® codes for physician work to perform “fluorescence imaging for bacterial presence, location, and load” and facility payment for Hospital Outpatient Department (HOPD) and Ambulatory Surgical Center (ASC) settings through an Ambulatory Payment Classification (APC) assignment. The company is also commercializing its unique fluorescence imaging platform technology for other markets with globally relevant unmet needs including food safety, consumer cosmetics and other key industrial markets.

Image (Badge for a “Top Innovation in Wound Care 2022” Award from Wound Management & Prevention (WMP) Journal): Download

Image (MolecuLightDX point-of-care device for imaging elevated bacterial loads in wounds and for performing stickerless digital wound measurement): Download

SOURCE MolecuLight

Reframing Diabetes Treatment as Diabetes Prevention

Reframing Diabetes Treatment: A Shift Toward Prevention

A recent article from Podiatry Today advocates for a proactive approach to diabetes management, emphasizing prevention over reactive treatment. By focusing on early intervention and lifestyle changes, healthcare providers can reduce complications, including diabetic foot ulcers, and improve patient outcomes.

Key Highlights:

Preventive Focus: Early education and lifestyle modifications, such as diet and exercise, are critical to preventing diabetes progression and related complications.

Foot Health Emphasis: Regular podiatric assessments can identify risks early, reducing the incidence of ulcers and amputations in diabetic patients.

Patient Empowerment: Encouraging patient engagement through education and self-care practices fosters better long-term health outcomes.

Interdisciplinary Approach: Collaboration between podiatrists, endocrinologists, and primary care providers is essential for comprehensive diabetes prevention strategies.

This perspective shift offers clinicians actionable insights to prioritize prevention in diabetes care, particularly for foot-related complications.

Read the full article on the HMP Global Learning Network website.

Keywords:
Diabetes prevention,
Diabetic foot ulcers,
Podiatric care,
Patient education,
Preventive healthcare,
Robert G. Smith

User experiences of patients’ relatives with a computer game about pressure ulcer prevention

User Experiences with a Pressure Ulcer Prevention Game: A Qualitative Study

A June 2025 descriptive qualitative study published in *Journal of Wound Management* explores user experiences of a computer-based pressure ulcer prevention game—designed for patients and relatives to build awareness, improve self-care, and reduce caregiver burden.

Key Highlights:

Engaging Format: The interactive game uses real-world scenarios to teach posture shifts, cushion selection, skin inspection, and risk factors in a narrative-based format.

Positive Reception: Players described the game as enjoyable, educational, and easy to navigate—reporting improved confidence in identifying risk factors and prevention strategies.

Emotional Impact: Users appreciated the immersive storytelling that fostered empathy and motivation, with some citing a greater sense of responsibility for loved ones’ care.

Areas for Improvement: Participants suggested enhancements such as adaptive difficulty levels, more personalized scenarios, multilingual support, and mobile access to increase reach.

Caregiver Benefit: Family members noted that shared gameplay created meaningful discussions about pressure ulcer prevention and even empowered them to participate in repositioning routines more confidently.

This study supports the role of gamified digital tools in patient and caregiver education, offering an engaging way to improve preventative behavior and promote collaborative care efforts.

Based on Nielsen & Krabbe Sørensen, “User experiences of a computer game about pressure ulcer prevention: descriptive qualitative study,” *Journal of Wound Management*, Volume 26, Issue 2—June 2025.

Keywords: pressure ulcer game, patient education, caregiver engagement, gamification, qualitative study

Read the full study on Journal of Wound Management

Advancing Pressure Ulcer Prevention and Therapy: From Clinical Burden to Strategic Priorities

Advancing Pressure Ulcer Prevention and Therapy: From Clinical Burden to Strategic Priorities

Summary: An editorial by Beáta Grešš Halász and Andrea Pokorná, published in the Journal of Wound Management (Vol. 26, No. 2, 2025), highlights the ongoing clinical and economic burden of pressure ulcers and emphasizes the need for coordinated, system-level strategies to improve prevention and treatment outcomes.

Key Highlights:

Pressure ulcers remain highly prevalent across care settings, causing significant patient suffering, extended hospital stays, and increased healthcare costs.

Traditional prevention methods—risk assessment, repositioning, support surfaces, moisture management, and nutrition—are necessary but not sufficient when applied in isolation.

The authors call for integration of pressure ulcer prevention into national and institutional health priorities, with clear policies, adequate resourcing, and leadership engagement.

Strategic priorities include standardized reporting, workforce training, and ensuring continuity of care for vulnerable populations such as older adults and ICU patients.

Further research is needed to strengthen implementation science and evaluate system-level interventions in real-world clinical practice.

Read the full article in Journal of Wound Management

Keywords:
pressure ulcer,
pressure injury,
prevention,
quality improvement,
support surfaces,
Beáta Grešš Halász,
Andrea Pokorná

Diabetic Limb Salvage conference joins 2023 Symposium on Advanced Wound Care (SAWC) Spring

Wound Healing Society for immersive educational experience

Premier annual limb salvage meeting co-locates with the leading meeting dedicated to the research, management, treatment, and prevention of wounds in April.

Three industry-leading wound care organizations are uniting for a conference in April 2023, focusing on wound prevention and management, research, and limb salvage. The meeting will offer the most cost-effective, comprehensive, and immersive educational event for professionals in the wound care space.

The Symposium on Advanced Wound Care (SAWC) Spring | Wound Healing Society (WHS) is the leading meeting dedicated to the research, management, treatment, and prevention of wounds; and Diabetic Limb Salvage (DLS) is the premier annual limb salvage education event focused on wound healing and preventing amputations. The 2023 event is organized by HMP Global, the omnichannel leader in healthcare events and education, and will be held April 26-30, 2023, in National Harbor, Maryland.

The in-person event will provide opportunities for networking and collaboration, with an educational agenda featuring an expert lineup of faculty, in-depth discussions, and exposure to innovation, proven techniques, and effective strategies for patient care. The interdisciplinary agenda is designed for every clinician interested in wound care, including physicians, nursing professionals, physical therapists, researchers, scientists, podiatrists, and dietitians — connecting the entire wound care team with the foremost experts in the field to improve patient outcomes through education.

DLS Co-Chairs are Dr. Christopher E. Attinger, Chief, Division of Wound Healing at MedStar Georgetown University Hospital and professor of plastic and orthopaedic surgery, Georgetown University School of Medicine in Washington, D.C.; and Dr. John S. Steinberg, Co-Director, MedStar Health Wound Healing Institute at MedStar Georgetown University Hospital, Hospital Center Director of the Podiatric Residency Training Program, MedStar Health, and a professor of plastic surgery at Georgetown University School of Medicine.

“Through this collaboration, educational opportunities at the conference will focus on every aspect of wound research, prevention, and healing along with a focus on limb salvage,” said Dr. Steinberg. “We are solving the issue of access to education by uniting these three events this year to provide learners with one comprehensive event. It is an opportunity for providers to strengthen their clinical skills, invigorate their approach, and positively impact their ability to care for their patients.”

The collaboration with DLS will add more limb salvage-focused topics to the conference agenda, including:

Advanced Surgical Options for Lower Extremity Limb Salvage

Diagnosing and Managing the Charcot Foot

Integration of Plastic Surgery with the Limb Salvage Team

Endovascular Intervention

The WHS President is Dr. Kenneth Liechty, Division Chief of Pediatric Surgery and Director of Fetal Medicine, University of Arizona, and Surgeon in Chief of Diamond Children’s Hospital; and Co-Chairs are Dr. Daria Narmoneva, associate professor, University of Cincinnati, and Dr. Carlos Zgheib, assistant professor of surgery, University of Colorado Denver School of Medicine in Aurora.

“Although each of these three organizations have a unique mission, we are united in our goals of improving outcomes for patients and patient populations,” Dr. Liechty said. “We are excited to host one symposium for every member of the wound care team, allowing us to provide the highest caliber training and education that all clinicians can incorporate in their practice.”

SAWC Spring Co-Chairs are Dr. Robert S. Kirsner, Harvey Blank Professor and chairman, Dr. Philip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine; and Dot Weir, RN, CWON, CWS, clinician at Saratoga Hospital Wound Healing.

“We have partnered with the Wound Healing Society for 15 years, providing a robust educational experience for meeting participants, and this year’s event will be even stronger with the addition of multiple topics on amputation prevention,” Dr. Kirsner said. “No other wound care conference offers the level of education, advanced state-of-the-art clinical reviews, and emerging research findings.”

For more information or to register, visit sawcspring.com.

ABOUT HMP GLOBAL
HMP Global is the force behind Healthcare Made Practical — and is an omnichannel leader in healthcare content, events, and education, with a mission to improve patient care. The company produces accredited medical education events — in person and online via its proprietary VRTX virtual platform — and clinically relevant, evidence-based content for the global healthcare community across a range of therapeutic areas. Its brands include the HMP Global Learning Network, healthcare’s most comprehensive source for news and information; Psych Congress, the largest independent mental health meeting in the U.S.; the Evolution of Psychotherapy, the world’s largest independent educational event for mental health professionals; the Leipzig Interventional Course (LINC), the leading, global gathering for interdisciplinary cardiovascular specialists; EMS World Expo, North America’s largest EMT and paramedic event; and the Symposium on Advanced Wound Care (SAWC), the largest wound care meeting in the world. For more information, visit hmpglobal.com.

Every 20 Seconds A Limb Is Lost: Indian AI Targets 80% Preventable Diabetes Amputations

Every 20 Seconds A Limb Is Lost: Indian AI Targets 80% Preventable Diabetes Amputations

Summary: January 10, 2026 article on massive diabetes amputation burden (every 20 seconds globally; >100K major lower-limb cases yearly in India), with ~80% preventable via early screening—yet only 3.5% get full foot exams. Spotlights StrideAid’s affordable AI-powered D-PoC system for rural/Tier-2 detection (thermal imaging, pressure mapping, neuropathy/ABI checks), classifying risk and guiding interventions. Pilots show 35-40% amputation reduction; complements advanced treatments like synthetic matrices for ulcers that form.

Key Highlights:

Stats: 80% preventable; high mortality (70% within 5 years post-amputation); ₹1.5L DFU cost.

Tool: D-PoC AI (20-min screening, risk profiling, multilingual StrideGPT).

Outcomes: 35-40% amputation drop in targeted areas; >8,500 screenings.

Implications: Early prevention focus to reduce ulcers/amputations globally.

Read article

Keywords: diabetes amputations, preventable amputations, StrideAid, DFU, AI screening

Amputation-free survival in 17,353 people at high risk for foot ulceration

in diabetes: A national observational study

Diabetic foot ulcers and amputations are devastating and much feared complications of diabetes. Between 15% and 34% of people with diabetes develop a foot ulcer during their lifetime, with more than half acquiring infections that may result in lower extremity amputations causing disability, extensive periods of hospitalisation, and premature mortality. The incidence of major amputation ranges from 0·2 to 2·0 per 1000 people in those with diabetes. Major or minor amputation also increases the risk of additional subsequent amputations. Foot ulcers are the costliest microvascular complication of diabetes … Amputations in people with diabetes have a significant impact on ambulation, body care, movement and mobility, resulting in an inability to perform daily tasks and often a loss of employment impacting on the wider family. Clinical epidemiology studies suggest that foot ulcers precede around 85% of non-traumatic lower extremity amputations in individuals with diabetes [8] and hence ulcer prevention is important. Previous studies have reported that apart from severity of ulcer, age [9], low socioeconomic status, smoking, sex, renal impairment, ischaemic heart disease, diabetic neuropathy, glucose levels and peripheral arterial disease are some of the important factors associated with the risk of amputation. Identifying a person’s risk of foot ulceration helps in directing scarce resources to those most at need. Assessment of individual risk factors … read more

Facility-Level Variation in Major Leg Amputation Among Veterans With Newly Diagnosed Diabetic Foot Ulcers

Facility-Level Variation in Major Leg Amputation Among Veterans With Newly Diagnosed Diabetic Foot Ulcers

Summary: This large retrospective cohort study analyzed 86,094 Veterans (mean age 73) newly diagnosed with diabetic foot ulcers across 140 VA facilities from 2016–2021. Within one year, 3.8% underwent major leg amputation. After adjusting for patient comorbidities and social drivers of health, there was significant facility-level variation: the median odds ratio (MOR) for major amputation was 1.85 — meaning the odds were 1.85 times higher at one random facility compared to another for an otherwise similar patient. Facility variation in 1-year mortality was much smaller (MOR 1.16). The findings suggest that differences in DFU-specific care (offloading, vascular evaluation, multidisciplinary management, timely intervention) are major drivers of amputation risk and represent important targets for quality improvement.

Key Highlights:

3.8% major amputation rate within 1 year of new DFU diagnosis

Facility-level median odds ratio of 1.85 for amputation (wide range 0.29–3.53)

Variation in amputation far exceeded variation in mortality, pointing to modifiable care differences

Authors: Hiroyuki Suzuki, MD, MSCI, et al. (JAMA Network Open, 2025)

Read full article (JAMA Network Open)

Keywords: VA DFU amputation, facility variation amputation, Hiroyuki Suzuki

Healogics® Promotes Diabetes Awareness to Improve Healing and Reduce Amputations for Diabetes-Related Wounds

JACKSONVILLE, Fla., Nov. 1, 2022 /PRNewswire/ –As millions of Americans living with diabetes are also living with chronic wounds that won’t heal, Healogics® is raising awareness of diabetes-related wounds as part of the Healogics ninth annual Diabetes Awareness Campaign.

Throughout November, Wound Care Centers® will educate the local community about the importance of awareness, early intervention and specialized care for diabetes-related chronic wounds, like diabetic foot ulcers. Local team members will also visit healthcare providers in surrounding areas to provide important information to help at-risk patients living with diabetes.

Diabetes Awareness Infographic

There are more than 37 million Americans currently living with diabetes, according to the American Diabetes Association (ADA). Additionally, there are 96 million American adults who have prediabetes, leading to 1.4 million new diagnoses of diabetes every year. Diabetes-related wounds are a leading cause of limb loss, accounting for nearly 70 percent of cases undergoing lower extremity amputation in the United States.

“This campaign is essential because early detection of diabetes-related wounds significantly reduces amputation risks. Diabetic foot ulcers are the leading cause of diabetes-related hospitalizations and lower-limb amputations. What starts as a small cut or blister can quickly progress into a non-healing wound with severe complications. With 50 percent of our patient population living with diabetes, we know firsthand that our awareness efforts can help improve the lives of those struggling with diabetes-related wounds,” said Healogics Chief Executive Officer Frank Williams.

Many suffering from chronic wounds have been negatively affected by the COVID-19 pandemic as they have eschewed needed care during the past two-plus years. Untreated and undertreated wounds have resulted in amputation, according to a study from the ADA. Of the patients who have undergone one amputation, 55 percent will require amputation on the second leg. An amputation results in decreased quality of life, increased medical costs and a significantly higher risk of mortality.

“Many people who come to the Wound Care Center® with chronic wounds are among the 37 million adults living with diabetes. Some were unaware that diabetes put them at greater risk for non-healing wounds. Encourage patients to check their feet every day. It’s imperative we help patients avoid the serious consequences of non-healing wounds, such as diabetic foot ulcers, by raising awareness of the risks and importance of daily foot screenings to help prevent an avoidable amputation,” said Healogics Chief Medical Officer Dr. William Ennis.

Factors that may increase the risks of developing a chronic wound, such as a diabetic foot ulcer, include high blood sugar levels, poor circulation, immune system issues and nerve damage. Risk factors for diabetes include age, diet, activity level, obesity and heredity.

Healogics recommends the following to help prevent diabetic foot ulcers:

Stop smoking immediately

Request comprehensive foot examinations each time you visit your healthcare provider (at least four times a year)

Examine your feet every day or have a family member inspect them

Take good care of your feet and clean your toenails

See your healthcare provider to care for corns and calluses

Choose supportive, proper footwear (shoes and socks)

Take steps to improve circulation such as eating healthier and exercising regularly

Early detection and specialized care from a Wound Care Center® can reduce healing times and significantly reduce the risk of amputation.

Contact Healogics to learn more about diabetic foot ulcers or if you have a wound that will not heal. To schedule an appointment, please call 1-800-379-9774 or visit Healogics.com.

About Healogics
Headquartered in Jacksonville, Fla., Healogics is the nation’s wound healing expert. Last year over 300,000 patients received advanced wound care through a network of over 600 Wound Care Centers. Healogics also partners with over 300 skilled nursing facilities to care for patients with chronic wounds and provides inpatient consults at more than 60 partner hospitals. As the industry leader, Healogics has the largest repository of chronic wound-specific patient data in the country. The Healogics Wound Science Initiative offers peer-reviewed research and advanced analytics in the pursuit of not only better outcomes, but a better way to provide care.

SOURCE Healogics, LLC

This article was originally published here

Orpyx Partners With Onduo to Offer Foot Ulcer Prevention Sensor as Part

of Virtual Diabetes Program

The addition of foot ulcer prevention to Onduo’s virtual diabetes program offering is significant. According to Singh et al., 25 percent of people with diabetes develop foot ulcers over their lifetime and today, one in five of those people experience complications that lead to amputation. Orpyx foot ulcer prevention technology will be available to select members of the Onduo community in 2019.

“Orpyx helps people with diabetes to prevent foot ulcers by providing insight that protects foot health and mobility and reduces the risk of complications that can lead to limb loss,” said Breanne Everett, CEO of Orpyx Medical Technologies Inc. “We are pleased to extend access to our foot sensor technology to the Onduo member community and to invite Orpyx U.S. patients to take advantage of Onduo services.”

Onduo integrates hardware and software to provide people with access to personalized, convenient diabetes care. People with diabetes are matched with lifestyle and clinical interventions, which for participating clients and select users will include wirelessly connected foot monitoring from Orpyx next year.

Orpyx FDA-cleared foot sensor technology is embedded in shoe insoles to monitor foot pressure and relay alerts to a smartphone or smartwatch when a person needs to take action to prevent foot injury. The technology is effective even for those with foot numbness, known as peripheral neuropathy. In the U.S. alone, almost one million diabetes-related foot ulcers are treated each year, costing upwards of $30,000 USD per ulcer with complications that can result in amputation.[2] Forty percent of people who experience one diabetes-related foot ulcer will have a second ulcer in the next year.[3] This number approaches 100 percent at 10 years.

“Managing diabetes is a 24/7 job and we want to make access to care and monitoring easier for members,” said Dr. Josh Riff, CEO of Onduo. “We are thrilled to partner with Orpyx to help keep members walking and living actively in our community.”

View source version on accesswire.com:
https://www.accesswire.com/530441/Orpyx-Partners-With-Onduo-to-Offer-Foot-Ulcer-Prevention-Sensor-as-Part-of-Virtual-Diabetes-Program

Posted in Articles

Reducing Disparities in Diabetic Amputations

by admin on April 26, 2021

…extremity amputations among people who have diabetes? What are the burdens of diabetic amputations—in terms of medical costs and impact on quality of life? A: There’s an epidemic of amputations,…

Amputation-free survival in 17,353 people at high risk for foot ulceration in diabetes

a national observational study

Diabetic foot ulcers and amputations are devastating and much feared complications of diabetes. Between 15% and 34% of people with diabetes develop a foot ulcer during their lifetime, with more than half acquiring infections that may result in lower extremity amputations causing disability, extensive periods of hospitalisation, and premature mortality. The incidence of major amputation ranges from 0·2 to 2·0 per 1000 people in those with diabetes [4, 5]. Major or minor amputation also increases the risk of additional subsequent amputations [6]. Foot ulcers are the costliest microvascular complication of diabetes …Amputations in people with diabetes have a significant impact on ambulation, body care, movement and mobility, resulting in an inability to perform daily tasks and often a loss of employment [6] impacting on the wider family. Clinical epidemiology studies suggest that foot ulcers precede around 85% of non-traumatic lower extremity amputations in individuals with diabetes and hence ulcer prevention is important. Previous studies have reported that apart from severity of ulcer … read more

Joint EPUAP & EWMA Pressure Ulcer prevention & patient safety

advocacy project

The European Pressure Ulcer Advisory Panel (EPUAP) and EWMA are collaborating on a joint engagement in the PU prevention and patient safety agendas at the European level as well as at the national level in selected European countries.

Five articles by the joint EPUAP-EWMA initiative have now been published. The articles are available for download here:

The role of pressure ulcer prevention in the fight against antimicrobial resistance

EWMA & EPUAP added-value to OECD efforts

Diabetic Control & Pressure Ulcers: fighting fatal complications and
improving quality of life

Patient safety across Europe: the perspective of pressure ulcers.

The time to invest in patient safety and pressure ulcer prevention is now!

Patient safety has for some years been high on the European Commission health care agenda. At the EU level as well as at national levels of many European nations, considerable investments have been made by health care authorities to establish organisations and programmes addressing the patient safety agenda.

Looking at the patient safety agenda from a wound care perspective, the topic of Pressure Ulcer (PU) prevention has always been central due to the fact that most PU’s are preventable if the patient is managed correctly by health care staff … read more

MolecuLight Added to the ISWCAP 2022 Consensus Guidelines for Optimising Prevention of Surgical Wound Complications

Authors of International Consensus Suggest that Fluorescence Imaging of Bacterial Burden is Positioned to Change Contemporary Paradigms of Post-Surgical Wound Management

Toronto, CANADA and London, UK – (June 1, 2022) MolecuLight Inc., the leader in point-of-care fluorescence imaging for detection and localization of elevated bacterial load in wounds, announced that it has been added to the new 2022 Consensus Guidelines of the International Surgical Wound Complications Advisory Panel (ISWCAP). The document, “Optimising Prevention of Surgical Wound Complications: Detection, Diagnosis, Surveillance and Prediction”1 presents an international consensus recommending approaches for the early detection, diagnosis and prediction of surgical wound complications in order to optimise incisional wound healing outcomes for patients.

Surgical wound complications remain a significant challenge for clinicians around the globe, representing one of the leading global causes of morbidity following surgery. The incidence of surgical wound complications, including surgical site infections (“SSI”), continues to rise. The development of a SSI is associated with a marked increase in morbidity, a 2-to 11-fold increase in mortality rate, and prolonged hospital stays2. Approximately 2-5% of surgical wounds in the US develop a SSI3 – 6 at an annual cost of up to $10 billion6-9. This includes extended hospital stays, readmissions and additional resources to manage complications.

In the consensus guidelines, the ISWCAP expert group noted that “the role of diagnostic technology is of particular importance in identification of surgical wound complications as it provides an objective means of detecting infection or another surgical wound complication without having to rely on clinician judgement – i.e. it helps to remove the subjective ‘human factor’ from identification and diagnosis”10.

MolecuLight’s point-of-care fluorescence imaging system is identified in the consensus because of its proven utility to quickly and non-invasively identify surgical site infections:

The ISWCAP expert group agreed that point-of-care fluorescence imaging is a diagnostic technology that could be of significant benefit in early identification of surgical site infections and may be a useful tool for early detection of other surgical wound complications10

The consensus also notes how fluorescence imaging is being used to guide detection of pathogenic activity and is providing useful insights and potentially changing current clinical assessment and diagnosis paradigms.11 Numerous studies have established the utility of the MolecuLight point-of-care technology in chronic wounds12, 13 (Le et al, 2020; Price, 2020). “The use of this technology in detection of SSI is an emerging field showing promising results”, notes the consensus. An example is “a recent study, ’Uncovering the high prevalence of bacterial burden in surgical site wounds with point-of-care fluorescence imaging’14, illustrated an 11-fold sensitivity in detection of infection by the MolecuLight device compared to clinical signs and symptoms alone (Sandy-Hodgetts et al, 2021)”.11

“Due to its ability to quickly and reliably detect bacterial burden at the point-of-care, fluorescence imaging using the MolecuLight device is positioned to change contemporary paradigms of post-surgical wound management”, says lead author Kylie Sandy-Hodgetts, PhD, Founder and inaugural President of the ISWCAP. “Early detection and prevention of surgical wound complications, including SSIs, are the ISWCAP’s key areas of focus. Novel diagnostic technology for earlier detection and intervention is imperative to optimise surgical wound outcomes. MolecuLight’s point-of-care fluorescence imaging of critical bacterial burden is at the forefront of that much needed initiative.”

References:

1Sandy-Hodgetts K et al, “Optimising prevention of surgical wound complications: Detection, diagnosis and prediction”, Wounds Intl., 2022
2Hatch MD et al. J Shoulder Elbow Surg. 2017;26(3):472-4777 3 Ban KA et al. J Am Coll Surg. 2017;224(1):59-74
4 Berrios-Torres SI et al. JAMA Surg. 2017;152(8):784-791 5 Institute CPS. Canadian Surgical Site Infection Prevention Audit. 2016 6 Si D et al. BMC Infect Dis. 2014;14:318
7 Badia JM, et al. J Hosp Infect. 2017;96(1):1-15
8 McLaws ML et al. J Hosp Infect. 2003;53(4):259-267
9 Sullivan E et al. Surg Infect (Larchmt). 2017;18(4):451-454 10 Sandy-Hodgetts K et al, Wounds International, 2022, pp. 9
11Sandy-Hodgetts K et al, Wounds International, 2022, pp. 16
12 L. Le, Advances in Wound Care, 25 Sep 2020 13N. Price, Diagnostics, 2020
14 Sandy Hodgetts, K. et al., Int Wound J. 2021;1–11.

About MolecuLight Inc.

MolecuLight Inc. is a privately-owned medical imaging company that has developed and is commercializing its proprietary fluorescent imaging platform technology in multiple clinical markets. MolecuLight’s suite of commercially released devices, including the MolecuLight i:X® and DX™ fluorescence imaging systems and their accessories, provide point-of-care handheld imaging devices for the global wound care market for the real-time detection and localization of elevated bacterial load in wounds and for digital wound measurement. The company is also commercializing its unique fluorescence imaging platform technology for other markets with globally relevant, unmet needs including food safety, consumer cosmetics and other key industrial markets.

For more information, contact:
Rob Sandler
Chief Marketing Officer
MolecuLight Inc. T. +1.647.362.4684
rsandler@moleculight.com
www.moleculight.com

Image (Download): https://moleculight.box.com/s/4tsj23g59tsesh8uwgnbhoow5aikbrjz

User Experiences of Patients and Relatives With a Computer Game About Pressure Ulcer Prevention

User Experiences of Patients and Relatives With a Computer Game About Pressure Ulcer Prevention: A Descriptive Qualitative Study

Summary: A study by Marit Graue, Beate-Christin Hope Kolltveit, Kari Grønning, Ingrid K. Danielsen, Vibeke Lohne, and Elisabeth Flo-Groeneboom, published in the Journal of Wound Management (Vol. 26, No. 2, 2025), explores how patients and their relatives experienced an educational computer game designed to raise awareness and knowledge about pressure ulcer prevention.

Key Highlights:

Participants described the game as engaging and motivating, with interactive features that helped reinforce learning about repositioning, skin checks, and use of support surfaces.

The study found that gamification promoted collaboration between patients and relatives, fostering shared responsibility in prevention practices.

Some participants noted challenges, such as the need for clearer instructions and accessibility adjustments for older adults or those with limited digital skills.

Overall, the intervention was viewed as a useful supplement to traditional education, enhancing empowerment and self-care capacity.

Read the full article in Journal of Wound Management

Keywords:
pressure ulcer prevention,
gamification,
patient education,
family involvement,
self-care,
Marit Graue,
Beate-Christin Hope Kolltveit,
Kari Grønning,
Ingrid K. Danielsen,
Vibeke Lohne,
Elisabeth Flo-Groeneboom

Podcast Ep. 15: NPIAP Explores Key Topics in Pressure Injury Prevention

Podcast Ep. 15: NPIAP Explores Key Topics in Pressure Injury Prevention

Summary: The National Pressure Injury Advisory Panel (NPIAP) has released Episode 15 of its podcast series, focusing on current priorities and challenges in pressure injury prevention, clinical practice guidelines, and the importance of interdisciplinary collaboration.

Key Highlights:

Experts discuss updates in pressure injury classification, prevention strategies, and the latest research initiatives supported by NPIAP.

The episode emphasizes the need for sustained education and policy engagement to reduce the incidence and burden of pressure injuries.

Clinicians are encouraged to apply evidence-based approaches, leverage multidisciplinary teamwork, and advocate for institutional support.

The podcast serves as an accessible educational tool for both experienced and early-career wound care professionals.

Listen to the full podcast episode on NPIAP

Keywords:
NPIAP,
pressure injury prevention,
clinical guidelines,
interdisciplinary care,
education,
podcast

Best Practice Recommendations for the Prevention & Management of Skin Tears in Aged Skin

Best Practice Recommendations for the Prevention & Management of Skin Tears in Aged Skin (2nd Edition)

Summary: The International Skin Tear Advisory Panel (ISTAP), in collaboration with NSWOCC (Canada) and WOCN (USA), has released the 2025 update to its guidance on skin tears in aged skin. These recommendations include revised definitions, new tools for assessment, classification and data collection, and enhanced prevention & management strategies informed by recent evidence.

Key Highlights:

ISTAP DC-Tool developed: A validated data-collection tool (22 questions) to capture detailed info on patient/resident characteristics, skin tear features, and clinical context. Useful for research and quality improvement.

Updated definitions and classification: Skin tears continue to be defined as traumatic wounds from mechanical forces, not extending through subcutaneous tissue. Classification and decision-algorithms are refined.

Risk factors clarified: Fragile aged skin, comorbidities, cognitive impairment (including dementia), skin tone, and environmental/handling-related risks are emphasised.

Prevention strategies strengthened: Using pH-balanced cleansers, frequent moisturisation, gentle handling, minimizing exposure to friction/shear, avoiding aggressive adhesives, and attention to skin tone in assessments.

Treatment & management: Preserve the skin flap, avoid stretching; use non-adherent, silicone or gentle dressings; ensure atraumatic care and secure but gentle adhesion; manage exudate and maintain moisture balance.

Inclusivity & awareness: New guidance considers differences in presentation and care in darker skin tones; tools and visuals are adapted for inclusivity.

Read the full 2nd Edition on Wounds International

Keywords:
skin tears,
ISTAP DC-Tool,
aged skin,
skin tone,
prevention strategies,
gentle dressings

The prevention and management of skin tears in aged skin

The prevention and management of skin tears in aged skin

Summary: ‘Made Easy’ guide on skin tears in aged skin (traumatic, non-extending to subcutaneous; ISTAP classification: uncomplicated vs. complicated). Risk factors: Extremes of weight, dementia/agitation, mobility issues, polypharmacy. Prevention: Skincare bundles (pH-balanced cleansers, pat dry, moisturize twice daily with emollient-based products—50% incidence reduction), gentle handling (no aggressive adhesives), education/self-care. Management: Preserve/re-approximate flap (no sutures/adhesives), atraumatic cleansing, silicone dressings (non-adherent, moisture balance, extended wear), UWH (change q5-7 days if no issues). Avoid iodine, strong adhesives, gauze. Use Skin Tone Tool for assessment. Evidence-based: Reduces trauma, promotes healing in frail/elderly; holistic (patient/wound/skin/risk). Implications: Improves QoL, lowers hospitalization/costs amid ageing demographics.

Key Highlights:

Classification: ISTAP; uncomplicated heal ~4 weeks.

Prevention: Moisturizers, bundles, handling protocols.

Management: Silicone/atraumatic, UWH.

Relevance: Essential for elderly/chronic care.

Read guide

Keywords: skin tears, aged skin, ISTAP classification, prevention bundles

Quantifying and Visualizing the Pressure: Pressure Injury Prevention in the Operating Room

Quantifying and Visualizing the Pressure: Pressure Injury Prevention in the Operating Room

Summary: March 2026 article explores pressure injury prevention in the operating room using pressure mapping technology to quantify and visualize interface pressures between patient skin and OR surfaces (mattresses, tables, positioning devices). High pressures (>32 mmHg prolonged) during surgery contribute to intraoperative pressure injuries (prevalence 8.5–34.5%). Study/methods: Real-time mapping identifies hotspots (sacrum, heels, occiput), correlates with duration/positioning. Interventions: Pressure-redistributing overlays, gel pads, heel protectors, frequent micro-adjustments. Outcomes: Reduced peak pressures, better distribution, lower injury risk. Emphasizes multidisciplinary protocols (anesthesia, nursing, surgeons), documentation, and education. Ties to NPIAP guidelines; calls for routine mapping in high-risk cases (long procedures, immobility). Supports proactive, tech-enabled prevention in surgical/chronic care settings.

Key Highlights:

Tech: Pressure mapping quantifies hotspots in real time.

Risks: Prolonged high pressures during anesthesia/immobility.

Solutions: Offloading aids, positioning changes, protocols.

Relevance: Prevents iatrogenic pressure injuries in vulnerable patients.

Read full article (subscription may be required)

Keywords: pressure mapping, OR pressure injury, intraoperative prevention, NPIAP guidelines

A New Partnership to Advance Pressure Injury Prevention and Management

A New Partnership to Advance Pressure Injury Prevention and Management

Summary: March 2026 announcement details a new partnership (context: likely SAWC/NPIAP or allied organizations) to advance pressure injury prevention/management. Goals: Enhance education, research, guideline dissemination, tool development, and clinical protocols. Activities: Joint initiatives (webinars, consensus docs, data sharing), improved resources for clinicians (risk assessment, offloading, dressings), focus on high-risk populations (elderly, immobile, diabetic). Ties to rising incidence and economic burden; emphasizes evidence-based, multidisciplinary approaches. Implications: Better outcomes, reduced complications/hospital stays, policy influence.

Key Highlights:

Focus: Prevention tools, management standards.

Benefits: Collaborative education/research.

Relevance: Strengthens pressure injury programs in chronic care.

Read announcement (subscription may be required)

Keywords: pressure injury partnership, prevention management, NPIAP

Factors Influencing Major Amputation and Death Following Diabetic Limb Salvage

Factors Influencing Major Amputation and Death Following Diabetic Limb Salvage

Summary: This systematic review of 49 studies (2020–2025) and real-world analysis of 72 high-risk diabetic patients via the Mid Essex Diabetes Amputation Reduction Plan (MEDARP) identifies key predictors of major amputation and mortality after limb salvage surgery for diabetic foot ulcers. Risk factors include older age, male sex, renal/cardiovascular disease, ischemia, osteomyelitis, and advanced ulcer classification. MDT models consistently lowered amputation rates (e.g., 35–80% reduction) and improved wound healing/survival, though heterogeneity limited meta-analysis. MEDARP achieved 6.9% major amputation and 12.5% mortality—below published medians—with significant gains in patient-reported outcomes like function and pain. Findings advocate standardized MDT protocols, early revascularization, and glycemic control to enhance limb preservation and chronic wound management.

Key Highlights:

Risk factors: Demographic (age, sex, race), clinical (CKD, PAD, ESRD, high HbA1c, low albumin, elevated CRP), surgical (wound size, infection, revascularization failure) predict 0–67.7% amputation and 9–18% 1-year mortality.

MDT benefits: Reduced amputations (e.g., 80% minor, 35% major), faster healing, cost savings; 17 studies showed survival gains, emphasizing coordinated care for DFUs.

MEDARP outcomes: 6.9% major amputation, 12.5% mortality in 72 patients; MSK-HQ scores rose from 29.3 to 49.4, MOXFQ pain/social scores improved markedly over 11 months.

Interventions: Revascularization, debridement, NPWT, antibiotics, flaps enhance salvage; glycemic optimization (time in range) and local vancomycin lower infection risks.

Limitations: Observational data, outcome variability; calls for standardized definitions, prospective trials to refine MDT for chronic diabetic wounds.

Read full article

Keywords: diabetic limb salvage, major amputation, multidisciplinary team, diabetic foot ulcers, wound healing MDT, Kit Ferguson, Sifat M Alam, Connor Phillips

Amputation Risk in Veterans with DFUs: What’s Driving Differences in Care and Outcomes

Amputation Risk in Veterans with DFUs: What’s Driving Differences in Care and Outcomes

Summary: Recent research highlights two major drivers of amputation risk in Veterans with diabetic foot ulcers (DFUs). First, developing a DFU is the strongest independent predictor of lower-extremity amputation — increasing risk nearly 10-fold. Second, a large JAMA Network Open study of over 86,000 Veterans found significant facility-level variation across VA centers: the odds of major leg amputation within one year were 1.85 times higher between two randomly selected facilities for an otherwise average patient. While mortality rates were relatively consistent, amputation rates varied widely (facility odds ratios ranging from 0.29 to 3.53), suggesting differences in care delivery, rather than patient factors alone, play a critical role.

Key Highlights:

DFU development increases amputation risk nearly 10-fold in Veterans

Significant VA facility-level variation in amputation rates (MOR 1.85) despite similar patient populations

Variation in care processes (early intervention, offloading, vascular assessment, multidisciplinary coordination) likely drives outcome differences

Emphasizes need for standardized, high-quality DFU protocols across all facilities

Source: Podimetrics analysis of recent VA studies

Read full LinkedIn post

Keywords: veterans DFU amputation, VA facility variation, limb salvage veterans

Diabetes-Related Extremity Amputation Depression and Distress (DREADD): A Multimethod Study

A Multimethod Study

Diabetes-related lower extremity amputations (LEAs) are among the most devastating complications of diabetes, profoundly impacting physical, psychological, and social well-being. The Diabetes-Related Extremity Amputation Depression and Distress (DREADD) study examines the emotional and psychological consequences of amputation in diabetic individuals, employing a multimethod approach to capture the full spectrum of patient experiences.

The Psychological Toll of Amputation

Individuals who undergo amputations due to diabetes-related complications, such as diabetic foot ulcers and peripheral artery disease (PAD), often experience profound emotional distress. Depression, anxiety, and post-traumatic stress are common, exacerbated by a loss of mobility, independence, and altered self-identity. Many struggle with feelings of grief, shame, and social isolation, impacting their overall quality of life and mental health.

A Multimethod Approach

The DREADD study employs both qualitative and quantitative research methods to explore these psychological impacts. Surveys and standardized depression scales, such as the Patient Health Questionnaire-9 (PHQ-9), are used to measure depression severity, while structured interviews provide insights into personal struggles, coping mechanisms, and unmet psychological needs. Additionally, biometric data, including heart rate variability and cortisol levels, offer physiological indicators of chronic stress and emotional dysregulation.

Findings and Implications for Care

Preliminary findings suggest that nearly half of patients experience moderate to severe depression post-amputation, with many lacking adequate mental health support. Factors such as poor social support, financial strain, and preexisting mental health conditions contribute to worse outcomes. The study underscores the need for integrated care models that address both physical and psychological rehabilitation, including peer support groups, counseling services, and cognitive behavioral therapy (CBT) to improve patient adaptation and emotional resilience.

By highlighting the critical intersection between diabetes, amputation, and mental health, the DREADD study aims to reshape post-amputation care, advocating for holistic interventions that go beyond wound healing to address the profound psychological distress faced by affected individuals.

After the Amputation…A Podiatrist’s Job Isn’t Done

After the Amputation: A Podiatrist’s Role in Postoperative Limb Preservation

Amputation is not the end of care—it’s the beginning of a new and critical phase. In this practice management piece, Dr. Andrew Schneider emphasizes the ongoing responsibilities podiatrists have after a patient undergoes a lower extremity amputation. Without proactive measures, patients are at high risk of stump breakdown, ulceration, and contralateral limb loss.

Key Highlights:

Patient Education is Essential: Patients may feel depression, grief, or even shame following amputation—regardless of severity. Clinicians must guide them through the transition and reinforce that quality of life is still possible.

Monitor the Stump: Even healed amputation sites are vulnerable. Regular evaluation for pressure points, breakdown, and poor prosthetic fit is necessary—especially in partial foot amputations like transmetatarsal or Chopart levels.

Protect the Contralateral Limb: After one amputation, the risk to the remaining limb rises sharply. Podiatrists must deliver comprehensive diabetic foot care, monitor for PAD, and apply the Q7 modifier for at-risk billing when appropriate.

Therapeutic Footwear is Not Optional: Post-amputation, custom toe fillers and accommodative insoles are critical to pressure redistribution. These are medical necessities—not just “free Medicare shoes.”

Team-Based Follow-Up: Optimal care includes referrals to prosthetists, physical therapists, diabetic educators, nutritionists, and mental health professionals to ensure holistic support.

Ultimately, limb preservation doesn’t stop with the surgical wound closure. Podiatrists must remain engaged to prevent a cascade of complications—and to empower their patients toward better mobility and health.

Originally published in the Nov/Dec 2024 issue of Podiatry Management Magazine.

Keywords:
amputation,
stump care,
contralateral limb risk,
therapeutic footwear,
diabetic foot

Posted in Articles

AOTI Participates in Panel Discussion at Preventing Diabetes-Related Amputations in America

by admin on August 24, 2023

A Solutions Summit Organized by the American Diabetes Association’s Amputation Prevention Alliance…

Antibiotic-Loaded Bone Cement Significantly Improves Diabetic Foot Ulcer Outcomes

Antibiotic-Loaded Bone Cement Significantly Improves Diabetic Foot Ulcer Outcomes: Systematic Review and Meta-Analysis

Summary: A systematic review and meta-analysis published in Frontiers in Cellular and Infection Microbiology (March 2026) evaluated antibiotic-loaded bone cement (ALBC) — a polymethylmethacrylate (PMMA)-based sustained-release drug delivery system — for managing diabetic foot ulcers (DFUs). Conducted by Xin Li and Zunhong Liang at Hainan Medical University, China, this is the most comprehensive synthesis to date, incorporating 22 randomized controlled trials (RCTs) and 1,295 patients. ALBC delivers high local antibiotic concentrations directly to infected tissue, circumventing systemic side effects and overcoming biofilm resistance that undermines systemic therapy in patients with neuropathy, impaired perfusion, and immune dysfunction. Using random-effects modeling in R, the authors assessed wound healing time, clinical effective rate, hospitalization duration, surgical frequency, VAS pain scores, and amputation rate. ALBC significantly shortened wound healing time by a mean of 7.10 days, improved clinical effective rate more than fourfold (OR = 4.05), reduced hospital stay by 8.56 days, decreased surgical frequency, lowered pain scores (SMD = −1.29), and reduced amputation risk by 81% (OR = 0.19) — with zero heterogeneity in the amputation outcome. Subgroup analyses by antibiotic regimen (vancomycin, gentamicin, combination) showed consistent superiority across all categories. A key limitation: all 22 RCTs originated from China, restricting generalizability; the authors call for international multicenter trials.

Key Highlights:

22 RCTs, 1,295 patients: ALBC shortened wound healing by 7.10 days and improved clinical effective rate fourfold (OR = 4.05) vs. standard care

Amputation risk reduced 81% (OR = 0.19; I² = 0%) — the most consistent finding across all included studies

Hospital stay shortened by 8.56 days; fewer surgeries required; VAS pain scores significantly lower (SMD = −1.29)

Efficacy consistent regardless of antibiotic regimen — vancomycin, gentamicin, and combination therapy all outperformed controls

Mechanism: high local antibiotic concentrations overcome biofilm-associated infection; Masquelet technique combination promotes vascularized membrane formation

All studies China-based; authors call for international multicenter RCTs to establish global external validity

Read full article

Keywords: antibiotic-loaded bone cement, diabetic foot ulcer, osteomyelitis, amputation prevention, wound healing meta-analysis, local antibiotic delivery

Xin Li, Zunhong Liang — Hainan Medical University / Hainan General Hospital, Haikou, China

PGIMER Marks World Diabetes Day with Special Patient Awareness Programme

PGIMER Marks World Diabetes Day with Special Patient Awareness Programme

Summary: On World Diabetes Day 2025, PGIMER Chandigarh hosted an awareness program for 100+ patients, focusing on diabetic foot ulcers (DFUs) as a major complication. Experts like Dr. Prabhat Rijal discussed hypoglycemia risks and DFU prevention through daily foot checks, proper footwear, and HbA1c <7%. The event highlighted multidisciplinary care (endocrinologists, surgeons, podiatrists) to reduce 15-25% DFU incidence and 20% amputation rate, with calls for community screening to address India's 77M diabetics.

Key Highlights:

DFU Risks: Neuropathy/circulation issues cause 15-25% incidence; 50% recur without care.

Prevention: Daily inspections, offloading, glycemic control; early referral cuts amputations 50%.

Event: 100+ attendees; sessions on hypoglycemia, DFU management; free screenings.

Expert: Dr. Rijal: “DFUs from poor sensation/healing; education saves limbs.”

Impact: Targets India’s 77M diabetics; promotes MDT for 80% 6-week healing.

Read full article

Keywords: World Diabetes Day, diabetic foot ulcers, PGIMER, amputation prevention, patient education

Prevention of Infection in Peripheral Arterial Reconstruction of the Lower Limb

Prevention of Infection in Peripheral Arterial Reconstruction of the Lower Limb

Summary: This Cochrane review synthesizes evidence from 40 RCTs and quasi-RCTs involving 7970 participants on pharmacological and non-pharmacological interventions to prevent infections after lower limb peripheral arterial reconstruction. Prophylactic antibiotics likely reduce surgical site infections (SSIs) and graft infections (low-certainty evidence), but no clear differences exist between short- vs. long-duration regimens or antibiotic types (very low-certainty). Closed incision negative pressure therapy (ciNPWT) may lower SSI and graft infection risks compared to standard closure (very low-certainty), while other methods like dressings or sutures show little benefit. The review highlights the need for standardized trials to guide wound care protocols in vascular surgery, where infections complicate healing and increase amputation risks.

Key Highlights:

Antibiotics vs. none: Reduced SSIs (RR 0.20, 95% CI 0.11-0.34; NNT 9) and graft infections (RR 0.19, 95% CI 0.06-0.63; low-certainty).

Short vs. long antibiotics: No difference in SSIs (RR 0.75, 95% CI 0.40-1.40) or graft infections (very low-certainty).

ciNPWT vs. standard: Possible reduction in SSIs (RR 0.49, 95% CI 0.27-0.86) and graft infections (RR 0.55, 95% CI 0.19-1.59; very low-certainty).

No effects on mortality, re-intervention, or amputation across comparisons (very low- to low-certainty evidence).

Implications: Suggest antibiotics for prevention; ciNPWT promising for high-risk surgical wounds; more research needed for dressings and techniques.

Read full article

Keywords: peripheral arterial reconstruction, surgical site infection, prophylactic antibiotics, closed incision NPWT, vascular wound care

Predictors of lower extremity amputation among

patients with diabetic foot ulcer in a tertiary health facility in north central Nigeria

INTRODUCTION: Diabetic foot ulcer is a complication of diabetes mellitus of great public health importance. It has the potential of leading to the dreaded sequelae of lower extremity amputation. This outcome is associated with significant morbidity and mortality, hence the need to explore its predictors among persons with diabetic foot ulcers.

METHODOLOGY: The study involved the review of the medical records of seventy (70) in-patients who had received treatment for diabetic foot ulcer at the Federal Medical Centre, Keffi, North Central Nigeria. In addition to obtaining sociodemographic and medical history, information on the Wagner grade of the ulcer, the presence of peripheral sensory neuropathy (using the 10g monofilament) and the presence of osteomyelitis (using plain X-ray of the foot) were obtained and documented. The prevalence rate of lower extremity amputation was also determined.

RESULTS: The study population comprised 52.9% males and 42.1% females. The mean age for male and female participants were 53.4±10.5 and 58.8±13.0 years respectively ( t = 2.35; p = 0.061). Majority of study subjects (37.1%) had Wagner grade 2 disease. Prevalence rate of amputation was 38.6%. Among the potential predictors of lower extremity amputation analyzed (Age, sex, foot care education, duration of diabetes, cigarette smoking, walking bare feet, impaired vision, peripheral neuropathy, hypertension, previous foot ulcer, osteomyelitis), none of them demonstrated a significant association with lower extremity amputation.

CONCLUSION: The list of potential predictors of lower extremity amputation considered in this study is by no means exhaustive. More studies involving larger study populations and other potential predictors of lower extremity amputation not considered in this work (such as peripheral artery disease and glycated haemoglobin) are encouraged.

read more

High Mortality & Amputation Rates After First Diabetic Foot Ulcer

High Mortality & Amputation Rates After First Diabetic Foot Ulcer: CODIA Cohort Findings

Summary: A large cohort study from Greater Paris hospitals (August 2017-October 2023) examines the one-year outcomes in over 3,100 patients hospitalized with their first diabetic foot ulcer (DFU). The findings are alarming: ~21.6% died and ~24.2% underwent lower-limb amputation within 12 months. Key risk factors for death included older age, cardiac, hepatic or renal disease, cancer history, and systemic inflammation; amputation risk was linked to male sex, peripheral artery disease, admission through emergency, and markers of inflammation.

Key Highlights:

Sample included 3,102 patients, median age ~70.7 years; 68% male.

Cumulative incidence of death within 12 months: **21.64%**.

Cumulative incidence of lower limb amputation within 12 months: **24.15%**.

Strong predictors of mortality: chronic comorbidities (heart, liver, kidney), history of cancer, and elevated systemic inflammation.

Key predictors of amputation: male gender, peripheral arterial disease, being admitted via the emergency department, and inflammation; interestingly, dementia was associated with *lower* risk of amputation.

Read the full article in Diabetes & Metabolism

Keywords:
first diabetic foot ulcer,
lower limb amputation,
one-year mortality,
peripheral artery disease,
systemic inflammation,
Julla Jean-Baptiste,
Théo Jolivet,
Candice Estellat,
Jean-François Gautier,
Florence Tubach

Predictive Model of Chronic Wounds Identifies Risk Factors for Amputation and Death

Predictive Model of Chronic Wounds Identifies Risk Factors for Amputation and Death

Summary: Multistate model from Regenstrief Chronic Wound Registry/INPC (n=52,916 Indiana lower-extremity chronic wound patients, 2011-2021) predicts progression to amputation/death. Key: DFUs ↑ minor amputation risk; venous ulcers ↓ amputation/death; pressure ulcers ↑ death but ↓ minor amputation; osteomyelitis ↑ amputation but ↓ death pre-major; sepsis ↑ death pre-major. 3-year mortality: >10% post-diagnosis, ~13% post-minor, 19% post-major. Model supports proactive decisions; registry expansion planned for ML on notes/socioeconomics.

Key Highlights:

Population: 52,916 patients; lower-extremity chronic wounds.

Risks: DFU ↑ minor amp; venous ↓ overall; pressure ↑ death; sepsis/osteomyelitis modifiers.

Mortality: 3-year >10% diagnosis, 13% minor amp, 19% major amp.

Quotes: Schleyer/Choi on real-world data for earlier intervention.

Source: Annals of Surgery (DOI: 10.1097/sla.0000000000006761).

Read full news

Keywords: chronic wounds, amputation risk, mortality, multistate model, Regenstrief

Columbia VA podiatrist recognized for diabetes-related amputation research

Columbia VA Podiatrist Recognized for Research on Emotional Impact of Diabetic Amputations

Dr. Brandon Brooks, a podiatrist at the Columbia VA Health Care System, received first place honors at the 10th Annual Conference of the American Society of Podiatric Surgeons for his innovative research on the psychological burden of diabetes-related amputations. His study introduces the concept of DREADD—Diabetes-Related Extremity Amputation Depression & Distress—to better understand the emotional trauma experienced by patients undergoing even minor amputations.

Key Highlights:

DREADD Framework: Dr. Brooks coined the acronym to emphasize that minor, non-traumatic amputations—such as toe removal—can lead to serious emotional consequences, including depression, anxiety, and treatment noncompliance.

Impact on Patient Behavior: The study found that approximately 90% of patients reported increased emotional distress after minor amputations, which contributed to poorer disease management, such as missed appointments and medication lapses.

Call for Integrated Care: Dr. Brooks advocates for integrating behavioral health into limb preservation teams and utilizing tools like the PHQ-9 to screen for depressive symptoms during podiatric care.

This research adds an important dimension to limb preservation, stressing that successful outcomes require attention not only to physical recovery but also to emotional well-being. Dr. Brooks collaborated on the study with his brother, Dr. Bradley Brooks, a board-certified psychiatrist, highlighting the value of interdisciplinary teamwork in advancing diabetic foot care.

Read the full article on the VA News website.

Keywords:
diabetes-related amputations,
psychological distress,
limb preservation,
Brandon Brooks,
Bradley Brooks

Diabetes Breakthrough: Sound Waves Offer New Hope for Foot Ulcers

Diabetes Breakthrough: Sound Waves Offer New Hope for Foot Ulcers

Summary:** Non-invasive sound wave therapy accelerates diabetic foot ulcer (DFU) healing by stimulating tissue regeneration and blood flow, considered an adjunct to standard wound care like debridement. While details on trial size/methods are limited, it reduces infection risks and may lessen surgery needs, improving quality of life and amputation prevention in diabetics. The approach builds on sound wave applications in medicine, positioning it as a safe, non-invasive option for chronic ulcers.

Key Highlights:

Mechanism: Sound waves enhance circulation and cellular repair in stalled DFUs.

Role: Adjunct to debridement/dressings; considered free of side effects.

Outcomes: Faster healing; potential to cut amputation risks in diabetics.

Expert View: Considered adjunct, not replacement; complements traditional care.

Implications: Improves mobility/QoL; broader medical applications for sound waves.

Read full article

Keywords: sound wave therapy, diabetic foot ulcers, non invasive, amputation prevention, adjunct therapy

Connected sensors for the prevention of chronic ulcers

As advancements in connectivity and miniaturization of electronics are made, smart sensors are beginning to find traction within the wound care pathway. IDTechEx has published a report titled Advanced Wound Care Technologies 2018 – 2028 and have previously reported on why disruption is needed in wound care in the next 10 years. Here, we explore a few connected devices that can contribute to the prevention of chronic wounds of pressure ulcers (PUs) and diabetic foot ulcers (DFUs).

Sensors for the Prevention of Pressure Ulcers MedicusTek have created the Sensable Care system which relies on a connected sensor pad or sensor mattress for detection of patient positioning to prevent pressure ulcer formation. By tracking patient position over time, the Sensable Care system can determine which areas of the patient are being exposed to prolonged pressure and notify caregivers accordingly for repositioning. The system resets if the patient successfully repositions themselves, thus decreasing the burden on caregivers where possible. Moreover, caregivers can receive immediate feedback as to whether their repositioning efforts were adequate in reliving the excessive pressure.

Read more at: https://www.wearabletechnologyinsights.com/articles/14270/connected-sensors-for-the-prevention-of-chronic-ulcers

Prevention and Management of Skin Tears in Aged Skin

Prevention and Management of Skin Tears in Aged Skin

Summary: A Wounds International “Made Easy” article authored by Karen Ousey, Corey Heerschap, Debra Thayer, and Emmy Nokaneng outlines updated ISTAP best practice guidelines for preventing and managing skin tears. These traumatic wounds are increasingly common in aged populations and require gentle, evidence-based care strategies.

Key Highlights:

Risk assessment: Updated ISTAP tools help identify patients at high risk, particularly older adults with fragile skin and comorbidities.

Prevention: Regular moisturisation, use of pH-balanced cleansers, avoidance of adhesives, and caregiver education reduce incidence.

Management: When skin tears occur, preserve and reposition flaps, avoid traumatic dressings, and minimize disturbance during healing.

Dressing selection: Silicone and non-adherent dressings support “undisturbed healing” and can lower costs and complications.

Read the full article on Wounds International

Keywords:
skin tears,
aged skin,
ISTAP,
Karen Ousey,
wound prevention

Enhancing Diabetic Foot Prevention: Global Guidelines and Questionnaire Tools

Enhancing Diabetic Foot Prevention: Global Guidelines and Questionnaire Tools

Summary: This systematic review examines international guidelines and validated questionnaire tools for diabetic foot screening (DFS), highlighting their role in preventing diabetic foot ulcers amid rising diabetes prevalence. It synthesizes core screening elements like neuropathy, vascular, and visual assessments, along with risk stratification models and screening frequencies, while identifying variations across guidelines and the potential of tools like Q-DFD and MNSI for accessible, self-managed prevention.

Key Highlights:

Core DFS components include monofilament testing for neuropathy, pedal pulse palpation for vascular status, and visual inspection for early ulcer signs.

Risk stratification categorizes patients as low-, moderate-, or high-risk, with screening intervals from annual to quarterly based on IWGDF and ADA guidelines.

Questionnaire tools such as Q-DFD and DFSQ-UMA enhance self-assessment and accessibility in diverse settings, reducing amputation risks.

Challenges involve guideline standardization and implementation in resource-limited areas; broader adoption by general practitioners could lower healthcare costs.

Read full article

Keywords:
diabetic foot screening,
diabetic foot ulcers,
risk stratification,
questionnaire tools,
wound healing prevention

AI and Pressure Sensors | Revolutionizing Pressure Ulcer Prevention in the NHS

AI and Pressure Sensors: Saving the NHS Billions on Bedsore Treatment

Summary: A collaborative feasibility study led by the University of South Wales (USW), in partnership with Graphene Trace Ltd and Cardiff & Vale University Health Board, is developing graphene-based e-textile pressure sensors integrated with AI to enable real-time monitoring and prediction of pressure ulcers (bedsores). Funded by £94,000 from the Henry Royce Institute, the project aims to transform prevention in clinical and community settings, where over 700,000 UK patients are affected annually at a cost of up to £2.1 billion to the NHS. By analyzing postures and delivering personalized alerts, this low-cost, scalable technology could drastically reduce avoidable ulcers, enhancing wound care efficiency and patient outcomes.

Key Highlights:

Project involves thin, flexible graphene sensors embedded in seating/bedding for continuous pressure mapping, outperforming bulky commercial systems in affordability and scalability.

AI/ML models classify postures, predict risks, and provide real-time interventions, building on USW’s expertise in CNNs for sitting posture analysis and postural scoring.

Pressure ulcers affect >700,000 people yearly in UK healthcare, with many preventable; current NHS costs reach £2.1B annually due to prolonged healing and complications.

Potential savings: Billions of pounds through proactive prevention, reducing treatment burdens and improving quality of life for at-risk patients with mobility issues.

Expert insights emphasize clinical-economic impact: Prof. Colin Gibson notes transformational potential for care quality; Prof. Janusz Kulon highlights life-changing AI-fabric integration.

Read full article

Keywords:
pressure ulcers,
AI prevention,
graphene sensors,
bedsores,
wound care innovation

Guideline Adherence, Team Approach to Prevention Impacts Surgical Site Infections

Guideline Adherence, Team Approach to Prevention Impacts Surgical Site Infections

Summary:** This review of 20+ studies demonstrates that strict adherence to SSI prevention guidelines—antibiotic timing, normothermia, and hair removal—combined with multidisciplinary teams (surgeons, nurses, IPs) reduces infection rates by 25-40%. Post-discharge wound care education is crucial, as 50% of SSIs occur after hospital stay; tools like apps for monitoring improve compliance and outcomes in high-risk surgeries like orthopedic or vascular procedures.

Key Highlights:

Adherence Impact: 95% compliance lowers SSIs by 30%; gaps in post-op care contribute 60% of cases.

Team Benefits: MDT protocols cut re-admissions; nurse-led education boosts patient self-monitoring.

Post-Discharge: Digital tools for wound checks; patient guidance on hygiene and signs of infection essential.

Evidence: Meta-analysis of 15 RCTs; NNT 8 for guideline bundles.

Implications: Standardize education; integrate IPs for waste reduction in wound care.

Read full article

Keywords: SSI prevention, guideline adherence, multidisciplinary team, post-discharge care, surgical wounds

From Screening to Full Risk Assessment in Pressure Injury Prevention

From Screening to Full Risk Assessment in Pressure Injury Prevention

Summary: Article outlines 2019 International Guideline’s two-step PI prevention: screening (quick, on admission for mobility/friction/Stage 1) then full assessment if risk not ruled out (scales like Braden + clinical judgment, head-to-toe skin check). PURPOSE-T tool supports both; high-risk settings may skip screening. Emphasizes modifiable factors, interprofessional input, reassessment; examples from Australia/Germany policies.

Key Highlights:

Screening: Dichotomous (risk/no risk); fast, no full skin exam.

Full: Scales + judgment; factors like perfusion/nutrition.

Tools: Braden/Norton/Waterlow; PURPOSE-T qualitative.

Best Practices: Structured, population-specific, ongoing evaluation.

Read full article

Keywords: PI risk assessment, screening, full assessment, PURPOSE-T, prevention

NPIAP Webinar | Pressure Injury Prevention Update

January 21st Webinar: Open for Registration

Summary: NPIAP webinar January 21, 2026: “Pressure Injury Prevention: Current Guidelines and Best Practices.” Covers updated staging, risk assessment tools, support surfaces, nutrition, and multidisciplinary prevention bundles. Free registration; 1 CE credit available.

Key Highlights:

Date: Jan 21, 2026; virtual.

Topics: Staging, risk tools, bundles, nutrition.

CE: 1 credit.

Registration: Open to all.

Register

Keywords: NPIAP webinar, pressure injury, prevention, guidelines

Knowledge and Practices in Diabetic Foot Ulcer Prevention Among Patients with Diabetes …

Knowledge and Practices in Diabetic Foot Ulcer Prevention Among Patients with Diabetes Mellitus in Gauteng, South Africa

Summary: This research assesses awareness and behaviors related to diabetic foot ulcer prevention among diabetes patients in Gauteng. Findings reveal moderate knowledge but inconsistent daily practices (foot checks, footwear, hygiene), underscoring the need for structured patient education and community programs to reduce DFU incidence and amputations.

Key Highlights:

Knowledge gaps in daily self-care routines

Low adherence to preventive behaviors

Call for culturally tailored education

Read full study

Keywords: DFU prevention, patient education, South Africa diabetes

Karnataka Leads National Push on Diabetic Foot Prevention with Launch of PRAIAS Initiative

Karnataka Leads National Push on Diabetic Foot Prevention with Launch of PRAIAS Initiative

Summary: Karnataka has launched the PRAIAS (Podiatry Reach Across India for Awareness and Screening) initiative at Gulbarga Institute of Medical Sciences in Kalaburagi to combat the rising burden of diabetic foot complications. Conceptualized by diabetic foot surgeons Dr. Sanjay Sharma and Dr. Pavan Belehalli and driven by FootSecure and StrideAide, the program features India’s first Digital Podiatry Screening Van equipped with advanced diagnostic tools. The mobile unit will travel across the country, focusing on underserved and remote areas to provide screening, awareness, and early intervention. Globally, a limb is lost every 20 seconds due to diabetes; in India, a new diabetic foot ulcer develops every 12 seconds. The initiative aims to reduce amputations through timely detection, education, and lifestyle management, with strong support from Karnataka’s Minister for Medical Education.

Key Highlights:

First-of-its-kind Digital Podiatry Screening Van for nationwide outreach

Focus on early detection and prevention in rural/underserved communities

Led by Dr. Sanjay Sharma and Dr. Pavan Belehalli; supported by FootSecure and StrideAide

Addresses alarming statistics: limb lost every 20 seconds globally due to diabetes

Read full article

Keywords: PRAIAS initiative, diabetic foot prevention, screening van, Sanjay Sharma

Prevention and Care of Pressure Ulcers in Long-Term Bedridden Adults: An Evidence-Based Review

Prevention and Care of Pressure Ulcers in Long-Term Bedridden Adults: An Evidence-Based Review

Summary: This review synthesizes current evidence on the prevention and management of pressure ulcers in long-term bedridden adults. It emphasises validated risk assessment tools (e.g., Braden Scale), regular repositioning schedules, appropriate support surfaces, nutritional optimisation, and skin care protocols. The authors stress the importance of multidisciplinary approaches to reduce incidence and improve healing outcomes in this vulnerable population.

Key Highlights:

Comprehensive risk assessment and early identification strategies

Evidence-based repositioning and pressure-redistribution recommendations

Role of nutrition, skin care, and multidisciplinary teams

Practical guidance for long-term care settings

Read full open-access article

Keywords: pressure ulcer prevention, bedridden pressure ulcers, Braden Scale

$70,000 Amputation or $250 Offloading Procedure

Please choose one

Easy choice right? Not for the Government of Ontario Canada. The vast majority of the 2,000 amputations that occur per year in that country would be preventable with common offloading practices (total contact casting*). Doris Grinspun, CEO of the Registered Nurses’ Association of Ontario was assured three years ago by government ‘premieres’ that they would begin to cover such procedures … that’s three years or 6,000 legs or $420,000,000 ago. “We’re willing to pay for the amputations but we’re not willing to pay for the prevention,” offered Grinspun.

Cost and human suffering aside, mortality rates jump significantly after an amputation especially in older patients, diabetes further increases mortality rates. In one rather grim study** 390 patients that had undergone lower extremity amputations were reviewed, of the patients with diabetes “the median time to death was 27.2 months“.

So if you are suffering from diabetic neuropathy and experience a diabetic foot ulcer and happen to be living in Ontario Canada you need to get your affairs in order. But there is hope as The Ontario Health Technology Advisory Committee is currently assessing total contact casting to treat foot ulcers, check back in three years.
original article

*total contact casting is considered “The Gold Standard of off-loading”. A comparison of the three major off-loading methods (total-contact casts (TCCs), removable cast walkers (RCWs), and half-shoes) reinforces this point. The proportions of healing for patients treated with TCC, RCW, and half-shoe were 89.5, 65.0, and 58.3%, respectively. A significantly higher proportion of patients were healed by 12 weeks in the TCC group when compared with the two other modalities.

**Mortality and Hospitalization in Patients After Amputation
http://care.diabetesjournals.org/content/29/10/2252.full

Off-Loading the Diabetic Foot Wound
A randomized clinical trial
http://care.diabetesjournals.org/content/24/6/1019.long

Kiwis are losing limbs in record numbers

Kiwis are losing limbs in record numbers – and most never see it coming

Summary: Diabetes is driving a surge in amputations across New Zealand, with nearly 1200 toes, feet, and legs lost each year. Despite most being preventable, health systems are struggling to stem the rise. Community-based podiatry programs are helping, but data show amputations have grown by 55% in less than a decade, underscoring the urgent need for prevention and early intervention.

Key Highlights

Growing toll: Official figures show 1181 amputations in 2023/24, including over 800 toes and more than 300 legs below or around the knee.

Younger patients: Thirteen diabetics under age 30 underwent amputations, highlighting the impact of obesity and poor diet on younger populations.

Regional disparities: Northland, Counties Manukau, Auckland, Waitemata, Wellington, and Waikato have seen cases nearly double in eight years, while regions like Canterbury remain stable.

Community podiatry: Podiatrist Lawrence Kingi works at marae-based clinics, treating foot injuries early and educating patients to prevent progression to sepsis and amputation.

Human impact: More than half of patients with major lower-leg amputations die within four years, making early podiatric intervention critical.

Everyday injuries: Even minor wounds like corns, ingrown toenails, or bumps can spiral into amputations when combined with neuropathy and poor circulation.

Conclusion

New Zealand’s rising diabetes-related amputations reveal a preventable public health crisis. Expanding podiatric care, education, and community outreach is essential to keep patients mobile, independent, and alive. Without intervention, the amputation burden will continue to climb, with devastating human and economic consequences.

Read the full article at Stuff

Keywords:
New Zealand,
diabetes,
amputations,
foot ulcers,
podiatry,
Lawrence Kingi

High Mortality Following Major Amputation in Diabetes: An Analysis of Risk Factors and Causes of Death

High Mortality Following Major Amputation in Diabetes: An Analysis of Risk Factors and Causes of Death (2024)

Summary: Summary of 2024 Diabetes UK conference abstract (published in Diabetic Medicine): Analyzed 48 major non-traumatic lower-limb amputations (2022–2023); 31% died within 1 year (mostly in-hospital). Risk factors: age >40 at diabetes diagnosis, advanced nephropathy, retinopathy; common profile includes long-duration T2DM, neuropathy/PAD. Causes: cardiorespiratory (40%), sepsis (DFU-related 13%, unrelated 20%). Implications: Emphasize managing comorbidities for better outcomes/prevention in diabetic wound/amputation cases.

Key Highlights:

Mortality: 31% at 1 year; similar for BKA/AKA.

Risks: Nephropathy/retinopathy predictors; high comorbidities (neuropathy 80%, PAD 80%).

Causes: Cardiorespiratory dominant; sepsis notable.

Amputation reasons: Ischaemia (56%), sepsis/gangrene (36%).

Read summary

Keywords: amputation mortality, diabetic amputation, risk factors, nephropathy

Kenya’s Wound Care Crisis and the Urgent Need for Early Intervention to Prevent Amputations

Kenya’s Wound Care Crisis and the Urgent Need for Early Intervention to Prevent Amputations

Summary: Kenya grapples with a mounting wound care crisis, where 15% of adults suffer injuries yearly, leading to untreated chronic conditions, infections, and preventable amputations, particularly in rural areas with 13% wound prevalence. Diabetes amplifies risks, with 22% of wounds developing secondary infections, as seen in cases like Kennedy Chesi Amunavi’s near-amputation from a neglected diabetic ulcer. Experts like Dr. Shilpa Mulki and Dr. Chris Kibiwott advocate for decentralized services, clinician training in diabetic foot management, compression therapy, and biotherapy, alongside awareness campaigns for early screening to save limbs and reduce healthcare burdens.

Key Highlights:

Stats: 15% annual adult injuries; 4% from road crashes, 10.9% unintentional; rural 13% wound rate; 22% secondary infections.

Case: Amunavi’s diabetic boil worsened by herbs, nearly requiring amputation, saved via grafting after delays.

Gaps: No public hospital wound programs; 46% NCD specialists; rural shortages in nutrition/lab support.

Recommendations: Daily foot checks, compression, biotherapy; train generalists; integrate podiatrists/nutritionists.

Impact: Early care prevents amputations, preserves livelihoods; calls for county/MoH prioritization.

Read full article

Keywords: wound care crisis, diabetic amputations, early intervention, rural wound care, compression therapy

How new technology is preventing diabetic foot ulcers and amputations

How New Technology Is Preventing Diabetic Foot Ulcers and Amputations

Published June 5, 2025 by the Disabled American Veterans (DAV), this article highlights how the VA partnered with Podimetrics to roll out the **SmartMat®**, a temperature-sensing floor mat designed to detect diabetic foot ulcer (DFU) risk before wounds appear—aiming to reduce amputation and improve veteran health.

Key Highlights:

Veteran Impact: Jesse Lee, a USA Navy veteran exposed to Agent Orange and managing Type 2 diabetes, received a SmartMat® from the VA. The simple 30‑second foot scan helps identify early “hotspots” (≥2.2 °C difference sustained for two days) that predict ulcer formation.

Critical Uplink: The SmartMat® sends temperature readings directly to VA clinicians, enabling proactive outreach—such as offloading advice or clinic visits—before ulceration occurs.

Life-Saving Potential: VA data shows 80% of non-traumatic amputations originate from DFUs. The five-year mortality rate post-first ulcer is ~43–70%. Early detection tools like SmartMat® could significantly lower these numbers.

Partnership and Innovation: Podimetrics CEO Dr. Jon Bloom—a physician and son of a Vietnam veteran—collaborated with the VA’s Office of Healthcare Innovation to make this technology accessible within the VA healthcare system.

Vision for Scale: The VA plans broader implementation of SmartMat® technology across medical centers to reduce amputations and better monitor diabetic veterans.

This initiative marks a shift toward predictive wound care—employing data-driven insights to intervene early and potentially save limbs and lives among high-risk diabetic populations.

Keywords:
SmartMat,
Podimetrics,
Jesse Lee,
Dr. Jon Bloom,
temperature monitoring,
diabetic foot ulcer,
early intervention

Read the full article on DAV.org

🔬 Spotlight: Temperature Monitoring and Predictive Tools for Diabetic Foot Ulcer Prevention

Emerging technologies are revolutionizing diabetic foot care by predicting wounds before they form. These platforms offer continuous, passive monitoring and early alerts—shifting the paradigm from reactive treatment to proactive prevention.

SmartMat® by Podimetrics: A home-based mat that passively captures plantar temperature data in seconds. Consistent temperature asymmetries (≥2.2 °C) signal inflammation, allowing clinicians to intervene before ulcers appear.

Orpyx SI® Sensory Insoles: Wearable insoles equipped with sensors that detect pressure and temperature changes. Real-time feedback is sent to a smartphone app to prompt offloading and reduce ulceration risk.

Thermal Imaging Platforms: Clinical devices that capture high-resolution thermal scans of both feet. AI-enhanced analytics identify risk zones not visible to the eye and track wound healing progression.

Remote Monitoring Integration: Platforms like Swift Medical and Tissue Analytics allow patients to capture foot data and transmit it securely to providers. When combined with temperature or pressure alerts, care teams can act before damage worsens.

By incorporating smart sensors and remote connectivity, these tools offer veterans and clinicians powerful new ways to prevent DFUs and reduce limb loss—particularly for high-risk, underserved populations.

Topical Pravibismane Shows Promise for Diabetic Foot Infections

Phase 1b Results: Topical Pravibismane Shows Promise for Diabetic Foot Infections

Summary: This phase 1b randomized, multi-center, double-blind, placebo-controlled trial assessed topical pravibismane—a novel broad-spectrum anti-infective targeting biofilm-associated pathogens—as an adjunct to standard care for moderate to severe diabetic foot ulcer (DFU) infections in 53 patients over 4 weeks. Primarily evaluating safety, the study also captured efficacy signals, revealing nearly 3-fold greater wound size reduction, lower amputation rates, and microbiological clearance of key pathogens compared to placebo. Well-tolerated across doses with no significant safety issues, pravibismane addresses antimicrobial resistance and biofilm challenges, potentially reducing reliance on systemic antibiotics and supporting faster wound closure in this high-risk population.

Key Highlights:

Trial design: Double-blind, placebo-controlled; topical application over 4 weeks; primary endpoint safety/tolerability; secondary: wound reduction, amputations, microbiology.

Efficacy: ~3x greater ulcer size reduction vs. placebo; reduced lower extremity amputations; effective against biofilm-forming bacteria in DFUs.

Safety: Well-tolerated with no significant concerns; supports advancement to larger trials.

Expert quote (Benjamin Lipsky, MD): “We are pleased with the safety results and signals of clinical efficacy, which we believe warrant further clinical development… There is currently a major unmet need for new, easy-to-apply drug agents with multiple modes of activity to treat infection.”

Expert quote (David Armstrong, DPM, PhD): “We are encouraged by the clinical efficacy signals… We need new agents that promote faster closing of infected wounds because we are currently dependent on an expensive, time-consuming, two-pronged approach.”

Future: Sponsored by Microbion; data published in International Wound Journal (April 3, 2024); plans for further development in DFI treatment.

Read full article

Keywords: topical pravibismane, diabetic foot ulcer infection, biofilm targeting, wound size reduction, amputation prevention, Benjamin Lipsky, David Armstrong, Microbion

Therapeutic Strategies for Managing Diabetic Foot Ulcers and Mitigating Associated Complications

Editorial: Innovative Therapeutic Strategies for Managing Diabetic Foot Ulcers and Mitigating Associated Complications

Summary: Published March 19, 2026 in Frontiers in Pharmacology (Vol. 17, IF 4.8), this editorial by Calvin A. Omolo (United States International University – Africa / University of KwaZulu-Natal), Vinod Kumar Yata (Malla Reddy University, Hyderabad), Yasodha Krishna Janapati, and Sudharshan Reddy Dachani (Shaqra University, Saudi Arabia) synthesizes findings from a 22-article Research Topic on innovative DFU therapeutic strategies and their associated complications. The editorial situates the field within an urgent global context — over 18.6 million new DFUs annually, a lower-extremity amputation every 20 seconds worldwide, and 5-year DFU mortality comparable to many cancers — and argues that conventional care centred on debridement, offloading, and infection control is insufficient for a condition with such devastating consequences. The editorial organises the 22 articles into five thematic pillars. On pharmacological innovation, it highlights a Boruta algorithm-guided approach to antibiotic selection for wound bone cement (Zhang et al.) and the identification of cuproptosis as a novel DFU therapeutic target (Li et al.). On polyherbal formulations, it notes that modern DFU herbal research is increasingly mechanistic, elucidating molecular pathways (NF-κB, Nrf2, growth factor signalling) through which plants like Curcuma longa, Aloe vera, and Centella asiatica promote healing, though standardisation and large RCT evidence remain lacking. On advanced drug delivery systems, the editorial discusses a systematic review and meta-analysis of hyaluronic acid and its derivatives (Yao et al.) and a study showing that NPWT combined with silver-ion dressings reduces IL-6 and TNF-α while improving healing outcomes. On wound microbiome modulation, it covers the contribution of dysbiosis to chronicity and the growing application of algorithm-guided microbiome science to antibiotic therapy. On clinical translation and personalised medicine, it highlights a scoping review of DFU clinical trial design (Zhang et al.) and a validated nomogram predicting moderate-to-severe DFU risk in type 2 diabetes patients (Zhang et al.). The editorial closes with a call for global equity in implementation — addressing the cost-prohibitive nature of advanced biomaterials and complex polyherbal formulations in low- and middle-income countries — and argues for simplified, locally adaptable, task-shifted care models that can deliver innovation equitably.

Key Highlights:

Global DFU burden framing: 18.6 million new ulcers annually, one amputation every 20 seconds worldwide, 5-year mortality rivalling multiple common cancers — yet DFU recurrence and its consequences remain normalised in clinical culture, which the editorial explicitly critiques

Precision pharmacology: algorithm-guided microbiome analysis for antibiotic selection in wound bone cement (moving away from empirical treatment) and cuproptosis as a novel mechanistic DFU target — both requiring substantial further validation before clinical readiness

Polyherbal and natural formulations: key wound-healing herbs (*Curcuma longa*, *Aloe vera*, *Centella asiatica*) showing mechanistic molecular evidence (NF-κB, Nrf2, growth factor signalling), but lacking standardised extracts and large-scale RCTs with hard endpoints such as amputation prevention

Advanced biomaterials: hyaluronic acid derivatives (systematic review confirming moist wound environment maintenance and controlled drug/growth factor release); NPWT + silver-ion dressings (reduced IL-6, TNF-α, and improved healing) — both showing promise but facing cost and regulatory complexity barriers

Clinical translation tools: a scoping review of DFU clinical trial design flaws; a nomogram for individual moderate-to-severe DFU risk prediction in type 2 diabetes patients — both addressing the gap between laboratory innovation and bedside implementation

Global equity imperative: the editorial explicitly calls for parallel development of simplified, affordable, locally sourced adaptations of advanced therapies, including low-cost point-of-care diagnostics, standardised herbal products, and task-shifted care models, to prevent innovation from widening existing health disparities

Read full article

Keywords: diabetic foot ulcer pharmacology, DFU wound microbiome, polyherbal DFU treatment, hyaluronic acid wound healing, precision medicine diabetic foot, DFU global amputation burden

Calvin A. Omolo, Vinod Kumar Yata, Yasodha Krishna Janapati, Sudharshan Reddy Dachani

Best practice recommendations for the Prevention and

Management of Diabetic Foot Ulcers

Diabetes mellitus (DM) is a metabolic disorder characterized by hyperglycemia that
leads to microvascular, macrovascular and neuropathic complications. In 2016, there
were 11 million Canadians living with type 1, type 2 or pre-diabetes, and every three
minutes another Canadian is diagnosed. Certain populations are at higher risk for
developing type 2 DM, including those of Asian, African, Hispanic and Indigenous decent.
The rates of DM are three to five times higher in Indigenous populations, an issue
compounded by unique barriers to care including, but not limited to, a lack of cultural
competency among health-care providers, jurisdictional confusion, limited access to
care, geographical location and language barriers.

Foot health should be a major consideration for people with diabetes and for those
who care for them. Foot complications in this high-risk population can lead to a cascade
of negative complications, potentially resulting in loss of limb and life.
The lifetime risk for foot ulceration in people with diabetes is 15 to 25%. According to
the International Diabetes Federation, persons with diabetes are 15 to 40 times more
likely to require lower-leg amputation compared to the general population. Approximately
85% of amputations are preceded by the development of a neuropathic foot
ulcer.

Following a lower-limb amputation, people with diabetes not only suffer the
clinical and psychological consequences of limb loss, but also have a five-year mortality
rate of 50%. This is a higher mortality rate than is seen in breast cancer in females,
prostate cancer in males or lymphoma … read more

How to Implement Diabetic Foot Ulcer Prevention

Diabetic foot ulcers (DFUs) are open sores or wounds caused by a combination of factors that include neuropathy (lack of sensation), poor circulation, foot deformities, friction or pressure, trauma, and duration of diabetes with complication risks. DFUs occur in 34% of people with diabetes,1 and approximately 14% to 24 % of patients with diabetes who develop a DFU will require an amputation … Diabetic complications cause 40% to 60% of nontraumatic lower limb amputations worldwide, and 80% of these amputations follow DFUs.2 However, a DFU is a preventable condition, despite being the leading cause of nontraumatic lower extremity amputations in the United States … read more

The Role of Physical and Occupational Therapy in Pressure Injury Prevention

Physical and occupational therapists are not always thought of when it comes to pressure injury prevention; however, their training and knowledge makes them key players in the interprofessional team. Pressure injuries are costly medical issues that can impact a patient’s ability to rehabilitate. Therapists need to understand the causes of pressure injuries to help reduce a patient’s risk. Nursing uses risk assessment instruments to identify patients who are risk for developing a pressure injury. Many of the elements that therapists address in an evaluation and daily treatment are those that are also being addressed in the risk assessment instruments. This article provides an overview to help therapists recognize ways to incorporate pressure injury prevention into their evaluation and daily practice and effectively communicate with other health care professionals … read more

Prevention of hospital-acquired foot pressure injuries

Assessment and consideration of foot risk factors is essential for proactive prevention of hospital-acquired foot pressure injuries

The research outlined in this article aimed to see if high-risk feet were also identified as ‘at risk of ulceration’ by the Braden Score. One-hundred-and-thirty-two patients had foot risk stratified by a podiatrist and their admission Braden pressure injury (PI) risk level was compared. Only 36% were decreed to be at the same level of risk by both methods. The lack of agreement was demonstrated by a very low Kappa score. The Braden score underestimated PI risk to feet for 52% of the study population. Therefore, the authors concluded that less reliance on the Braden score is needed for the implementation of prevention to reduce rates hospital-acquired foot PIs … read more

Post-Procedure Infection Prevention – video

Scott Freeman, PA-C, talks post-procedure infection prevention at the current New Wave Dermatology conference.

Scott Freeman, PA-C, in a video for Dermatology Times®, highlighted the importance of making sure patients adhere to good wound care at the Florida Society of Dermatology Physician Assistants New Wave Dermatology Conference being held this week in Coral Gables, Florida. Additionally, he gave pearls on infection prevention.
… watch

PREVENTION AND MANAGEMENT OF PERIWOUND SKIN COMPLICATIONS

ISTAP Best Practice Recommendations for Prevention and Management of Periwound Skin Complications

The International Skin Tear Advisory Panel (ISTAP) has published comprehensive guidelines to enhance the prevention and management of periwound skin complications. These recommendations emphasize the significance of periwound skin health in promoting effective wound healing and reducing associated complications. Read the full document.

Key Highlights:

Definition of Periwound: The periwound is identified as the area surrounding a wound that may be affected by wound-related factors and/or underlying pathology.

Risks of Periwound Damage: Complications such as maceration, skin stripping, and medical adhesive-related skin injury (MARSI) can delay healing, increase infection risk, and elevate treatment costs.

Assessment Protocols: Regular evaluation of the periwound area should be integrated into wound assessments, focusing on skin integrity, moisture levels, and signs of infection or inflammation.

Management Strategies: Effective approaches include managing exudate to prevent moisture-associated skin damage (MASD), using appropriate dressings, and employing gentle cleansing techniques with pH-balanced solutions.

Infection Control: Implementing antimicrobial stewardship principles is crucial to prevent and manage infections without contributing to antimicrobial resistance.

Education and Training: Ongoing education for healthcare professionals and caregivers is essential to ensure best practices in periwound care are understood and applied consistently.

These guidelines serve as a valuable resource for clinicians aiming to improve patient outcomes through diligent periwound care.

Read the full document on the Wounds International website.

Keywords:
periwound skin care,
moisture-associated skin damage,
medical adhesive-related skin injury,
wound assessment,
antimicrobial stewardship

Optimizing Nutrition Interventions for Prevention and Treatment of Pressure Injuries

Optimizing Nutrition Interventions for Prevention and Treatment of Pressure Injuries

Summary: This educational blog post by WoundSource highlights the pivotal role of nutrition in pressure injury prevention and management. The key message: regular nutritional screening is linked with lower rates of pressure injuries and shorter hospital stays.

Key Highlights:

Early nutritional screening helps reduce the incidence of pressure injuries and shortens length of stay in hospitalized patients.

A collaborative, multidisciplinary care strategy is essential for improving nutritional status and supporting skin integrity.

Read the full post on WoundSource

Keywords: nutrition interventions, pressure injuries, nutritional screening, length of stay, multidisciplinary care

From Pressure to Prevention: Rethinking Ulcer Care in Emergency Settings

From Pressure to Prevention: Rethinking Ulcer Care in Emergency Settings

Summary: This webinar, hosted during #STOPTHEPRESSURE week, examines pressure ulcer prevention in emergency settings, focusing on challenges in Emergency Departments (ED) and pre-hospital care. It highlights barriers such as limited space in ambulances, corridor care, and prolonged trolley use, alongside staff shortages and inadequate training for paramedics on skin checks. Collaborative efforts between North Bristol Trust ED teams and South Western Ambulance Service (SWAST) aim to improve outcomes through better skin assessments, use of repose overlays, trauma mattresses, and dynamic mattresses for high-risk patients. The event features panel discussions on patient dignity, frailty increases, and system-driven changes to reduce harm and transform care culture.

Key Highlights:

Challenges in ED and ambulance settings include limited repositioning space, patients on chairs or trolleys for extended periods, and dignity issues during skin checks.

Staff recognize that corridor care and ambulance waits deviate from standard care, with paramedics prioritizing clinical assessments over pressure ulcer checks due to minimal training.

Collaborative working between ED teams and SWAST enhances skin checks and early pressure ulcer detection.

Patient comfort improves with repose overlays on trolleys and trauma mattresses, even for low-risk individuals.

High-risk patients benefit from beds with hybrid dynamic or full dynamic mattresses to prevent ulcers.

Read full article

Keywords: pressure ulcers, emergency departments, ambulance services, skin checks, dynamic mattresses

Implementation Strategies for the Prevention and Management of Diabetes-Related Foot Disease

Implementation Strategies for the Prevention and Management of Diabetes-Related Foot Disease: A Consensus Document

Summary: This international consensus document translates evidence-based guidelines into actionable implementation strategies for diabetes-related foot disease. It covers systematic screening, risk stratification, patient education, therapeutic offloading, timely vascular intervention, infection management, and integrated multidisciplinary pathways. The document aims to bridge the gap between guidelines and real-world clinical practice to reduce ulcers, amputations, and mortality.

Key Highlights:

Clear pathways for annual screening and risk stratification

Practical offloading and footwear recommendations

Emphasis on rapid access to multidisciplinary teams

Strategies to overcome implementation barriers in different settings

Read full consensus document

Keywords: diabetes foot disease implementation, DFD prevention, international DFU guidelines

Interpretable Machine Learning for the Prediction of Amputation Risk Following

Lower Extremity Infrainguinal Endovascular Interventions for Peripheral Arterial Disease

Abstract
Purpose: Severe peripheral artery disease (PAD) may result in lower extremity amputation or require multiple procedures to achieve limb salvage. Current prediction models for major amputation risk have had limited performance at the individual level. We developed an interpretable machine learning model that will allow clinicians to identify patients at risk of amputation and optimize treatment decisions for PAD patients.

Methods: We utilized the American College of Surgeons National Surgical Quality Improvement Program database to collect preoperative clinical and laboratory information on 14,444 patients who underwent lower extremity endovascular procedures for PAD from 2011 to 2018. Using data from 2011 to 2017 for training and data from 2018 for testing, we developed a machine learning model to predict 30 day amputation in this patient population. We present performance metrics overall and stratified by race, sex, and age. We also demonstrate model interpretability using Gini importance and SHapley Additive exPlanations.

Results: A random forest machine learning model achieved an area under the receiver-operator curve (AU-ROC) of 0.81. The most important features of the model were elective surgery designation, claudication, open wound/wound infection, white blood cell count, and albumin. The model performed equally well on white and non-white patients (Delong p-value = 0.189), males and females (Delong p-value = 0.572), and patients under age 65 and patients age 65 and older (Delong p-value = 0.704).

Conclusion: We present a machine learning model that predicts 30 day major amputation events in PAD patients undergoing lower extremity endovascular procedures. This model can optimize clinical decision-making for patients with PAD.

Keywords: Endovascular intervention; Machine learning; Peripheral artery disease; Risk assessment.

… from PubMed

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WCA Introduces LUVO as a Solution for Eliminating Amputations and Death

Due to Non-Healing Wounds During Limb Loss Awareness Month

SIERRA MADRE, Calif., April 7, 2022 /PRNewswire/ — Wound Care Advantage (WCA), the leading provider of support services for wound care programs, is proud to release the first digital network platform for wound centers, LUVO. Available now, LUVO supports wound centers by offering a suite of digital tools designed to streamline and simplify day to day operations, allowing program leaders to get more done in less time.

WCA was founded 20 years ago with a singular goal: to eliminate amputations caused by non-healing wounds within our lifetime. To that end, WCA is dedicated to building a national network of profitable and effective wound centers that can treat non-healing wounds in their community before amputation is the only option. LUVO makes this possible. The platform modernizes referral management, offers intelligent reporting that lets leaders know where their center stands, and offers a direct line to WCA experts for chart reviews, audit assistance, and general guidance. A full list of tools can be found at www.thewca.com/expertise/technology

“Wounds lead to amputations, amputations lead to death. LUVO was created to break this cycle,” says CEO Mike Comer. “LUVO can strengthen any wound center, works with any EMR system a hospital may use, and is the most cost-effective option for wound center operations. It ensures wound programs operate efficiently and effectively while keeping their doors open for the next generation of wound care patients.”

April is Limb Loss and Limb Difference Awareness Month, a time to raise awareness about this issue and remember the millions of people living with limb loss. Of the estimated 150,000 lower limb amputations performed in the U.S. each year, approximately 82 percent stem from a diabetic foot ulcer. Patients undergoing these procedures have a three-year mortality risk of 71 percent. By incorporating LUVO into wound centers, they can run more effective and profitable healing programs, without bringing in an outside management company.

“Having LUVO in our centers means more gets done everyday with less frustration. It’s become the heart of our program,” says Mary Mary Brightwell Tuttle, Program Director at Placentia-Linda Hospital Center for Wound Care. “Our staff and clinicians can focus on patients because LUVO handles so much of our busy work, tracks metrics across our program, and catches errors before we make them.”

The LUVO platform powers the WCA Network of independent wound centers across the country, allowing every hospital to take advantage of the cost effective benefits of joining a powerful cohort of wound centers dedicated to eliminating wound related amputations.

“Having subject matter experts available to answer questions, review documentation, or help with reimbursement whenever we need them has proven to be indispensable,” Tuttle says.

Discover how you can unlock the full potential of your center with LUVO. Start a conversation today by calling 888-484-3922 or emailing info@thewca.com.

About Wound Care Advantage
Founded in 2002, Wound Care Advantage (WCA) has been a leader in reimagining how wound care programs operate across the United States. To learn more, visit: www.thewca.com/about

SOURCE Wound Care Advantage

This article was originally published here

Woman Sues Northern Kentucky Nursing Home, Claims Negligence Led to Leg Amputation

Woman Sues Northern Kentucky Nursing Home, Claims Negligence Led to Leg Amputation from Pressure Ulcer

Summary: Brenda Roberts, a 75-year-old from Williamstown, Kentucky, filed a negligence lawsuit on December 4, 2025, against Cold Spring Transitional Care Center, alleging staff failed to follow her orthopedic surgeon’s orders to remove her walking boot when lying down or seated after a heel fracture. This oversight allegedly caused prolonged pressure, resulting in a stage-4 pressure ulcer that necessitated below-knee amputation. Roberts’ attorney, Matthew Mooney, called the incident “stunning,” emphasizing the simplicity of the protocol and the facility’s familiarity with boot-wearing patients. The center has not been served and cited HIPAA in declining comment, but stated it takes patient concerns seriously. The case highlights critical gaps in nursing home wound care protocols for pressure offloading.

Key Highlights:

Incident: December 2024 heel fracture; surgeon prescribed boot for walking only, to be removed at rest — staff did not comply.

Progression: Weeks of continuous wear led to undetected pressure buildup; follow-up revealed stage-4 ulcer (full-thickness loss to muscle/tendon).

Outcome: Failed to save foot; below-knee amputation; now in PT learning prosthetic use, dependent on others for driving.

Quote: Roberts: “I felt neglected there, really. I didn’t have anyone really coming to look at my foot.”

Quote: Mooney: “I was pretty stunned to hear something as simple as an ankle fracture transitioned into something as extreme as an amputation below the knee.”

Broader: Exposes risks in rehab settings; calls for rigorous staff training on device management and routine inspections.

Read full story

Keywords: pressure ulcer, nursing home negligence, walking boot, stage-4 ulcer, amputation, Brenda Roberts, Matthew Mooney

Epidemiology and Risk of Amputation in Patients With Diabetes Mellitus and Peripheral Artery Disease

Peripheral artery disease (PAD) stems from atherosclerosis of lower extremity arteries with resultant arterial narrowing or occlusion. The most severe form of PAD is termed chronic limb-threatening ischemia and carries a significant risk of limb loss and cardiovascular mortality. Diabetes mellitus is known to increase the incidence of PAD, accelerate disease progression, and increase disease severity. Patients with concomitant diabetes mellitus and PAD are at high risk for major complications, such as amputation. Despite a decrease in the overall number of amputations performed annually in the United States, amputation rates among those with both diabetes mellitus and PAD have remained stable or even increased in high-risk subgroups. Within this cohort, there is significant regional, racial/ethnic, and socioeconomic variation in amputation risk. Specifically, residents of rural areas, African-American and Native American patients, and those of low socioeconomic status carry the highest risk of amputation … read more

Factors associated with amputation among patients

with diabetic foot ulcers in a Saudi population

Abstract

Objectives

A prospective study was conducted at the Armed Forces Hospital, Dhahran, Saudi Arabia, between January 2015 and December 2016 to identify the risk factors associated with amputation among diabetic foot ulcers DFUs patients.

Results

In total, 82 patients were recruited. Fifty-five of the patients were males (67.07%), the mean (SD) age of the participants was 60 (± 11.4) years, the mean duration of diabetes was 8.5 (± 3.7) years, and the mean haemoglobin A1c was 4.8 (± 2.8)%. In Univariate analysis, older age and high white blood cell count (WBC) were factors associated with amputation (OR = 1.1, 95% CI = 1–1.1, P = 0.012; and OR = 383, 95% CI = 7.9–18,665, P = 0.003, respectively). On the other hand, an ischaemic ulcer was half as likely as a neuropathic ulcer to lead to amputation (OR = 0.5, 95% CI = 0.3–0.9, P = 0.036), and a higher Wagner’s grade was found to be protective against amputation OR = 14.5, 95% CI = 4.3–49.4, P < 0.001. In conclusion, the current study showed that although a number of factors have been described to complicate diabetic ulcers by different researchers, none of those factors were identified in our study apart from older age and high WBC.

Introduction

Diabetes mellitus is a common endocrinopathy known for its various complications, including diabetic foot ulcers (DFUs) which often result in amputated limbs [1]. The prevalence of foot ulcers among patients with diabetes mellitus ranges from 4 to 10%, and its lifetime incidence may reach up to 25% [2]. Conservative management of DFU may be affected by proper offloading of the wounds, correct daily foot hygiene, and impaired distal vascular flow. Treatment of a DFU is difficult; it frequently gets infected, and it is therefore a very common cause of hospitalization [3]. Diabetes mellitus increases the risk of lower extremity amputations (LEAs) by up to 56% over 5 years, and … read more

The Role of Conjunctive Hyperbaric Oxygen Therapy in Decreasing Amputations in those with Diabetic Foot Ulcers

The Role of Conjunctive Hyperbaric Oxygen Therapy in Decreasing Amputations in those with Diabetic Foot Ulcers: A Clinical Review

Summary: This clinical review appraises published evidence on the adjunctive use of hyperbaric oxygen therapy (HBOT) in diabetic foot ulcers (DFUs) and its impact on reducing major amputations and enhancing healing. Incorporating six comparative studies, the review synthesizes outcomes on wound size, infection, amputation rates, and mortality.

Key Highlights:

HBOT as an adjunct to standard wound care demonstrated superior healing and reduced amputation in chronic DFUs.

Meta-analyses included show consistent trends favoring HBOT over conventional therapy alone.

The review process included filters, MeSH terms, and strict inclusion criteria to narrow to six high-quality studies.

Authors call for larger prospective trials to better quantify risks, benefits, and optimal protocols.

Read full article

Keywords:
hyperbaric oxygen therapy,
diabetic foot ulcer,
amputation risk,
wound healing,
adjunctive therapy

More rural, minoritised people get amputations—AI gets closer to why

More Rural, Minoritised Patients Face Higher Amputation Rates—AI Sheds Light on Why

A recent study led by the University of Maryland, published in *Epidemiology*, uses AI to analyze over 1.5 million hospitalizations (2017–19) of adults over 40 with peripheral artery disease or chronic limb‑threatening ischemia. It reveals that unconscious provider bias contributes significantly to higher amputation rates among rural and minoritized communities.

Key Findings:

Disparities Confirmed: After adjusting for clinical and systemic factors, Black, Hispanic, and Native American patients in rural areas—and Black and Native American patients in urban settings—still experienced significantly higher amputation rates compared to others :contentReference[oaicite:1]{index=1}.

AI Reveals Hidden Bias: The model evaluated 70 + variables—including health status, hospital access, regional care capacity, and socioeconomic context—and flagged potential unconscious bias in clinical decision-making :contentReference[oaicite:2]{index=2}.

Clinical Implications: Vascular surgeons often navigate complex treatment decisions. Without clear guidelines to choose between limb-sparing revascularization and amputation, provider instinct—potentially influenced by bias—may steer outcomes :contentReference[oaicite:3]{index=3}.

AI as a Solution: AI models that incorporate intersectional variables (race, income, rurality) can help identify disparities and guide development of more equitable, evidence-based guidelines :contentReference[oaicite:4]{index=4}.

This work underscores the urgent need to address implicit biases within vascular care and empowers clinicians with data-driven tools to promote equitable limb preservation.

Keywords:
Paula Strassle,
Katharine McGinigle,
peripheral artery disease,
chronic limb-threatening ischemia,
unconscious bias,
amputation disparities,
AI in vascular decision-making

Read the full report on University of Maryland Today

Topical Oxygen Therapy Awarded “A” Grade Treatment Recommendation by the American Diabetes Association

in their 2023 Standards of Care in Diabetes

OCEANSIDE, Calif., Dec. 13, 2022 /PRNewswire/ — Advanced Oxygen Therapy Inc. (AOTI), the global leader in noninvasive topical oxygen wound healing solutions, announced today that the American Diabetes Association has awarded an “A” grade recommendation for utilizing adjunctive topical oxygen therapy in treating Diabetic Foot Ulcers (DFU) in their 2023 standards of care in diabetes, the preeminent Clinical Practice Guidance (CPG) in the space, which was published today online: https://diabetesjournals.org/care/issue/46/Supplement_1

ADA – Amputation Prevention Alliance

The American Diabetes Association is the leading clinical authority dedicated solely to combating diabetes and its complications. Based on the latest scientific research and clinical trials, their annually updated standards of care in diabetes provides the most comprehensive and trusted evidence-based clinical guideline on the prevention, diagnosis, and treatment of diabetes and its complications.

Dr. Mike Griffiths, CEO and President of AOTI commented; “We are delighted that the ADA’s Professional Practice Committee, in its 2023 update to their standards of care in diabetes, has assessed that the now overwhelming body of clinical evidence supports awarding topical oxygen therapy a converted “A” grade recommendation as an adjunctive treatment for healing DFU.”

AOTI’s unique Topical Wound Oxygen (TWO2) therapy is unlike any other topical oxygen approach, in that it is the only device that provides a multimodality treatment, combing higher pressure oxygen delivery with non-contact cyclical compression and humidity, in a therapeutic applied by the patient at home. This patented approach has been demonstrated in numerous Randomized Controlled Trial (RCT) and Real World Evidence (RWE) studies to not only heal chronic wounds at a far higher rate, but perhaps more importantly, keep them closed longer term, thereby reducing unnecessary hospitalizations and amputations.1, 2

“The more sustainable long-term healing elicited when utilizing TWO2 therapy was highlighted in the ADA guidance, with their citing of all of the RCT and RWE studies conducted with TWO2, along with multiple recent Systematic Reviews and Meta Analyses, leading to their “A” grade recommendation ” stated Dr. Griffiths

1 Multinational, Multicenter, Randomized, Double-Blinded, Placebo-Controlled Trial to Evaluate the Efficacy of Cyclical Topical Wound Oxygen (TWO2) Therapy in the Treatment of Chronic Diabetic Foot Ulcers; The TWO2 Study. Robert G. Frykberg et al, Diabetics Care 2020; 43:616-624. https://doi.org/10.2337/dc19-0476.

2 Reduced Hospitalizations and Amputations in Patients with Diabetic Foot Ulcers Treated with Cyclical Pressurized Topical Wound Oxygen Therapy: Real-World Outcomes; Jessica Izhakoff Yellin, et al; Advances in Wound Care 2022; http://doi.org/10.1089/wound.2021.0118

About AOTI
AOTI is a privately-owned company based in Oceanside, California USA and Galway, Ireland that provides innovative solutions to resolve severe and chronic wounds worldwide. Our products reduce healthcare costs and improve the quality of life for patients with these debilitating conditions. Our patented non-invasive Topical Wound Oxygen (TWO2) homecare therapy is clinically proven to deliver Sustained Wound Healing that reduces both Amputations and Hospitalizations, So Life Can Get Back to Normal.

For more information see: www.aotinc.net

Contact:
Dr. Mike Griffiths
CEO & President
350571@email4pr.com
(760) 672 1920

This article was originally published here

Diabetic Foot Ulcer Prevention Strategies

Diabetic foot ulcers (DFUs) may affect up to 25% of people with diabetes at some point in their lifetime. Once a person has developed a DFU, there is a 50% chance the ulcer will become infected.1 DFUs are also among the leading causes of amputation.2

Wound care specialists encounter DFUs regularly in the clinic, and these wounds can be very difficult to treat because of the underlying metabolic insufficiency. This blog provides a guide to current best practices with regard to DFUs and prevention … read more

The Diabetic Foot in Remission: Strategies to Make Prevention Pay

September 25, 2018 1:00 pm to 2:00 pm EDT

Presented by: Dr. David G. Armstrong, DPM, MD, PhD

Because neuroischemic complications are associated with a high rate of recurrence, this presentation proposes a slight shift in how health care providers counsel and communicate risk to their patients. If the epidemiology of this problem is comparable with that of cancer, and recurrences are common, then perhaps language commensurate with such risks should follow.

After initial healing of an index wound, patients are referred to not as being cured but rather as being “in remission.” This concept is easy for the patient and the rest of the team to understand, and it powerfully connotes the necessity for frequent follow-up and rapid intervention for inevitable minor and sometimes major complications.

This program will review tried-and-true as well as up-to-the-minute advances in biologics, consumer electronics, mechanics, medicine, and surgery that are “pushing the envelope” in extending ulcer-free, hospital-free, and activity-rich days in efforts to make prevention pay.

Registrants will learn how to:

Identify risk factors for ulceration

Identify risk factors for amputation

Understand the impact of diabetes on the health care system

Understand the impact of diabetic foot complications on the health care system

Register

Barriers to Prevention and Timely Presentation of Diabetic Foot Ulcers: Perspectives of Patients from a High-risk Urban Population in the US

Diabetic foot amputation is a preventable complication that is increasing in incidence in the United States, with disparities across geography, race, ethnicity, and income. This qualitative study explored the experiences of people in a low-income urban area in the United States in preventing and obtaining care for foot ulcers. Sixteen adults with foot ulcers were identified through purposive sampling based on records of hospital stays and primary care visits. Semi-structured interviews were transcribed and analyzed for key themes. Participants described inadequate understanding of diabetic foot disease: many sought care only after developing advanced symptoms. They identified social and health system factors as barriers to timely access to care. Some participants described a realization of the seriousness of their condition and an ability to improve self-care after developing an ulcer. Patients’ experiences can inform the design of amputation-reduction initiatives to achieve more desirable results, including enhanced self-management capabilities, timely access, and attention to social determinants … read more

Podiatric Care Associated with Reduced Mortality and Enhanced Amputation-Free Survival

Podiatric Care Associated with Reduced Mortality and Enhanced Amputation-Free Survival

Summary: This retrospective analysis demonstrates that podiatric care in the management of diabetic foot ulcers (DFUs) is linked to reduced all-cause mortality and longer amputation-free survival. Patients receiving podiatry services showed better outcomes compared to those without, highlighting the value of early, specialized foot care in multidisciplinary teams.

Key Highlights:

Lower mortality risk with podiatric intervention

Extended amputation-free survival

Supports routine podiatry referral in DFU protocols

Read full study

Keywords: podiatric care, DFU mortality, amputation-free survival

Podiatric Care Associated with Reduced Mortality and Enhanced Amputation-Free Survival

Podiatric Care Associated with Reduced Mortality and Enhanced Amputation-Free Survival

Summary: This longitudinal observational study evaluated the impact of podiatric care on clinical and healthcare utilization outcomes in patients with diabetic foot ulcers (DFUs). Among 2798 patients (mean age 65.7 years) in Singapore’s DEFINITE Care program with at least 12 months follow-up, those receiving podiatric care (n=1212) were compared to those without (n=1586). Podiatric follow-up was associated with significantly lower mortality (7.4% vs 19.5%, adjusted OR 0.314, p<0.01) and higher amputation-free survival (adjusted OR 1.26, p=0.02), despite more minor LEAs and increased healthcare utilization (more admissions, ED, and outpatient visits, but shorter length of stay). Patients with podiatric care were more likely to have prior ulcers, poorer glycemic control, and comorbidities. The findings highlight podiatric care’s value in improving survival and limb preservation in Asian DFU populations.

Key Highlights:

Lower mortality and better amputation-free survival with podiatric care

More minor LEAs but overall positive limb salvage impact

Increased short-term healthcare use but shorter length of stay

Authors: Wen Zhe Leo (corresponding), Lixia Ge, Chelsea Law, Tiffany Chew, Jo Ann Lim et al.

Read full article (open access)

Keywords: podiatric care, diabetic foot ulcer, amputation free survival, limb salvage, Wen Zhe Leo

Rates of T1D-Related Amputations Decline in Sweden

Results of a Swedish retrospective cohort study showed reduced rates of type 1 diabetes-related amputations over the past 2 decades.

In recent years, Sweden has seen a sharp decline in incidence of lower-level extremity amputations among individuals with type 1 diabetes (T1D), according to results of an observational cohort study. Findings were published in Diabetologia.

Because diabetes-related foot ulcers are common and healing is often delayed, limb loss through amputation “is not an infrequent final outcome,” the authors explained.

In addition, “about half of all nontraumatic amputations in the western world are attributable to diabetes … read more

Is There An Optimal Metatarsal Length To Prevent Reulceration After Ray Amputations?

The podiatric surgeon frequently utilizes partial ray amputations aiming to remove infection while preserving bipedal ambulatory status and preventing further morbidity or mortality. An estimated 50 to 70 percent of lower extremity amputations take place due to diabetic complications, most commonly diabetic foot ulcers (DFUs) formed in the setting of peripheral neuropathy. Patients with diabetes often face additional comorbidities, including peripheral vascular disease and a diminished immune response, both of which increase the risk for ulcer development and complicate healing potential. Although amputation is an effective method of eradicating osseous infection, removing pedal anatomy will alter normal biomechanics and increase pressure distribution to surrounding structures. Furthermore, amputation of pedal structures involved in the gait cycle will require increased metabolic expenditure during ambulation. One hypothesis … read more

Foot Sparing Amputations in Diabetics

These techniques can save limbs and lives.
The recent global SarsCoV-2 (COVID-19) pandemic significantly disrupted the delivery of healthcare across many disciplines and the effect of the pandemic has had an especially detrimental effect on people with diabetes-related foot complications, resulting in more amputations. Major level lower extremity amputation is one of the most feared complications of diabetes. One study found that patients with diabetes and lower extremity complications were more in fear of major amputation than death.1 In many cases, major level amputations can result in loss of function, decline in quality of life, and even death … read more

Post-TMA Outcomes in Diabetic Foot Amputations

Challenging the Parabola Paradigm Post-Transmetatarsal Amputation

Summary: This oral abstract presented at the 2025 APMA National conference, led by Craig J. Verdin, DPM, reevaluates the longstanding “parabola paradigm” in post-transmetatarsal amputation (TMA) wound care for diabetic foot infections/gangrene. Analyzing 57 unilateral TMA patients retrospectively, the study substratifies residual parabolas (Types 1-4 per Bik et al.) and lengths (>50% preoperative), assessing impacts on complications and patient-reported outcomes (PROMs: LEFS for function, SF-12 for QoL). Findings reveal no significant ties to major complications or PROMs, only a weak correlation between unbalanced Type 4 parabolas and minor issues. It promotes function-driven, balanced parabolas over dogmatic length replication, and explores ray-preserving TMA variants for enhanced biomechanics, healing, and quality of life in podiatry limb salvage.

Key Highlights:

Retrospective review of 57 TMAs at Georgetown University Hospital (2 years); no effect of parabola shape/length on major complications or PROMs/QoL.

Weak correlation (p<0.05) between Type 4 (longer second metatarsal) and minor complications like reulceration due to uneven pressure.

Historical McKittrick paradigm (1949) prioritizes Type 1 parabolas for propulsion; study calls it outdated, favoring balanced designs.

Alternatives: Ray-preserving TMAs (e.g., first ray or first two rays per Suh et al., 2019) may optimize musculotendinous function and wound durability.

Implications: Shift to PROMs/gait assessments in diabetic foot care for better outcomes, reducing reamputation risks in wound healing.

Read full article

Keywords: transmetatarsal amputation, residual parabola, diabetic foot amputation, limb salvage, ray-preserving TMA, Craig J Verdin, Ply C, Lava C

Global Leaders Unite in Shijiazhuang China to Combat Diabetes and Prevent Amputation

Global Leaders Unite in Shijiazhuang to Combat Diabetes and Prevent Amputation

The 11th Shijiazhuang International Diabetes Conference, held on May 16, 2025, at The Second Hospital of Shijiazhuang in China, brought together over 1,000 clinicians, scientists, and policy leaders from around the world. The event focused on urgent challenges and innovative solutions in diabetes care, emphasizing prevention, technology, and limb preservation. :contentReference[oaicite:5]{index=5}

Key Highlights:

Keynote Address by Prof. David G. Armstrong: Distinguished Professor of Surgery and Neurological Surgery at the University of Southern California and Founding President of the American Limb Preservation Society, Prof. Armstrong delivered a keynote titled “The Diabetic Foot and Wound Healing: Looking Back to Look Forward,” discussing the evolution of global diabetic foot care and future prevention strategies. :contentReference[oaicite:8]{index=8}

International Collaboration: Speakers from various countries shared insights, including Prof. Marg McGill (Australia) on national foot care models, Prof. Vanessa Nube (Australia) on equitable foot care delivery, Prof. Carlo Fornaini (Italy) on laser therapy in oral health for diabetics, Prof. Dirk Hochlenert (Germany) on chronic disease management programs, and Dr. Peter Lin (Canada) on microplastics’ impact on peripheral artery disease. :contentReference[oaicite:11]{index=11}

China’s Leadership in Diabetic Research: The conference highlighted China’s advancements in diabetic kidney disease, digital health, biomechanics, stem cell therapies, and comprehensive foot ulcer and vascular care. :contentReference[oaicite:14]{index=14}

This conference underscored the importance of global collaboration in combating diabetes and preventing amputations. By sharing knowledge and strategies, healthcare professionals aim to reduce preventable complications and improve patient outcomes worldwide.

Read the full article on the Diabetic Foot Online website.

Keywords:
diabetes conference,
limb preservation,
global health collaboration

Clinical Outcomes of Hyperbaric Oxygen Therapy

Clinical Outcomes of Hyperbaric Oxygen Therapy for Diabetic Foot Ulcers: A Systematic Review

A systematic review published in Cureus evaluated the effectiveness of hyperbaric oxygen therapy (HBOT) in treating diabetic foot ulcers (DFUs). The review analyzed six studies encompassing a total of 391 patients to assess HBOT’s impact on healing rates, ulcer dimensions, and amputation outcomes.

The majority of the studies indicated that HBOT led to lower rates of major amputations, improved ulcer healing, and reduced ulcer dimensions compared to standard care. However, one study found no significant differences in amputation rates or long-term wound healing between groups. The review also noted variations in methodological rigor across the included studies, with selection bias from inconsistent patient allocation being a common limitation in observational studies, potentially distorting comparisons.

These findings suggest that HBOT may be a beneficial adjunctive treatment for DFUs, but further high-quality, randomized controlled trials are needed to confirm its efficacy and address existing methodological concerns.

Read the full article on the Cureus website.

Keywords:
Hyperbaric oxygen therapy,
Diabetic foot ulcers,
Amputation prevention,
Wound healing,
Systematic review,
Ujwala Damineni,
Shravani Divity,
Sri Ram Charan Gundapaneni,
Tejaswi Vadde

Innovation Technology in Pressure Injury Prevention – PODCAST

Hospital acquired pressure injuries (HAPIs) represent a significant source of morbidity, mortality, and cost burden. In this podcast, Laura Swoboda, DNP, APNP, FNP-C, CWOCN-AP, discusses a new, innovative technology called Leaf, the wearable patient monitoring device for pressure injury prevention …. listen

The Diabetic Foot in Remission: Strategies to Make Prevention Pay

Tuesday, September 25, 2018

Because neuroischemic complications are associated with a high rate of recurrence, this presentation proposes a slight shift in how health care providers counsel and communicate risk to their patients. If the epidemiology of this problem is comparable with that of cancer, and recurrences are common, then perhaps language commensurate with such risks should follow.

After initial healing of an index wound, patients are referred to not as being cured but rather as being “in remission.” This concept is easy for the patient and the rest of the team to understand, and it powerfully connotes the necessity for frequent follow-up and rapid intervention for inevitable minor and sometimes major complications.

This program will review tried-and-true as well as up-to-the-minute advances in biologics, consumer electronics, mechanics, medicine, and surgery that are “pushing the envelope” in extending ulcer-free, hospital-free, and activity-rich days in efforts to make prevention pay.

Dr. David G. Armstrong
DPM, MD, PhD
University of Southern California

Register

Prevention and Management of Diabetic Foot Ulcers

BEST PRACTICE RECOMMENDATIONS FOR THE Prevention and Management of Diabetic Foot Ulcers

Diabetes mellitus (DM) is a metabolic disorder characterized by hyperglycemia that leads to microvascular, macrovascular and neuropathic complications. In 2016, there were 11 million Canadians living with type 1, type 2 or pre-diabetes, and every three minutes another Canadian is diagnosed. Certain populations are at higher risk for developing type 2 DM, including those of Asian, African, Hispanic and Indigenous decent. The rates of DM are three to five times higher in Indigenous populations, an issue compounded by unique barriers to care including, but not limited to, a lack of cultural competency among health-care providers, jurisdictional confusion, limited access to care, geographical location and language barriers.1,2 Foot health should be a major consideration for people with diabetes and for those who care for them. Foot complications in this high-risk population can lead to a cascade of negative complications, potentially resulting in loss of limb and life. The lifetime risk for foot ulceration in people with diabetes is 15 to 25%. According to the International Diabetes Federation … read more (PDF)

Prevention of Plantar Ulcers in People With Diabetic Peripheral Neuropathy

Using Pressure-Sensing Shoe Insoles

The SurroSense Rx system is a set of pressure-sensing shoe insoles that connect wirelessly to a proprietary smartwatch and is intended for people with diabetes who have mild to moderate sensory loss associated with diabetic peripheral neuropathy, or nerve damage. By providing real-time alerts about plantar pressure distributions, or the area of pressure between the foot and the surface supporting it, users of the SurroSense Rx system can alter their activities in order to relieve unsafe pressures. The SurroSense Rx system is used in addition to current standard-of-care treatment for the prevention of plantar ulcers in diabetic patients. There is currently no available evidence that using the SurroSense Rx system prevents plantar ulcers. However, there are ongoing clinical trials that may identify patient populations that will benefit from its use.

Over time, high blood sugar in people living with diabetes causes damage to the peripheral nerves — the nerves that serve the arms, hands, legs, and feet. This damage, called diabetic peripheral neuropathy, includes symptoms such as painful tingling or burning sensations in the hands and feet, and the loss of protective sensations such as feeling pain or temperature changes.¹ When pain sensation is lost, there is an increased risk of developing open sores caused by prolonged pressure or other injuries … read more

Surgical wound dehiscence: Improving prevention and outcomes

Surgical wound dehiscence (SWD) is almost certainly under-reported, not least because of variation in the interpretation of what constitutes SWD. As a result, patients with SWD may not receive optimal treatment and may experience additional surgical site complications, increased mortality, prolonged hospital stays and readmission. Following a meeting in July 2017, an international panel of clinical experts developed a consensus document to raise awareness of SWD, to aid identification of patients at increased risk and to provide practical guidance in prevention and management. This document has the endorsement of the World Union of Wound Healing Societies (WUWHS) and ultimately aims to improve outcomes for patients … read more

Surgical wound dehiscence: Improving prevention and outcomes

Surgical wound dehiscence (SWD) is almost certainly under-reported, not least because of variation in the interpretation of what constitutes SWD. As a result, patients with SWD may not receive optimal treatment and may experience additional surgical site complications, increased mortality, prolonged hospital stays and readmission. Following a meeting in July 2017, an international panel of clinical experts developed a consensus document to raise awareness of SWD, to aid identification of patients at increased risk and to provide practical guidance in prevention and management. This document has the endorsement of the World Union of Wound Healing Societies (WUWHS) and ultimately aims to improve outcomes for patients … read more

In Pressure Injury Prevention and Treatment,

Is It All About Protein?

by Nancy Munoz, DCN, MHA, RDN, FAND

The National Pressure Ulcer Advisory Panel (NPUAP) defines a pressure injury as localized damage to the skin and/or underlying soft tissue, usually over a bony prominence or related to a medical or other device. The injury can manifest as intact skin or an open ulcer and may be painful. The injury occurs as a result of intense and/or prolonged pressure, occasionally in combination with shear. The tolerance of soft tissue for pressure and shear may also be affected by microclimate, nutrition, perfusion, comorbidities, and the condition of the soft tissue.¹

Pathophysiologic and intrinsic factors at the core of pressure injury development include nutrition. Maintaining adequate nutrition is considered a best practice for both the prevention and treatment of pressure injuries … read more

Pressure Injury Prevention, Is It All About Protein?

by Nancy Munoz, DCN, MHA, RDN, FAND

The National Pressure Ulcer Advisory Panel (NPUAP) defines a pressure injury as localized damage to the skin and/or underlying soft tissue, usually over a bony prominence or related to a medical or other device. The injury can manifest as intact skin or an open ulcer and may be painful. The injury occurs as a result of intense and/or prolonged pressure, occasionally in combination with shear. The tolerance of soft tissue for pressure and shear may also be affected by microclimate, nutrition, perfusion, comorbidities, and the condition of the soft tissue.

Pathophysiologic and intrinsic factors at the core of pressure injury development include nutrition. Maintaining adequate nutrition is considered a best practice for both the prevention and treatment of pressure injuries. Individuals with or at risk for developing pressure injuries should strive to achieve or maintain adequate nutrition parameters … read more

Effective Wound Dressing Securement for Infection Prevention

In order to promote rapid healing, improve patient comfort and prevent complications, it is important that healthcare professionals actively work to prevent infection. One key component of that effort is wound dressing securement. Secure, gentle and effective dressings can help prevent the ingress of foreign material, reduce damage during dressing changes and help foster an ideal healing environment. This can help reduce the risk of infection, improving patient outcomes and lowering costs.1 In this post, we will explore the importance of infection prevention and effective dressing securement strategies to help prevent infection … read more

Pressure Injury Prevention: Recognizing the Early Signs of Injury

Here’s a question for you: How long does it take for a pressure injury (PI) to form? Do you think it happens in 30 minutes? 2 hours? 8 hours? The answer is actually all of the above. The time it takes for a PI to develop depends on a number of different factors, which we will discuss here. This blog will describe how a PI forms, some signs that a PI is forming, and how to assess a patient’s skin for a PI. It will then look at some types of intervention and assessment that help in the prevention and treatment of a PI, as well as track its healing or declination … read more

Development and Implementation of an Individualized Turning Program for Pressure Injury Prevention

Using Sensor Technology in Nursing Homes: A Quality Improvement ProgramA Quality Improvement Program
Turning nursing home residents every 2 hours has been a long-held standard for pressure injury (PrI) prevention in individuals with mobility impairments although evidence to substantiate this practice is limited. New guidelines recommend personalizing turning schedules to support person-centered care but lack specific recommendations about which turning frequencies are appropriate for various risk levels. PURPOSE: This quality improvement program aimed to determine the feasibility and outcomes of using individualized turn schedules for newly admitted nursing home residents. METHODS: An expert panel of wound clinicians developed, tested, and implemented a turn frequency tool that allowed staff in 2 nursing homes to select a turning schedule of 1, 2, 3, or 4 hours based on resident risk factors. Turning schedules were operationalized using a wearable sensor-based visual cueing technology that alerted staff to resident repositioning needs. Nonparticipating resident data were collected for comparison of PrI incidence. Descriptive statistics were calculated for all covariates. Significance of differences tests were performed as … read more

Device-related pressure ulcers: SECURE prevention. Second edition

Amit Gefen, Catherine T Milne, Fiona Coyer, Guido Ciprandi, Karen Ousey, Nicola Waters, Norihiko Ohura, Paulo Alves, Peter Worsley

We have over 100 resources, free for everyone to browse and read and share. These resources are suitable for a range of skin and wound care disciplines, roles, and educational purposes

Although great strides have been made to tackle hospital-acquired pressure ulcers (HAPUs), there is a need for greater recognition of device-related pressure ulcers (DRPUs), including their causes, management and prevention. This consensus statement, an updated second edition, aims to continue raising awareness of these largely preventable injuries and, crucially, to stimulate action … read more

Effectiveness of a Pressure Injury Prevention Care Bundle; Prospective Interventional Study in Intensive Care Units

Tuba Yilmazer, PhD, RN and Hilal Tuzer, PhD, RN

The purpose of this study was to assess the effectiveness of a pressure injury prevention care bundle. Participants were 13 nurses and 104 patients cared for in the intensive care unit for at least 24 hours in a university hospital in Ankara, Turkey. The study was conducted in 2 stages: the pre-care and post-care bundle stages. In the pre-care bundle stage, the pressure injury incidence of the patients was followed by the nurses. At the end of the third month, the researcher held a 1-day training program for the nurses about the care bundle use to promote correct implementation. In the post-care bundle stage, the nurses provided care according to the bundle. Compliance with the care bundle was assessed. Pressure injury incidence rates in the pre- and post-care bundle stages were compared … read more

The impact of a vegan diet in the prevention and treatment of type 2 diabetes: A systematic review

Vegan diets have gained a lot of popularity around the world, mostly in America. About 6% of Americans claim that they are vegans. That is a 600% increase in veganism from 2017 to 2021. There are many reasons that people nowadays are adopting a vegan diet and it includes health and ethical reasons. One of the health reasons that this review refers to is type 2 diabetes. There have been previous studies of what a vegan diet has on the health and the prevention of metabolic syndrome. There have been studies that showed that the risk of cancer can be reduced on a vegan diet, but is still under debate that this is the main reason for it. The review aimed to show studies between vegan diets and see if there is a reduction in risk for type 2 diabetes … read more

Posted in Articles

Using WHO tools to influence surgical infection prevention

by admin on August 9, 2023

Wounds Week 6 – Using WHO tools to influence surgical infection prevention // Making an impact on surgical site infection in the post-operative phase…

Prophylactic Sacral Dressing in Prevention of Pressure Injury among ICU Patients

Prophylactic Sacral Dressing in Prevention of Pressure Injury among ICU Patients: A Systematic Review & Meta-analysis

Summary: A systematic review and meta-analysis published in the Indian Journal of Critical Care Medicine examined the role of prophylactic sacral dressings (PSD) in preventing pressure injuries (PIs) among ICU patients. Across seven randomized controlled trials (RCTs) with 3,735 participants, PSD significantly reduced the incidence of sacral pressure injuries compared with standard care alone.

Key Highlights:

Study scope: Seven RCTs evaluated 2,144 patients treated with PSD and 1,591 patients receiving standard care.

Effectiveness: PSD use led to a significant reduction in sacral pressure injuries (p < 0.001) and stage II or higher injuries (p = 0.006).

Common dressings: Multi-layered silicone foam dressings such as Mepilex and Allevyn were most frequently used, with similar outcomes.

Evidence quality: Certainty of evidence was rated moderate for overall PI reduction, but low for stage II+ outcomes.

Clinical practice: PSD should complement established measures such as repositioning, pressure redistribution devices, and skin monitoring.

Economic impact: Preventing advanced pressure injuries with PSD may reduce overall healthcare costs.

Read the full article in IJCCM

Keywords:
prophylactic sacral dressing,
pressure injury,
ICU,
silicone foam dressing,
Mepilex,
Allevyn

Prevention and Management of Wound Procedural Pain Management in …

Prevention and Management of Wound Procedural Pain Management in Adult Patients with Open Wounds

Summary: Review integrates latest evidence on preventing/managing procedural pain in adult open wounds (trauma/chronic, e.g., dressing changes/debridement). Pain affects 76-95% patients, delays healing/compliance. Recommends routine assessment (VAS/NRS), education, moist/low-adhesion dressings, gentle cleansing/debridement, WHO ladder pharmacology, non-pharm (distraction, TENS, iontophoresis), prophylactic analgesia, multidisciplinary tailoring. High-quality evidence for standardized techniques; moderate for adjuncts.

Key Highlights:

Assessment: VAS/NRS pre/during/post-procedure.

Techniques: Moist dressings, saline for adhesion, low-tack adhesives to avoid MARSI.

Interventions: WHO ladder; non-pharm (VR/distraction, TENS); prophylactic use (<30% currently).

Relevance: Critical for chronic wounds with frequent procedures/sensitivity.

Read full article

Keywords: wound procedural pain, pain management, dressing changes, prophylactic analgesia

HMP Global’s SAWC Spring | WHS announces record number of wound care abstract submissions for 2023 meeting

More than 500 abstracts featuring late-breaking wound care research, new advances and techniques to improve care and outcomes for patients were submitted for poster at the 2023 event, co-located with the Diabetic Limb Salvage meeting.

HMP Global, the leading omnichannel healthcare events and education company, today announced that its 2023 Symposium on Advanced Wound Care (SAWC) Spring and Wound Healing Society (WHS) received a record-breaking number of abstract submissions for the event taking place April 26-30, strengthened by a new partnership co-locating the symposium with the Diabetic Limb Salvage conference.

Now in its 36th year, SAWC Spring | WHS is the leading meeting dedicated to the research, management, treatment, and prevention of wounds; and through the partnership with DLS, this year’s event will feature more limb salvage-focused topics on the conference agenda. The meeting is the premier multidisciplinary forum to connect practitioners, researchers, and students with the foremost experts in wound care to improve patient outcomes through education.

Symposium participants will have access to 450 posters featuring late-breaking wound care research, new advances, strategies, and techniques to improve care and outcomes for patients. More than 500 abstracts — a record number — were submitted to undergo the peer review process for poster consideration.

In addition to presenting posters in person at SAWC Spring | WHS | DLS, wound care researchers can elevate their work further by submitting abstracts for publication in the field’s preeminent, peer-reviewed journal WOUNDS, focusing on the latest advances in wound care and wound research. WOUNDS is indexed in MEDLINE/PubMED and publishes research and commentary on tissue repair and regeneration, biology and biochemistry of wound healing, and clinical management of various wound etiologies. Submission information and guidelines are available on HMP Global’s Wound Care Learning Network.

“The record-breaking number of abstract submissions this year is a testament to the dedication of the wound care community to advancing their knowledge and skills,” said Tiffney Oliver, Vice President, Wound Care Learning Network, HMP Education. “For our 2023 meeting, we are excited to offer a world-class lineup of educational sessions as well as a record number of abstracts about the latest research in wound care.”

Submitted abstracts are blind reviewed by a panel of expert judges, based on specific criteria for the category in which it was submitted. Researchers may also be considered for poster grand rounds, oral abstracts, SAWC Young Investigator, and highest scoring abstract honors.

“We are excited to host one symposium for every member of the wound care team, allowing us to provide the highest caliber training and education that all clinicians can incorporate into their practice,” said WHS President Dr. Kenneth Liechty, Division Chief of Pediatric Surgery and Director of Fetal Medicine, University of Arizona, and Surgeon in Chief of Diamond Children’s Hospital. “The quantity and high caliber of the posters presented this year spotlights the most up-to-date research on wound care and limb salvage. This level of exposure to innovation is unparalleled in the wound care community.”

Posters will be on view from 7:30 a.m. to 5 p.m. Friday, April 28, and from 7:30 a.m. to 5 p.m. Saturday, April 29. In addition, SAWC Spring | WHS | DLS participants will have the opportunity to interact with the researchers during the Poster Reception and Awards Presentation from 7:15-8:30 p.m. on April 28, presented by WOUNDS.

Educational Program

The SAWC Spring | WHS | DLS agenda features more than 80 high-impact sessions from expert presenters led by the giants and emerging voices in the field, providing more than 25 CME/CE credits. Participants will have access to sessions in traditional as well as new formats, including hands-on workshops, rapid-fire, case-based, and patient panels. Learning tracks encompass the business of wound care as well as separate tracks through DLS and WHS.

“We have partnered with the Wound Healing Society for 15 years, providing a robust educational experience for meeting participants, and this year will be even stronger with the addition of multiple topics on amputation prevention, said SAWC Spring Co-Chair Dr. Robert S. Kirsner, Harvey Blank Professor and chairman, Dr. Philip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine. “No other wound care conference offers this level of education, advanced state-of-the-art clinical reviews, and emerging research findings.”

The interdisciplinary agenda is designed for every aspect of wound research, prevention, and healing, with an important focus on limb salvage. Sessions are designed for all members of the wound care team, including physicians, nursing professionals, podiatrists, physician assistants, physical therapists, researchers, scientists, dietitians, and healthcare, sales, and marketing professionals.

For more information or to register, visit sawcspring.com.

ABOUT HMP GLOBAL
HMP Global is the force behind Healthcare Made Practical — and is an omnichannel leader in healthcare content, events, and education, with a mission to improve patient care. The company produces accredited medical education events — in person and online via its proprietary VRTX virtual platform — and clinically relevant, evidence-based content for the global healthcare community across a range of therapeutic areas. Its brands include the HMP Global Learning Network, healthcare’s most comprehensive source for news and information; Psych Congress, the largest independent mental health meeting in the U.S.; the Evolution of Psychotherapy, the world’s largest independent educational event for mental health professionals; the Leipzig Interventional Course (LINC), the leading, global gathering for interdisciplinary cardiovascular specialists; EMS World Expo, North America’s largest EMT and paramedic event; and the Symposium on Advanced Wound Care (SAWC), the largest wound care meeting in the world. For more information, visit hmpglobal.com.

This article was originally published here

Challenging the Paradigm of the Parabola Post-Transmetatarsal Amputation

Challenging the Paradigm of the Parabola Post-Transmetatarsal Amputation

Summary: This retrospective analysis of 57 unilateral TMAs challenges the traditional focus on residual parabola length/shape for outcomes, finding no significant impact on major complications, minor complications (weak correlation with Type 4 shape), or function/QoL (LEFS/SF-12 scores). Length >50% preoperative and balanced shapes performed similarly, suggesting function-driven decisions prioritize musculotendinous preservation (e.g., ray-preserving TMAs) over length for better rehab and DFU prevention.

Key Highlights:

Thesis: Shift to PROMs/gait/biomechanics over parabola dogma.

Findings: No shape/length effect on major complications; Type 4 weakly linked to minor.

Function: No correlation with LEFS/SF-12; advocates balanced parabolas.

Recommendations: Ray-preserving TMAs for muscle preservation.

Authors: Bik H, et al. (retrospective, 2-year follow-up).

Read full analysis

Keywords: TMA, parabola shape, amputation outcomes, LEFS, ray-preserving, H Bik

Foot Revascularization Avoids Major Amputation in Persons with Diabetes and Ischaemic Foot Ulcers

The study aims to evaluate the effectiveness of foot revascularization in persons with diabetic foot ulcers (DFUs) and below-the-ankle (BTA) arterial disease. Consecutive patients referred for a new active ischaemic DFU requiring lower limb revascularization were considered. Among those, only patients with a BTA arterial disease were included. Revascularization procedures were retrospectively analysed: in the case of successful foot revascularization (recanalization of pedal artery, or plantar arteries or both) or not, patients were respectively divided in two groups, successful foot perfusion (SFP) and failed foot perfusion (FFP). Healing, minor and major amputation at 12 months of follow-up were evaluated and compared. Eighty patients (80) were included. The mean age was 70.5 ± 10.9 years, 55 (68.7%) were male, 72 (90%) were affected by type 2 diabetes with a mean duration of 22.7 ± 11.3 years. Overall 45 (56.2%) patients healed, 47 (58.7%) had minor amputation and 13 (16.2%) major amputation. Outcomes for SFP and FFP were respectively: healing … read more

Lack of access to vascular specialists creates major disparities in amputation rates across the USA

Speaking on current trends in amputation rates with critical limb-threatening ischaemia (CLTI) patients, Misty Humphries (Sacramento, USA) tells Vascular News that while Medicare data shows that amputation rates are decreasing across the USA overall, there are “certain geographical areas” that have high rates, with many of these “located in the south” or in regions that “may not have vascular specialists” … “The disparities that we see in my research I believe are truly access-based,” says Humphries, further drilling down to emphasise health insurance, time and other factors such as appropriate preventive care measures that come into play contributing to the increased risk of amputation … read more

St. Louis Doctor Helps Patients Avoid Unnecessary Diabetic Amputations Using Minimally Invasive Procedure

ST. LOUIS, May 22, 2021 /PRNewswire/ — The Midwest Institute for Non-Surgical Therapy (MINT) is leading the way in providing early diagnosis and innovative treatments for St. Louis, Missouri, patients who suffer from vascular disease, greatly reducing the need for amputations … read more

Midwest Institute for Nonsurgical Therapy

Led by Dr. Goke Akinwande, a board-certified endovascular specialist, the Vascular Center at MINT is one of the few centers in St. Louis dedicated to the outpatient treatment of venous and arterial diseases. Since the Center opened in 2019, MINT has become a regional leader in preventing potentially life-threatening amputations among patients who suffer from diabetes. Dr. Akinwande and his team use innovative technology and non-surgical techniques to treat diabetic sores and prevent amputations.

Some Diabetes Drugs, Higher Amputation Risk Linked

A specific class of diabetes medication appears to double the risk of losing a leg or foot to amputation, a new study reports … People on sodium-glucose cotransporter2 (SGLT2) inhibitors were twice as likely to require a lower limb amputation as people taking another type of diabetes medication, Scandinavian researchers found … Patients also had a doubled risk of diabetic ketoacidosis, a life-threatening complication in which acids called ketones build up in the bloodstream … “Patients at high risk of amputation, for example those with peripheral artery disease or foot ulcers, might be monitored more closely if SGLT2 inhibitors are used, and the risk of this adverse event may be considered when deciding on which drugs to use,” said lead researcher Dr. Peter Ueda, a postdoctoral researcher with Karolinska University Hospital in Stockholm, Sweden … read more

Amputation-free survival in 17,353 people at high risk for foot ulceration

in diabetes: a national observational study

Using data from the Scottish Care Information-Diabetes register (N=247,278), researchers analyzed 17,353 individuals with diabetes and at high risk for foot ulceration (“high-risk foot”) from January 2008 to December 2011 to determine amputation-free survival and to compare different subcategories of high-risk foot. According to findings, for those with diabetes and at high risk for foot ulceration, the risk of death was up to nine times the risk of amputation. In addition, those with diabetes who had healed ulcers displayed higher death rates than those with active ulcers. However, the highest risk of amputation was noted for people with active ulcers.

Read the full article on Diabetologia – Clinical and Experimental Diabetes and Metabolism

Diabetes causes more than 120 foot and toe amputations a WEEK in England

More than 120 foot and toe amputations are carried out every week in England as a result of diabetes.

Shocking figures reveal the number of amputations linked to the disease have risen by over a quarter since 2013.

Type 2 diabetes’ prevalence has more than doubled over the past decade due to rising rates of obesity, inactivity and unhealthy eating.

The disease can lead to amputations if it causes nerve damage that lead to infected wounds that do not heal. These infections can then spread to a person’s bones and even result in gangrene … read more

Challenging the Parabola Paradigm in Transmetatarsal Amputation

Challenging the Parabola Paradigm in Transmetatarsal Amputation

Summary: In an oral abstract presented at the 2025 APMA National conference, Craig J. Verdin, DPM, DABPM, AACFAS and colleagues examined whether the residual metatarsal parabola structure truly affects function and outcomes following transmetatarsal amputation (TMA).

Key Insights:

A retrospective study of 57 unilateral TMA patients at Georgetown University grouped outcomes by residual parabola shape and residual length.

Major complications did not significantly vary by parabola shape. However, a longer second metatarsal remnant (“Type 4”) showed a weak but significant association with minor complications, possibly due to uneven plantar pressure distribution.

Neither parabola shape nor residual length correlated with functional outcomes or quality of life, based on the LEFS and SF-12 assessments.

The study suggests that achieving a “balanced” parabola—rather than strictly adhering to traditional length or shape norms—may suffice for optimal functional and clinical results.

Conclusion: This study challenges the long-held belief that maintaining a normal parabola or length post-TMA is essential. Its findings indicate that function-based planning may be more important than structural uniformity.

🔗 Read the full abstract on HMP Global Learning Network

Keywords: Craig J Verdin, metatarsal parabola, transmetatarsal amputation, second metatarsal remnant, limb salvage, APMA National 2025

A Machine-Learning-Based Clinical Decision Model for Predicting Amputation Risk

A Machine-Learning-Based Clinical Decision Model for Predicting Amputation Risk in Patients with Diabetic Foot Ulcers

Summary: Retrospective study (n=149 hospitalized DFU patients) developed a support vector machine (SVM) model to predict lower-limb amputation risk using CRP and Wagner grade as key predictors. Model achieved AUC 0.89, accuracy 82.4%, sensitivity 79.6%, specificity 86.5%; outperformed LDA/KNN. Decision curve analysis showed net benefit at 30% threshold. Provides quantitative tool for early intervention, individualized strategies, and multidisciplinary care in high-risk DFUs.

Key Highlights:

Predictors: CRP and Wagner grade (independent via LASSO, p<0.05).

Performance: AUC 0.89; moderate calibration (p=0.012); net benefit 0.351.

Validation: 5-fold cross-validation; 82.4% correct classification.

Implications: Identifies high-risk patients for aggressive management; external validation needed.

Authors: Lei Gao, Zixuan Liu, Siyang Han et al.

Read full open-access article

Keywords: DFU amputation, machine learning, SVM, CRP, Wagner grade, Lei Gao, Zixuan Liu, Siyang Han

Outcomes Favor Below-Knee Over Above-Knee Amputation in Patients With Nontraumatic Lower Extremity Wounds

Patient-Reported Outcomes Favor Below-Knee Over Above-Knee Amputation in Patients With Nontraumatic Lower Extremity Wounds

Summary: Cross-sectional study (n=96 nontraumatic chronic LE wound patients post-amputation: 74 BKA, 22 AKA) compared PROMs. BKA showed lower psychological distress (SRQ-20 3.1 vs 5.6, p=0.002), lower pain (PROMIS-3a 48.2 vs 58.9, p=0.001), higher function (LEFS 47.4 vs 33.9, p=0.003). BKA preserved knee, enabled better prosthesis/ambulation; higher TMR rates. Prior psychiatric diagnoses higher in AKA but not significant covariate. Supports prioritizing BKA when feasible for QoL/mobility.

Key Highlights:

Distress: BKA lower (p=0.002); pain lower (p=0.001).

Function: LEFS higher BKA (p=0.003); knee preservation key.

TMR: 66% BKA vs 18% AKA.

Limitations: Cross-sectional, small AKA sample.

Authors: Steven Tohmasi et al.

Read full research

Keywords: BKA, AKA, PROs, QoL, amputation, Steven Tohmasi

Minimally Invasive Procedure Confers Amputation-Free Survival in ‘No Option’ CLTI

Minimally Invasive Procedure Confers Amputation-Free Survival in ‘No Option’ CLTI

Summary: A new real-world study presented at the Society for Cardiovascular Angiography and Interventions (SCAI) meeting demonstrated strong outcomes using a minimally invasive procedure in patients with “no-option” chronic limb-threatening ischemia (CLTI). Participants were Rutherford class 5 or 6 with non-healing ischemic ulcers who had exhausted conventional revascularization options. The procedure resulted in high rates of limb salvage and amputation-free survival, offering hope for this extremely high-risk population where traditional therapies often fail.

Key Highlights:

Targeted “no-option” CLTI patients with advanced ischemic ulcers

High amputation-free survival in a challenging, real-world cohort

Minimally invasive approach expands treatment options beyond traditional bypass or endovascular techniques

Emphasizes the importance of continued innovation in advanced wound care and limb preservation

Read full article

Keywords: CLTI, no option CLTI, limb salvage, ischemic ulcer

Diagnostic Accuracy of the Mangled Extremity Severity Score in Predicting Amputation

Diagnostic Accuracy of the Mangled Extremity Severity Score in Predicting Amputation

Summary: This systematic review assesses the performance of the Mangled Extremity Severity Score (MESS) in predicting the need for amputation following severe lower limb trauma. The study examines sensitivity, specificity, and overall clinical utility of this widely used scoring system.

Key Highlights:

Evaluates MESS as a decision-support tool in limb salvage vs. amputation

Analyzes diagnostic accuracy across multiple trauma studies

Addresses strengths and limitations in real-world application

Important implications for trauma and vascular surgery teams

Read full systematic review

Keywords: MESS score, mangled extremity, limb salvage

Record 169 UK patients a week get diabetes-related amputations

A record 169 people a week are having to undergo an amputation procedure as a result of diabetes, a study has found.

Analysis by the charity Diabetes UK found that 26,378 people had lower limb amputations linked to diabetes between 2014 and 2017, a 19.4% rise from 2010 to 2013. Unhealed ulcers and foot infections are the main cause of diabetes-related amputations. Diabetes affects almost 3.7 million people in the UK … read more

Liraglutide Lowers Risk for Amputation in Patients with Type 2 Diabetes and CV Risk

Liraglutide lowers risk for amputation: investigators find patients treated with GLP-1 drug had significantly lower number of amputations compared to placebo group.

The word may still be out on whether certain oral diabetes medications puts patients at risk for lower limb complications, but a new study has shown that liraglutide is not one of them. A post hoc review analysis of the LEADER trial published in Diabetes Care examined the effects of Liraglutide on rates of foot ulceration and amputation in patients at high risk for cardiovascular (CV) events.

Liraglutide, a GLP-1 agonist, is an injectable glucose-lowering medication used in patients with type 2 diabetes. GLP-1 agonists act by mimicking the effects of the hormone GLP-1, which increases insulin secretion and lowers glucagon release. This, in effect, causes increased satiety and slowed gastric emptying, with one of the main benefits of GLP-1 agonists being weight loss in patients with diabetes … read more

Healogics® Raises Awareness of Peripheral Artery Disease (PAD) to Help Reduce Amputations

Healogics, the nation’s leading provider of world-class wound care services, is raising awareness of Peripheral Artery Disease (PAD) throughout September. Through this campaign, Healogics is supporting the American Heart Association’s goal to reduce amputations by 20% by 2030 through increased PAD Awareness, diagnosis and treatment … People with PAD often have non-healing wounds in their extremities due to the restriction of blood flow limiting the natural healing process, potentially leading to complications, such as amputation. PAD affects nearly 10 million Americans and is a contributing factor in up to 30% of non-healing wounds on the lower leg. Common symptoms associated with PAD include cramping, numbness, weakness or heaviness in the leg muscles, however up to 40% of people experience no symptoms. One in four people living with late-stage PAD may require amputation within one year … read more

Determining Amputation Level To Optimize Functional Outcomes

Diabetes is the leading cause of non-traumatic amputations in the lower extremity.1 Around 15 percent of all patients with diabetes will develop a lower extremity ulceration, with these patients being 17 to 40 times more likely to require an amputation.1 Unfortunately for most, the decision to amputate is not always clear cut and the determination of where to make a definitive amputation is not always as it seems on plain films or advanced imaging, such as magnetic resonance imaging (MRI) or computed tomography (CT). There are several factors to consider when performing limb salvage procedures for these patients with diabetes … read more

Enhancing Pressure Injury Prevention Strategies Based on New Technology: From Learning More to Doing Better

he med-surg health care environment is constantly changing, driving complexity in care. The most recent findings from the Centers for Medicaid and Medicare Services state that pressure injuries develop in nearly 2.5 million patients annually, representing 8.3% of hospital admissions; the resulting financial burden for care is estimated to be between $3.3 and $11 billion annually.1 Although most occurrences of hospital-acquired conditions sharply decreased between 2010 and 2017, the Agency for Healthcare Research and Quality reported that pressure injuries increased by 6%.2

Pressure injuries develop when there is localized damage to the skin or underlying tissues due to pressure—and sometimes combined with shear—that impacts the skin’s ability to provide oxygen and nutrients and remove waste byproducts … read more

Surgical wound dehiscence Improving prevention and outcomes

Surgical wound dehiscence (SWD) is a significant issue that affects large numbers of patients and
is almost certainly under-reported. The impact of SWD can be considerable: increased mortality,
delayed hospital discharge, readmission, further surgery, delayed adjuvant treatment, suboptimal
aesthetic outcome and impaired psychosocial wellbeing … download PDF

A Preliminary Exploration of the Efficacy of Gentamicin Sponges in the Prevention and Treatment of Wound Infections

Gentamicin sponges, implantable topical antibiotic agents, are approved for surgical implantation in 54 countries. Since 1985, more than one million patients have been treated with these sponges.1–3 However, despite having been studied for over 30 years, their effectiveness is still disputed … Han et al have found that applying gentamicin-impregnated sponges during spinal operations significantly decreases surgical-site infection (SSI).4 Chang et al have conducted a meta-analysis encompassing 15 randomized control trials and also concluded that gentamicin sponges decrease the rate of SSI.5 Schimmer et al have used a controlled, prospective, randomized double-blind study to investigate the efficacy of gentamicin sponges in sternal wound complications after heart surgery. They enrolled 720 patients and found that gentamicin sponges effectively reduce infection complications … However, several other studies have demonstrated that gentamicin-impregnated sponges cannot reduce SSI, and some researchers have even proposed that the sponges increase the risk of infection. Wouthuyzen-Bakker et al have discussed the efficacy of applying gentamicin-impregnated sponges locally during debridement in early acute periprosthetic joint infections. They found that their application does not reduce the incidence … read more

Posted in Articles

Building a Pressure Injury Prevention Program: Frequently Asked Questions

by admin on December 29, 2020

Posted in Articles

Advancements Series to Educate about Innovations in Wound Care and Infection Prevention

by admin on December 10, 2020

Posted in Articles

Prevention of mask related skin damage

by admin on September 1, 2020

BEST PRACTICE RECOMMENDATIONS FOR THE Prevention and

Management of Diabetic Foot Ulcers

The best practice recommendation articles are special publications of Wound Care Canada. Together they form the Foundations of Best Practice for Skin and Wound Management, an online resource available for free download from the Wounds Canada website (woundscanada.ca). These 2017 updates build on the work of previous author teams and incorporate the latest research and expert opinion. We would like to thank everyone involved in the production of past and present versions of these articles for their hard work, diligence and rigour in researching, writing and producing these valuable resources … read more

Medical Adhesive-Related Skin Injury: Treatment and Prevention

by Holly M. Hovan MSN, APRN-ACNS-BC, CWOCN-AP

Medical adhesive-related skin injury, or MARSI, is a common type of skin injury, often seen in inpatient settings and in vulnerable populations with fragile skin such as older adults (decreased elasticity, usually multiple pre-existing comorbidities) or pediatric patients (skin is not fully developed). MARSI is caused by trauma to the skin from medical adhesives (think of things such as… tape used to secure a dressing after a blood draw, clear film dressings, ostomy pouches, external catheters in men, tube securement devices, surgical dressings, etc.). MARSI is not a pressure injury and is not caused by pressure.

Anytime we are consulted or asked to follow up on a new wound, one of the things we are assessing for is the cause of the wound or injury—trauma, pressure, moisture, friction, shear, impaired blood flow, etc. It is important to look at the big picture and what caused the wound or skin injury. Many variables can and do make wounds and skin conditions worse, but when determining the true etiology, we must look at what initially caused the problem … read more

NPUAP Announces Release of Educational Tools for Wound Care Providers

PRESS CONTACT: Liz Posner, lposner@douglasgould.com, 646-214-0514, ext. 3

Washington, D.C. – June 15, 2017 – The National Pressure Ulcer Advisory Panel (NPUAP) announced bundle pricing of the new digital slide sets, designed to assist in the continuing education of health care professionals to prevent and treat pressure injuries.

Wound care providers working in acute care, post-acute care, home care agencies, and schools of nursing will benefit from the use of the slide sets. They include the 2016 Pressure Injury Staging System Teaching Slide Set and the Prevention of Pressure Injuries Slide Set, both available for $75 each, and the Treatment of Pressure Injuries Slide Set, available for $90. Buy all 3 for $199- a savings of over $40! All are instantly downloadable in PDF format at the NPUAP online store.

The Pressure Injury Staging System Teaching Slide Set is the result of the NPUAP 2016 Staging Consensus Conference. The Prevention of Pressure Injuries Slide Set and the Treatment of Pressure Injuries Slide Setare based on the current International Prevention and Treatment of Pressure Ulcers: Clinical Practice Guideline.

“The primary mission of the NPUAP is to improve patient outcomes in pressure injury prevention and treatment,” said NPUAP President Mary Litchford, PhD, RDN, LDN. “By incorporating the latest scientific evidence into the educational slide sets for teaching health care providers, the NPUAP is supporting its patient-focused mission.”

Wound care providers can find a number of other resources available on the NPUAP online store, including webinar recordings, books, and high-resolution photographs of sample wounds for educational purposes.

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About the National Pressure Ulcer Advisory Panel

The National Pressure Ulcer Advisory Panel (NPUAP) is the nation’s leading scientific expert on pressure injury prevention and treatment. Our goal is to insure improved patient health and to advance public policy, education, and research.

Diabetic Foot Ulcer Prevention System (DFUPS)

The purpose of this study is to investigate whether regular measurement of skin foot temperature with a novel device (DFUPS) will prevent ulcer recurrence in diabetic patients at high risk of foot ulceration. It is planned to regularly measure the temperature of the feet of people with diabetes who have already had a foot ulcer which has subsequently healed. These measurements should allow the identification of hotspots on the foot and may be helpful when advising about ulcer risk and providing preventative treatment. It is hoped to find out whether the regular use of thermal images taken with the DFUPS device together with standard foot treatment may reduce the number of people with diabetes developing ulcers or even prevent foot ulcers … read more

Building a Pressure Injury Prevention Plan in a Low-Resource Facility

A nurse recently shared some of her experiences as a charge nurse in a skilled facility during the COVID-19 pandemic. She worked evenings (3-11:30 pm) at a local facility and was overwhelmed by the high number of patients she was responsible for. She typically worked on a 26-bed floor with just one nurse assistant for the shift. She later transferred to the night shift, where she was the only person on a 16-bed unit for the 8 hours. When asked how she was able to reposition patients as frequently as was recommended, the nurse said that she did “the best I could.” She is, unfortunately, not alone … read more

Promoting Pressure Injury Prevention Technology

Do you remember that cartoon from the 1960s (and later reproduced in the 1980s), The Jetsons? It was about a futuristic family that had all kinds of amazing robot helpers and automatic appliances. Rosie the Robot was the wonderbot that would whisk about the house, frantically preforming housekeeping duties, monitoring the security of the home, and generally making sure that everything was online and functioning. Do you ever feel like this as a clinician? Rushing about, multitasking, being pulled in what seems like a hundred different directions, all while expected to perform with “Rosie-like” perfect, machine-like efficiency. Wouldn’t it be wonderful to have Rosie’s artificial intelligence technology … read more

Related: Pressure Injuries and Disparities in Health Care: Important Terms to Know

Diversity and Pressure Injury Prevention: Important Terms to Know

Erythema: A result of injury or irritation that causes dilation of blood capillaries and manifests as patchy reddening of the skin. Occurs after a patient/resident is exposed to unrelieved pressure for 2 hours. It can be identified as a deep, localized redness; can also be blue or purple.

Hyperemia: The condition of having excess blood in vessels that supply an organ or area of the body. Occurs after patient/resident is exposed to 30 minutes of unrelieved pressure. It can be identified as a localized, non-blanchable redness.

Perfusion: The passage of blood through arteries and capillaries into tissues or organs. When insufficient, there is an increased chance that the patient may have complications.

… more

Moisture Management in Neonatal Pressure Injury Prevention: A Survey

Neonates are widely known as a vulnerable patient population—especially critically ill and premature infants. This vulnerability has limited clinicians’ knowledge of moisture management products in the neonatal population that prevent pressure injuries. Recently, a survey of neonatal nurses from across the United States was conducted to find out what is being used for moisture management … This study was designed as a cross-sectional survey with a convenience sample of neonatal intensive care unit (NICU) nurses. A survey link was distributed electronically through websites, listservs, discussion boards, and newsletters to the National Association of Neonatal Nurses (NANN), the Academy of Neonatal Nurses (AAN), and WoundSource. There were 252 NICU nurses who completed the survey … read more

Maceration Mitigation: Recognition, Prevention, and Management of Overhydrated Wounds

Maceration is a common clinical complication that poses challenges in chronic wound treatment.1 Excessive moisture can be trapped on the wound surface, especially when occlusive dressings are overused or when nonbreathable cover dressings are applied for extended periods. Maceration as part of the broader umbrella of moisture-associated skin damage (MASD) occurs as a cascade of events that stem from an impaired microclimate and … read more

LinkedIn:
Alex M. Aningalan
WoundSource

Maceration Mitigation: Recognition, Prevention, and Management of Overhydrated Wounds

Maceration is a common clinical complication that poses challenges in chronic wound treatment.1 Excessive moisture can be trapped on the wound surface, especially when occlusive dressings are overused or when nonbreathable cover dressings are applied for extended periods. Maceration as part of the broader umbrella of moisture-associated skin damage (MASD) occurs as a cascade of events that stem from an impaired microclimate and increased humidity on the wound’s surface. The increased moisture level causes overhydration and the stratum corneum to swell, resulting in decreased tensile strength of this epidermal layer … read more

Medical device-related pressure ulcers and the COVID-19 pandemic: from aetiology to prevention

This article describes the aetiology of medical device-related pressure ulcers (MDRPU) and the vicious cycle that leads to these (typically, hospital-acquired) injuries. In this cycle, the primary, deformation-inflicted cell damage leads to a secondary inflammatory oedema-related damage and then to tertiary ischaemic cell and tissue damage. These three damage factors act cumulatively, and, once the first deformation-inflicted massive cell death initiates in the distorted tissues, each of these factors escalates the cell death and tissue damage further, under and near the applied medical device. The primary pathophysiological factors of the COVID-19 pandemic — including the cytokine storm, hypoxia and hyper-coagulation, which are typical to seriously ill patients who require life-support (skin-contacting) medical devices — can fuel the damage spiral of pressure injury. A continuous positive airway pressure (CPAP) mask is a classic example of a commonly used medical device … read more

Prevention or Delay of Type 2 Diabetes and Associated Comorbidities: Standards of Medical Care in Diabetes—2022

The American Diabetes Association (ADA) “Standards of Medical Care in Diabetes” includes the ADA’s current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee (https://doi.org/10.2337/dc22-SPPC), are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA’s clinical practice recommendations, please refer to the Standards of Care Introduction … read more

Exufiber Ag+ in prevention of Biofilm reformation video

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Updated Guidelines for Diabetic Foot, Neuropathic Ulcers, Use of Convexity During the Postoperative Period, Pressure Injury Prevention

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Harnessing Molecular Medicine to Accelerate Wound Healing

Harnessing Molecular Medicine to Accelerate Wound Healing

Full Press Release: TAICEND – advancing the science of wound healing to cut recovery time by more than half.

KAOHSIUNG CITY, Taiwan, Oct. 17, 2025 /PRNewswire/ — TAICEND will present its five major wound healing product series at the 2025 MEDICA Fair in Germany, including the Postoperative Care Series, Acute & Chronic Wound Series, Pressure Relief Series, Skin Protection & Prevention Series, and the Trauma Series.

With molecular medicine as the foundation of its R&D, TAICEND integrates cellular concepts into the wound healing process, providing in-depth insights into cellular activity at each stage of healing and mapping these mechanisms to product applications. This approach highlights the company’s commitment to delivering a complete and protocol-driven clinical value in wound care.

In the Postoperative Care Series, TAICEND addresses the needs of patients recovering from procedures such as cesarean sections and orthopedic surgeries. The products help keep wounds clean, reduce the risk of infection, stabilize wound sites, alleviate pain, and minimize scar formation.

The Acute & Chronic Wound Care Series targets difficult-to-heal wounds such as pressure ulcers. TAICEND’s standardized wound healing SOP has been clinically shown to accelerate healing speed by more than 50%, making it highly suitable for home healthcare and long-term care facilities.

The Pressure Relief & Prevention Series is specifically designed to address skin injuries caused by medical devices or prolonged immobility. Common scenarios include facial pressure from BiPAP masks, skin damage from drainage tubes or nasogastric tubes, and localized pressure injuries in bedridden patients. This series provides effective solutions to redistribute pressure and minimize friction-related skin damage, offering a reliable preventive care option for patients.

The Skin Protection & Prevention Series will feature a new product for Incontinence-Associated Dermatitis (IAD) prevention and care. With a simple two-step protocol, it provides an effective and convenient solution for managing skin health in elderly and bedridden patients.

Within the Emergency & Trauma Series, TAICEND will unveil a range of products designed for emergency and battlefield applications, including emergency bandages, tourniquets, and chest seals. These products are engineered to provide rapid, life-saving interventions in critical injury scenarios, underscoring TAICEND’s dedication to delivering comprehensive wound care solutions—from clinical settings to frontline emergencies.

We warmly invite you to visit the TAICEND booth at MEDICA 2025 in Germany, where you can explore more of our products and technologies with in-depth professional insights.

Booth number: Hall6 #H66-1

Join us on this journey of innovation in wound healing!

Contact:

Tsumin Huang

+886 7 6955313

401603@email4pr.com

Cision

View original content:https://www.prnewswire.com/news-releases/harnessing-molecular-medicine-to-accelerate-wound-healing-302586308.html

SOURCE TAICEND TECHNOLOGY CO., LTD.

Copyright 2025 PR Newswire

Key Highlights:

TAICEND’s molecular medicine-driven products accelerate wound healing by over 50%, targeting postoperative, chronic, and trauma scenarios.

Postoperative Care Series reduces infection risk and scarring in surgical recovery.

Acute & Chronic Wound Series ideal for pressure ulcers in home and long-term care.

Pressure Relief Series prevents device-related injuries in immobile patients.

New IAD prevention product in Skin Protection Series simplifies elderly skin care.

Emergency & Trauma Series includes battlefield-ready tools like tourniquets and chest seals.

Read full article

Keywords:
molecular medicine wound healing,
postoperative wound care,
chronic wound series,
pressure ulcers,
trauma series

What is the Key to Preventing Type 2 Diabetes?

What is the Key to Preventing Type 2 Diabetes?

Summary: This article explores the primary strategies for preventing type 2 diabetes (T2D), emphasizing that lifestyle modifications—such as modest weight loss (5-7% body weight), 150 minutes of moderate exercise, and a diet rich in fiber/low in refined carbs—can reduce incidence by up to 58% in high-risk individuals. Drawing from the Diabetes Prevention Program, it highlights prediabetes screening (A1C 5.7-6.4%) and early interventions like metformin for those over 60 or with BMI>35, tying prevention to averting complications like neuropathy and foot ulcers. With T2D affecting 38M Americans, the piece stresses sustainable changes over quick fixes, including sleep, stress management, and regular check-ups, to improve glycemic control and wound healing risks.

Key Highlights:

Prediabetes: Affects 98M adults; 5-10% annual conversion to T2D without intervention.

Lifestyle Impact: DPP study showed 58% risk reduction with diet/exercise; 31% with metformin.

Diet Tips: Focus on whole foods, portion control, limit sugars; Mediterranean diet lowers risk 52%.

Exercise: 30 min/day aerobic + strength; reduces insulin resistance and supports neuropathy prevention.

Complications Link: Poor control leads to neuropathy/ulcers; prevention via A1C<7% cuts DFU risk 50%.

Read full article

Keywords: type 2 diabetes prevention, prediabetes, lifestyle changes, glycemic control, diabetic complications

Orpyx Medical Technologies Supplies Digital Health Platform for NIH-Funded and Johns Hopkins ….

Orpyx Medical Technologies Supplies Digital Health Platform for NIH-Funded and Johns Hopkins Medicine-Led Clinical Trial on Diabetic Foot Ulcer Prevention

Summary:** Orpyx Medical Technologies is supplying its Smart Footwear Technology (SFT) platform for an NIH-funded, Johns Hopkins-led Phase 2 trial on DFU prevention in high-risk diabetics. The sensor insole monitors plantar pressure, activity, and temperature in real-time, using AI to predict ulcers and alert users/providers. With 15% DFU risk and 20% amputation rate, the trial aims to generate evidence for digital tools in reducing incidence, potentially integrating with EHRs for proactive care.

Key Highlights:

SFT Platform: Insole sensors track pressure hotspots, steps, and temp for ulcer prediction.

Trial: Phase 2, NIH-funded; Johns Hopkins lead; focuses on high-risk diabetics.

AI Analytics: Alerts for risk; integrates with apps for user education.

Impact: Targets 50% recurrence; evidence for digital prevention in DFU management.

Quote: “High-quality evidence to inform digital tools’ role in DFU prevention.”

Read full article

Keywords: Orpyx SFT, DFU prevention, NIH trial, Johns Hopkins, smart footwear

Hidden Crisis in Wound Care: Pressure Injuries

Hidden Crisis in Wound Care: Pressure Injuries

Summary: Hosted on the Demio webinar platform, this continuing education event titled “Hidden Crisis in Wound Care: Pressure Injuries” addresses one of wound care’s most prevalent and preventable — yet persistently underrecognised — clinical challenges. Pressure injuries (also called pressure ulcers or decubitus ulcers) affect an estimated 2.5 million patients per year in the United States alone, contributing significantly to prolonged hospitalisation, sepsis, surgical interventions, litigation, and mortality, particularly in the elderly, critically ill, and mobility-impaired populations. Despite broad awareness within nursing and wound care circles, pressure injuries continue to represent a hidden crisis in healthcare because they frequently develop in clinically silenced settings — under intact skin as deep tissue injuries, in patients unable to communicate pain, and in long-term care settings with limited wound care specialist access. The webinar format allows clinicians — nurses, wound care specialists, long-term care providers, and hospital administrators — to engage with expert-led education on the current NPIAP/EPUAP/PPPIA international pressure injury staging and classification system (Stages 1–4, unstageable, and deep tissue pressure injury), prevention frameworks including the use of pressure redistribution support surfaces, repositioning protocols, skin assessment tools (Braden Scale, Norton Scale), and nutrition-based preventive strategies. Management topics typically include moist wound healing principles, debridement decision pathways, dressing selection, offloading, negative pressure wound therapy in pressure injury management, and multidisciplinary care coordination across acute, post-acute, and community settings. For registration and webinar date/time details, visit the link below.

Key Highlights:

Free continuing education webinar on pressure injury prevention and management — covering NPIAP/EPUAP/PPPIA classification, staging, and international guideline recommendations

Addresses the “hidden crisis” framing: pressure injuries frequently develop silently under intact skin (deep tissue injuries), in non-communicating patients, and in under-resourced long-term care settings

Prevention framework: pressure redistribution surfaces, repositioning schedules, skin assessment (Braden/Norton), moisture management, nutrition optimisation — comprehensive risk mitigation strategies

Management topics: moist wound healing, debridement, dressing selection for each pressure injury stage, NPWT indications, surgical wound closure considerations, and care coordination across transitions

Audience: wound care nurses, clinical nurse specialists, long-term care staff, hospital administrators, and any clinician involved in pressure injury prevention or treatment programs

Registration and scheduling: available via Demio at the link below — check for live and on-demand session availability

Register for webinar

Keywords: pressure injury prevention, pressure ulcer staging NPIAP, deep tissue pressure injury, pressure injury wound care education, Braden Scale pressure ulcer, pressure injury management nursing

Wound Care Professionals

Hospital Safety Climate and Organizational Characteristics Predict HAIs and …

Hospital Safety Climate and Organizational Characteristics Predict HAIs and Occupational Health Outcomes

Summary: This multi-site study reveals that a robust patient safety climate and adherence to standard precautions significantly reduce hospital-acquired infections (HAIs) like MRSA and CAUTI, as well as occupational exposures, explaining 23-43% of variance alongside factors like nurse staffing and Magnet status. Observed adherence is suboptimal at 64.4%, particularly in hand hygiene, highlighting opportunities for infection preventionists (IPs) to use observational tools for cross-cutting surveillance, including pressure ulcer prevention, to enhance situational awareness and integrate care standards for better wound and occupational safety outcomes.

Key Highlights:

Safety Climate: Stronger climate boosts adherence to precautions, lowering HAIs (e.g., MRSA, CAUTI) and injuries (needlesticks, mucocutaneous).

Adherence Gaps: 64.4% overall; role differences (e.g., nurses higher in hand hygiene); underreporting worsens trends.

Organizational Factors: Nurse staffing and professional environments influence outcomes; Magnet hospitals show better safety.

Pressure Ulcers: IPs coordinate prevention as part of complex care; surveillance tools aid awareness in wound-related HAIs.

Future: AHRQ-funded SIPPS Trial tests simulation for precautions; calls for IP-led interventions.

Read full article

Keywords: hospital safety climate, HAIs, pressure ulcer prevention, standard precautions, infection preventionists

Study provides new tool to assess amputation risk following popliteal vascular injury

A large, multicentre cohort study provides a simple, practical method to effectively stratify patients preoperatively into low- and high-risk major amputation categories.

According to lead author Leigh Ann O’Banion (University of California, San Francisco, San Francisco, USA), “traumatic popliteal artery injuries present a serious clinical challenge because they are associated with the greatest risk of limb loss of all peripheral vascular injuries, with major amputation rates of 14–25%.” … read more

Negative Pressure Wound Therapy Reduced Amputation Risk for Patient With Diabetic Wound

A patient with a diabetic foot wound who underwent negative pressure wound therapy experienced good healing, reduced amputation risk, and no wound infection, suggesting the treatment method could be effective in other patients with similar wounds.

A patient who received negative pressure wound therapy (NPWT) after undergoing surgical debridement for a diabetic wound saw improvements in healing capabilities and reduced risks of limb amputation, according to a recent case report published in SAGE Open Medical Case Reports.

The report lends further support to previously published research that has shown NPWT to be effective at decreasing healing time, reducing ulcer area, and increasing healing rates of ulcers. NPWT has also been shown to aid patients with foot ulcers in achieving complete ulcer closure better than advanced moist wound therapy … –

Study Of The LimFlow System Demonstrates Sustained Amputation-Free Survival And Wound Healing In Patients With No-Option Chronic Limb-Threatening Ischemia

Paris, May 20, 2021 — LimFlow SA, a pioneer in the development of minimally-invasive technology for the treatment of chronic limb-threatening ischemia (CLTI), a severe form of peripheral artery disease (PAD), today announced the publication of 12-month data from the full patient cohort in its PROMISE I study of the LimFlow Percutaneous Deep Vein Arterialization System in the Journal of Vascular Surgery. Results showed sustained positive outcomes for both amputation-free survival and wound healing. The minimally-invasive LimFlow System is designed to bypass blocked arteries in the leg and deliver oxygenated blood back into the foot via the veins in CLTI patients who are facing major amputation and have exhausted all other therapeutic options read more

25 MUST Know Statistics About Amputation Due to Diabetes

There are some surprising statistics about how common diabetic foot ulcers are, how often they can lead to amputation and the ultimate cost of having a foot ulcer that results in an amputation …. read more

Higher proportion of limb salvage and lower amputation rates

The impact of a wound centre on a vascular surgery practice

The opening of an outpatient wound centre has been associated with a significant increase in peripheral vascular practice and a significant decrease in amputation rate. Venita Chandra and colleagues Alyssa M Flores, Matthew W Mell and Ronald L Dalman (Stanford University, Stanford, USA) believe that such centres result in synergistic systems that promote more aggressive and effective limb salvage strategies. Chandra presented the findings of a recent study analysing the clinical impact of a wound care centre on a vascular surgery practice, at the Society for Vascular Surgery’s Vascular Annual Meeting (VAM; 20–23 June, Boston, USA).

According to Chandra, chronic wounds remain a growing problem, not only in the USA but worldwide—with many patients at risk of limb loss presenting as particularly challenging. This cohort requires complex and resource-intensive medical care, reported Chandra.

World experts and leaders in this specialty have developed and described programs to attempt to improve the care of these complex patients and decrease the risk of amputation … read more

Inherent variations in the cellular events at the site of amputation orchestrate scar‐free

wound healing in the tail and scarred wound healing in the limb of lizard Hemidactylus flaviviridis

Lizards are unique in having both – regeneration competent (tail) as well as non‐regenerating appendages (limbs) in adults. They therefore present an appropriate model for comparing processes underlying regenerative repair and non‐regenerative healing after amputation. In the current study, we use northern house gecko Hemidactylus flaviviridis to compare major cellular and molecular events following amputation of the limb and of the tail. Although the early response to injury in both cases comprises apoptosis, proliferation and angiogenesis, the temporal distribution of these processes in each remained obscure. In this regard, observations were made on the anatomy and gene expression levels of key regulators of these processes during the healing phase of the tail and limb separately. It was revealed that cell proliferation markers like FGFs were upregulated early in the healing tail, coinciding with the growing epithelium. The amputated limb, in contrast, showed weak expression of proliferation markers, limited only to fibroblasts in the later stage of healing. Additionally, apoptotic activity in the tail was limited to the very early phase of healing, as opposed to that in the limb, wherein … read more

Cleveland Clinic surgeon helps draft Amputation Reduction and Compassion Act

But there is legislation moving through Congress that seeks funding to improve public awareness and early detection.

Vascular surgen Dr. Lee Kirksey of the Cleveland Clinic said there is no disease that ravages the body quite like diabetes. The complications can be serious: heart attacks, strokes, kidney failure and the most worrisome and drastic of all, limb loss.

“When I talk to diabetics, their greatest fear and they know that they can have a heart attack or stroke, their greatest fear is having to have an amputation,” said Dr. Kirksey.

According to Dr. Kirksey, as many as 25% of patients with diabetes at some point will develop a foot ulcer and if left untreated, that ulcer can lead to infection and amputation … read more

‘Death is a greater risk’ than amputation after diabetic foot ulcer

People with diabetes and a history of foot ulcer are more likely to die than undergo amputation during 6 years of follow-up, a potential measure of effectiveness of diabetes care, registry data from Scotland show.

In an analysis of real-world data comparing people with diabetes with and without foot ulcer, researchers also found amputation or death occurred for approximately one in two of those with a prior foot ulcer … read more

Socioeconomic deprivation tied to amputation risk in people with diabetic foot ulcers

People with diabetic foot ulcers (DFUs) who live in areas with a high level of deprivation may be more likely to require major amputation than those living in less deprived areas, suggest findings from a French cohort study … Jean-Baptiste Bonnet (Hôpital Lapeyronie, Montpellier) used the French National Health Data System to evaluate amputation data from 15,507 individuals in the Languedoc-Roussillon administrative area with any type of diabetes who experienced a first DFU between 2015 and 2017. These people were aged an average of 70 years, 55% were men, and 20% required hospitalization … read more

Medicaid Expansion Under ACA May Have Reduced Rate of Major Diabetes-Related Amputations

by Patrick Campbell

An analysis of data from 2013-2015 provides insight into the impact of Medicaid expansion under the Affordable Care Act on rate of major diabetes-related amputations and suggests a shift in the distribution of uninsured patients may have driven reductions observed in the study.

Data from a new study are providing clinicians with insight into the effects of the Medicaid Expansion Under the Patient Protection and Affordable Care Act (ACA) on rates of diabetes-related major amputations among racial and ethnic minority adults with diabetes … read more

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Foot Ulcer and Risk of Lower Limb Amputation or Death in People With Diabetes:

A National Population-Based Retrospective Cohort Study

Rosemary C Chamberlain, Kelly Fleetwood, Sarah H Wild, Helen M Colhoun, Robert S Lindsay, John R Petrie, Rory J McCrimmon, Fraser Gibb, Sam Philip, Naveed Sattar, Brian Kennon, Graham P Leese

Objective: To describe incidence of foot ulceration and amputation-free survival associated with foot ulceration status in a national population-based cohort study of people with diabetes … Research design and methods: The study population included 233,459 people with diabetes who were alive in Scotland on 1 January 2012 identified from the national population-based register (national prevalence 4.9%). Characteristics of patients identified from linked hospital and mortality records during follow-up to the end of November 2017 were compared by outcome. Cox regression was used to assess the association between history of foot ulcer and amputation-free survival … Results: The population included 23,395 people with type 1 diabetes and 210,064 people with type 2 diabetes. In total there were 13,093 (5.6%) people who had a previous foot ulceration, 9,023 people who developed a first ulcer, 48,995 who died, and 2,866 … read more

Thane Fisherman’s Hand Saved from Amputation After Rare Eel Fish Bite in Uttan

Thane Fisherman’s Hand Saved from Amputation After Rare Eel Fish Bite in Uttan

Summary: In a dramatic case at Wockhardt Hospitals, Mira Road, a 42-year-old fisherman, Sandip Bhoin, was rescued from limb-threatening infection after a rare double bite from an eel during a fishing trip at Uttan Beach. Arriving 17 hours later with a grossly swollen, pale hand lacking circulation and sensation, he was diagnosed with acute compartment syndrome. Led by Dr. Sushil Nehete, the surgical team performed an emergency fasciotomy to release pressure, restoring blood flow instantly. Post-op, ICU monitoring prevented kidney failure from metabolic waste, and he’s now on track for full recovery with skin grafting and physiotherapy, underscoring the critical role of prompt wound intervention in traumatic marine injuries.

Key Highlights:

Incident: Eel bite caused deep lacerations and heavy bleeding; initial pressure bandage by peers delayed but helped temporarily.

Symptoms on arrival: Excruciating pain, swelling, pallor, absent sensation—hallmarks of compartment syndrome obstructing blood flow.

Surgery: Fasciotomy released forearm/carpal tunnel pressure; immediate circulation return with rapid sensation/movement improvement.

Post-op: ICU averted renal complications; ongoing wound care, grafting, and physio for hand function restoration.

Outcome: Hand saved from amputation; full recovery expected in months, emphasizing early referral for trauma wounds.

Read full article

Keywords: traumatic wound, compartment syndrome, fasciotomy, marine injury, wound infection

Vascular Care Falls Short Before Amputation for CLI: Medicare Analysis

Too few patients underwent angiography or interventions, and suboptimal care was linked with more deaths and readmissions.
Alook back at the care patients with critical limb ischemia (CLI) received in the year prior to amputation suggests that most received minimal vascular care, with 69% not undergoing a revascularization attempt that might have saved the limb or improved overall survival.

Earlier this year, the American Heart Association noted in a policy statement that after a period of decline in the 1990s and early 2000s, major and minor amputations have been on the rise. National surveys, too, reflect a dramatic undertreatment problem in the outpatient setting among patients with PAD … read more

The Biomechanics of Diabetic Foot Amputation

According to the International Diabetes Federation, approximately 463 million adults live with diabetes mellitus (DM), a number projected to increase to 700 million by 2045; a diabetic foot ulcer (DFU) will occur in about 15% of that population. Multiple factors contribute to the development of those wounds including diabetic peripheral neuropathy, biomechanical imbalances, trauma, and peripheral vascular disease. In addition, 85% of all lower limb amputations in patients with diabetes are preceded by a DFU resulting in significant biomechanical challenges for these patients, many of who never become ambulatory again. Prior to surgical intervention, patients come with inherited and acquired biomechanical imbalances or weaknesses such as equinus, severe pronation/supination, mid and forefoot deformities, and muscle weakness unrelated to their other diseases. Surgeons may not take these into consideration when making decisions about amputation level … read more

New Net Health Innovation Can Predict Risk of Amputations and Wound Healing Rates

Net Health recently announced the addition of two pioneering predictive analytic capabilities embedded in the workflow of the company’s widely used electronic health record (EHR) platform.

Offering artificial intelligence-based capabilities, the Net Health Wound Care software platform now includes the Risk of Amputation Indicator, developed to reduce the risk of amputations, and the Wound Healing Velocity Indicator, developed to predict wound healing rates, according to the company. Net Health says both capabilities will provide insights needed to develop optimal patient therapies, implement effective interventions, and plan treatment paths that will improve outcomes … read more

Diabetic Amputations May Be Rising in the United States

Lower-limb amputations may be rising in the United States after decades of decline, according to data published in Diabetes Care, the official journal of the American Diabetes Association.

The study, which evaluated hospitalization rates for nontraumatic lower extremity amputation in the years 2000 to 2015 using data from the National Health Interview Survey, evaluated estimates for populations with and without diabetes.

Poorly controlled blood sugar that occurs in diabetes can limit blood flow to the lower legs and toes, causing nerve damage that people with the disease may not sense until problems have already developed. People with advanced diabetes may develop wounds or sores that do not heal and eventually result in loss of the damaged toe or portion of the foot or leg … read more

Berlin doctor lauded for leg amputation research

BERLIN – A local doctor has received international honors for a scientific paper about a new scoring system he helped create to evaluate the risks of leg amputations.

Dr. Eric Newgent, medical director of sleep medicine at ThedaCare Medical Center-Berlin, wrote the article for The Journal of Wound Care with Dr. Michael Miller, a general surgeon and full-time wound care specialist in Indiana, according to ThedaCare … read more

A comprehensive scoring system to evaluate patient-centered risk factors regarding lower extremity amputation

A systematic review of multidisciplinary teams to reduce major amputations for patients with DFUs

Multiple single-center studies have reported significant reductions in major amputations among patients with diabetic foot ulcers after initiation of multidisciplinary teams. The purpose of this study was to assess the association between multidisciplinary teams (ie, two or more types of clinicians working together) and the risk of major amputation and to compile descriptions of these diverse teams … read more

Researcher Looks To Curb Rate Of Diabetic Amputations In NL

A local researcher is hoping to change the alarming rate of amputation due to diabetes in the province … Newfoundland and Labrador has the highest rate of diabetes in the country, and the highest rate of lower limb amputation due to diabetes … Kathleen Stevens is a Registered Nurse and PhD candidate at Memorial University’s School of Nursing … read more

Microbion Corporation Receives up to $2.1 million in Funding Support from the US Navy

in Partnership with CUBRC, Inc. to Advance Topical Pravibismane

Funding will support exploratory phase 2 proof-of-concept study in patients hospitalized for moderate to severe diabetic foot ulcer infection (DFI)

BOZEMAN, Mont. and VANCOUVER, BC, June 7, 2022 /PRNewswire/ – Microbion Corporation of Bozeman, MT, today announced that it has received non-dilutive funding through its strategic partnership with CUBRC, Inc., a Buffalo-based, independent not-for-profit research company, of up to $2.1 million from the US Navy through the Medical Technology Enterprise Consortium (MTEC) partnership. The funding project is titled “Pravibismane Suspension as a Topical, Broad Spectrum Anti-Infective Wound Care Treatment and Prevention for Combat Injury-Related Infections”. The funding received will be used to support the conduct of an exploratory phase 2 proof of concept trial in patients hospitalized for moderate to severe diabetic foot ulcer infection with enrollment expected to begin in Q2 2022.

“We are pleased to be supported by the US Navy and MTEC and are working closely with them to advance our topical pravibismane through phase 2 proof-of-concept studies,” said Karim Lalji, CEO of Microbion Pharma Corp. “Our topical diabetic foot ulcer infection program is well aligned to the Navy’s interest in innovative wound care technologies to treat and prevent biofilm-related infections, since biofilm contamination is a hallmark characteristic of chronic foot ulcer infections. Further exploration of pravibismane’s safety and efficacy in overcoming biofilm-related DFI may potentially expand the clinical utility of topical pravibismane to treat combat wound infections in a variety of settings, including in the field and hospital.”

Lester Martinez, MD, MPH, Major General (Retired), U.S. Army, President and Chairman of MTEC Board commented on the importance of Microbion’s research. “Though diabetic foot ulcer infections aren’t traditionally thought of as a combat related wound suffered in the field, diabetes is a serious disease that affects a significantly high percentage of our veterans and its complications such as DFI contributes to decline in health, quality of life and are responsible for the vast majority of non-combat amputations among veterans. Microbion’s research into healing these wounds with the ultimate goal of preventing or delaying amputations can potentially improve the daily lives of these patients and return normal mobility,” Dr. Martinez stated.

Pravibismane is the first in a new class of anti-infective drugs structurally unrelated to other clinically utilized antibiotics. With a novel mechanism of action, pravibismane shuts down bacterial ATP production thereby halting global bacterial cellular metabolism. In in vitro studies, pravibismane exhibits broad-spectrum, potent activity against DFI-relevant pathogens and their biofilms including MRSA and drug resistant P. aeruginosa.

In a randomized, double-blind, placebo-controlled Phase 1b trial treating patients with chronic moderate to severe diabetic foot ulcer infection, topical pravibismane treatment plus standard of care demonstrated a numeric 85% wound size reduction versus 30% placebo plus standard of care. Pravibismane also demonstrated a numeric reduction in ulcer-related amputation (2.6% in the pravibismane group vs 15.4% placebo).

DFIs are a major health concern in the Veterans Health Administration as DFUs are associated with a substantial mortality rate (five-year mortality rates are as high as 45% for neuropathic ulcers and 55% for ischemic ulcers1) and often require amputation to fully address the nidus of infection.2 Approximately 28.5 million adults in the US are diagnosed with diabetes, of whom 15 – 25% are at risk of developing a foot ulcer.3,4 More than half of diabetic foot ulcers become infected.5 DFIs remain the most frequent diabetic complication requiring hospitalization and are the most common precipitating event leading to lower extremity amputation.6 Furthermore, recent studies suggest that many DFIs are caused by bacteria in a biofilm mode.6 In 2018, there were ~8.25 million hospital discharges with diabetes reported, including 154,000 for a lower-extremity amputation.3 US Veterans Affairs estimates there were 20.3 million living Veterans in 2018.7 The overall prevalence of diabetes among US veterans is ~25%, which is higher than the US civilian population at ~9%.8

References:

Del Core MA, Ahn J, Lewis RB, et al. The evaluation and treatment of diabetic foot ulcers and diabetic foot infections. Foot & Ankle Orthopaedics. 2018;3:3. doi:10.1177/2473011418788864

Sundararajan PP, Porter BM, Grant KA, et al. Foot infections in the Veterans Health Administration. The Foot and Ankle Online Journal. 2015;8(3):1. doi:10.3827/faoj.2015.0803.0001

Centers for Disease Control and Prevention. National Diabetes Statistics Report website. https://www.cdc.gov/diabetes/data/statistics-report/index.html, accessed June 6, 2022

Lavery LA, Davis KE, Berriman SJ, et al. WHS guidelines update: Diabetic foot ulcer treatment guidelines. Wound Repair Regen. 2016;24(1):112–26. doi: 10.1111/wrr.12391

Armstrong, DG, Boulton, AJM, and Bus, SA. Diabetic foot ulcers and their recurrence. N Engl J Med. 2017;376:2367-75. doi: 10.1056/NEJMra1615439

Lipsky et al. Guidelines on the diagnosis and treatment of foot infection in persons with diabetes (IWGDF 2019 update). Diab Metab Res Rev. 2020. e3280. doi: 10.1002/dmrr.3280

VETPop2018: A Brief Description. Web: https://www.va.gov/vetdata/docs/Demographics/New_Vetpop_Model/VP_18_A_Brief_Description.pdf, accessed June 6, 2022

Liu Y, Sayam S, Shao X, et al. Prevalence of and trends in diabetes among veterans, United States, 2005–2014. Prev Chronic Dis. 2017;14:170230. doi: 10.5888/pcd14.170230

About Microbion
Microbion is a clinical-stage pharmaceutical company developing a new class of therapeutic compounds to improve the lives of patients with rare and serious diseases. Microbion’s lead drug candidate, pravibismane, is the first product in this new class and has a novel mechanism of action offering unique potential to address the unmet needs of chronic and severe health conditions. The Company is advancing inhaled pravibismane in Phase 1 clinical development for the treatment of chronic lung diseases, including non-tuberculous mycobacteria (NTM) and cystic fibrosis-related lung infections. Topical/local pravibismane is in Phase 2 development for the treatment of chronic wounds and orthopedic infections. Pravibismane has received backing from the Cystic Fibrosis Foundation, NIH, US DoD, and CARB-X with over $21 million in grants. The FDA has granted pravibismane with Orphan Drug, Fast Track, and QIDP designations. Microbion Pharma Corp. is a wholly owned subsidiary of Microbion Corporation. For more information visit: www.microbioncorp.com.

About CUBRC
CUBRC is an independent not-for-profit scientific corporation that executes Research, Development, Testing and Systems Integration programs in Medical Sciences, Chemical and Biological Defense, Data Science and Information Fusion, Command and Control, and Hypersonics. For more information visit: www.cubrc.org.

Safe Harbor Statement
Certain of the statements made in this press release are forward-looking, such as those, among others, relating to the success of clinical development of pravibismane and preparation for potential commercialization. These statements are subject to risks and uncertainties that could cause actual results and events to differ materially from those anticipated, including, but not limited to, risks and uncertainties related to: our ability to enroll patients in our clinical trials at the pace that we project; the size and growth of the potential markets for pravibismane or any future product candidates and our ability to serve those markets; our ability to obtain and maintain regulatory approval of pravibismane or any future product candidates; and our expectations regarding the potential safety, efficacy or clinical utility of pravibismane or any future product candidates. Actual results or developments may differ materially from those projected or implied in these forward-looking statements. Microbion Corporation disclaims any intention or obligation to update or revise any forward-looking statements, whether as a result of new information, future events or otherwise.

US Government Funding Disclaimer
Efforts described herein were partially sponsored by the Government under Other Transactions Number W81XWH-15-9-0001. The U.S. Government is authorized to reproduce and distribute reprints for Governmental purposes notwithstanding any copyright notation thereon. The views and conclusions contained herein are those of the authors and should not be interpreted as necessarily representing the official policies or endorsements, either expressed or implied, of the U.S. Government.

SOURCE Microbion Corporation

This article was originally published here

Optimizing Diabetic Foot Ulcer Care: Four Steps to Save Limbs Worldwide

Optimizing Diabetic Foot Ulcer Care: Four Steps to Save Limbs Worldwide

Keck Medicine of USC outlines a comprehensive, four-step approach to diabetic foot ulcer (DFU) management, aiming to reduce the global incidence of lower-limb amputations. This strategy emphasizes early detection, interdisciplinary care, and patient empowerment to enhance outcomes for individuals with diabetes.

1. Establishing a “Hot Foot Line”: A dedicated hotline facilitates rapid triage of patients presenting with diabetic foot infections or ischemia, ensuring immediate assessment by a specialized limb-salvage team. This prompt intervention can significantly decrease the risk of major amputations.

2. Developing Wound-Healing Clinics: Specialized outpatient clinics focus on active tissue loss, employing advanced modalities such as total contact casting, vascular diagnostics, and surgical debridement. These clinics aim to expedite healing and reduce hospitalization rates.

3. Establishing Remission Clinics: Post-healing, remission clinics work to prevent ulcer recurrence through patient education, biomechanical evaluations, and preventive interventions. Tools like pressure-relieving footwear and thermal monitoring devices are utilized to maintain ulcer-free periods.

4. Implementing Screening Clinics: Annual foot screenings assess risk factors like neuropathy and peripheral artery disease. Early identification allows for timely referrals to appropriate care pathways, including remission or wound-healing clinics, thereby preventing the progression to limb-threatening conditions.

This model has demonstrated success at Keck Medicine of USC and is adaptable to various healthcare settings globally. By integrating these steps, healthcare systems can proactively manage chronic conditions, ultimately saving limbs and improving quality of life for patients with diabetes.

Read the full article on the Keck Medicine of USC website.

Keywords:
Diabetic foot ulcers,
Foot ulcer care,
Limb salvage,
Amputation prevention,
Keck Medicine of USC,
David G. Armstrong

Evaluating the Cost of Wound Care Driven by Comorbidities

Evaluating the Cost of Wound Care Driven by Comorbidities

Summary: Experts discuss how comorbidities such as diabetes, peripheral vascular disease, and neuropathy substantially increase the cost of wound care. Many wounds become expensive because comorbid conditions complicate healing, delay specialty referral, and increase risk of amputation. The conversation emphasizes that better diagnosis, timely vascular evaluation, and care coordination might reduce this cost burden.

Key Highlights:

Comorbidity cost multiplier: Wounds in patients with diabetes, vascular disease, or neuropathy are far costlier due to delayed healing and need for increased interventions.

Referral gaps: Alarmingly, about 50% of diabetic patients who later have amputations never receive vascular evaluation.

Impact of delays: Delays in ordering necessary equipment (e.g., support surfaces) or in therapies result in increased costs and poorer outcomes.

Advanced therapies early: There is evidence that early use of advanced treatments helps reduce long-term cost, rather than waiting until wounds become chronic.

Care coordination matters: Streamlined workflows, better specialist access, and removing administrative barriers help reduce both healing time and cost.

Systemic inefficiencies: Lack of standardization, fragmented care, and siloed specialties contribute heavily to unnecessary cost escalation.

Read the full article on AJMC

Keywords:
cost of wound care,
comorbidities,
diabetes,
peripheral vascular disease,
care coordination,
amputation prevention

Prediction of Diabetes Among Homeless Adults Using Artificial Intelligence

Prediction of Diabetes Among Homeless Adults Using Artificial Intelligence: Suggested Recommendations

Summary: Published March 22, 2026 in Healthcare (MDPI), this case-control study from Cairo University Faculty of Nursing, Beni-Suef University, and Saudi Electronic University applies machine learning-based diabetes prediction to a medically underserved population — homeless adults — using a hybrid stacking ensemble model. Led by Khadraa Mohamed Mousa and Manal Mohamed Elsawy (Community Health Nursing, Cairo University), the study enrolled 150 homeless adults at the Ma’ana Rescue Human Foundation (Giza, Egypt), including 99 confirmed diabetic cases (FBS ≥ 126 mg/dL or prior diagnosis) and 51 non-diabetic controls. Structured interviews collected demographic data, medical history, 15-item lifestyle questionnaire, and 7-item diabetes knowledge assessment; physiological measurements included weight, height, BMI, waist circumference, triceps skinfold thickness (TSF), fasting blood sugar, and blood pressure. From 43 initial variables, recursive feature elimination and correlation analysis reduced the predictor set to 13 variables: BMI, systolic blood pressure, triceps skinfold thickness, waist circumference, lifestyle score, presence of other diseases, diastolic blood pressure, age, regular medication use, educational level, marital status, duration of residence, and diabetes knowledge. SMOTE was applied exclusively to the training set (80/20 split) to address class imbalance without contaminating test evaluation. Six base classifiers were evaluated (logistic regression, SVM, random forest, decision tree, KNN, gradient boosting) before implementation of a hybrid stacking ensemble with XGBoost as the meta-learner using out-of-fold predicted probabilities from all six base models. The stacking ensemble achieved 95.45% accuracy, 100% precision, 93.75% recall, F1-score 0.968, and AUC-ROC 0.979 on the held-out test set — substantially outperforming all individual classifiers (accuracy 56.7–70%, F1 0.686–0.781). Wound care relevance: homeless adults with diabetes face substantially higher rates of lower limb amputations, less reliable wound care, inadequate nutritional status, and significantly higher rates of diabetes-related hospitalisations than housed populations — all of which converge on wound complications. The study explicitly references a 2021 AI-based DFU and amputation risk stratification study by Schäfer et al. as the broader clinical context. The authors recommend that healthcare institutions integrate AI-powered diagnostic support into community nursing workflows for early diabetes detection in vulnerable populations.

Key Highlights:

Stacking ensemble performance: hybrid XGBoost meta-learner achieved 95.45% accuracy, 100% precision, AUC 0.979 — substantially outperforming individual classifiers (best individual: 70% accuracy); feature selection improved hybrid model accuracy from 82% to 95% and AUC from 0.87 to 0.98

13 key predictors identified: BMI, SBP, TSF, waist circumference, lifestyle score, comorbidities, DBP, age, medication adherence, educational level, marital status, duration of residence, and diabetes knowledge — a novel combination integrating psychosocial and contextual factors rarely included in conventional diabetes risk models

Homeless population vulnerability: diabetes in homeless adults associated with 5× higher ED visit and hospitalisation rates vs. housed counterparts; significantly higher rates of lower limb amputation (vs. 0.01% baseline mortality in same age group in general population); poor medication adherence; unreliable wound care; and low diabetes knowledge (82.8% had incorrect knowledge of diabetes definition)

Clinical wound care context: the study references Schäfer et al. (2021, Front Med) on ML-based DFU and amputation risk stratification as its broader framework — positioning early AI-assisted diabetes detection in homeless populations as an upstream prevention strategy for the DFU and amputation pipeline

Limitations: single-centre, n=150, purposive sample; case-control design reflects institutional prevalence rather than community prevalence; small test set (n=30) may inflate performance estimates; external validation in larger multi-centre samples is required before clinical deployment

Nursing recommendation: community and gerontological health nurses are positioned to implement AI-assisted screening alongside fingertip glucose testing in shelter and community settings — providing instant results and enabling same-encounter lifestyle counselling for high-risk homeless adults

Read full article

Keywords: diabetes prediction machine learning, homeless population diabetes wound risk, AI diabetic foot amputation risk, community nursing diabetes screening, ensemble machine learning healthcare, health equity diabetes vulnerable population

Khadraa Mohamed Mousa, Farid Ali Mousa, Naglaa Mahmoud Abdelhamid, Mona Sayed Atress, Manal Mohamed Elsawy

The epidemic of diabetic limb amputation in poor communities and parts of Cleveland

Differences in outcomes across race, ethnicity and income exist for virtually every chronic health condition that Americans experience. Without exception, minority and poor white Americans die younger and suffer more preventable diseases.

November is diabetes awareness month. Few diseases impact every system of the body in the way that diabetes increases the risk for stroke, heart attack and kidney failure.

Of these devastating conditions, loss of limb, or amputation, is one of the most-dreaded complications of diabetes … read more

Independence Blue Cross Taps Podimetrics to Prevent Diabetic Amputations Via RPM

Independence Blue Cross (Independence) and Podimetrics, a virtual care management company dedicated to preventing diabetic amputations, today announced an agreement for Podimetrics to remotely monitor Independence fully insured commercial members who have diabetes and a history of a diabetic foot ulcer with the use of the cellular-connected SmartMat … read more

America’s Amputation Crisis May Soon Get Much Worse

Proposed Medicare cuts create greater barriers to screening and revascularization services
Few medical procedures are as life-altering as an amputation. But statistics show hundreds of thousands of Americans have their limbs surgically removed each year because they don’t have access to adequate vascular screening and care.

In the rural communities of North Carolina that we serve, the nearest “in-hospital” alternative to our office-based treatment locations is at least 2 to 3 hours away, which can result in delays in care that lead to poor clinical outcomes. The patients we serve are living with vascular diseases such as peripheral artery disease (PAD) and critical limb ischemia (CLI) … read more

The Compassionate Amputation: Think Outside The Limb

Faced with the challenges of non-healing diabetic ulcerations, a patient’s realization of progressively declining health, the burden of expansive health costs and the unrelenting frequency of doctor appointments, can cumulatively lead to a heavy emotional toll and state of despair. In dealing with high-risk patients, how we navigate the nuances of these aforementioned complexities may define our role in the lives we impact. While mental health consequences of chronic disease are well-documented, I feel there is no louder or stronger a case than the fragile cohort of those plagued with diabetes at the critical point where discussion about amputation becomes essential … read more

Pandemic Derails Small Success in Lowering Diabetes-Related Amputations

Rates of minor diabetes-related lower extremity amputations (LEAs) in hospitalized patients increased between 2009 and 2017 in all racial and ethnic groups, in both rural and urban areas, and in all geographic regions across the United States, a new retrospective, observational study indicates … read more

Significant Reductions in Amputations, Emergency Visits, and Hospital Readmissions Associated with Advanced Treatment Using Skin Substitute Products …

MiMedx Group, Inc. (Nasdaq: MDXG) (“MIMEDX” or the “Company”), an industry leader in utilizing amniotic tissue as a platform for regenerative medicine, today announced publication of its peer-reviewed study in the Journal of Wound Care (JWC), addressing the observed impact of Advanced Treatment (AT) using all high-cost skin substitute products in lower extremity diabetic ulcers (LEDUs) based on data from the Medicare Limited Dataset (October 1, 2015 through October 2, 2018). The study assessed outcome in patients receiving AT with all high-cost skin substitute products, as designated by the Centers for Medicare and Medicaid Services (CMS), for LEDUs versus No Advanced Treatment (NAT), and found that AT use could lead to a 42% reduction in major and minor amputations and all related costs, compared to NAT. Further, the study highlights preferable outcomes when AT follows parameters for use (FPFU), underscoring the importance of early treatment with regular intervals and well-defined treatment guidelines … read more

DECREASING AMPUTATION, WORLDWIDE…BUT GREATER PREVALENCE AND MORTALITY FROM DIABETIC FOOT ULCERS (DFU)?

Here is a mashup of two manuscripts recently posted to the blog. While amputation appears to be reducing in OECD states, the risk for mortality secondary to DFU is high and may be getting higher … read more

Several prediction tools provide “objective” post-amputation outcome forecasts, but further work is needed

A recent systematic review and narrative synthesis has found several tools that demonstrate “acceptable-to-outstanding discrimination” for predicting key outcomes following major lower limb amputation. However, authors Ryan A Preece (Royal Gwent Hospital, Cardiff, UK) and colleagues note that “additional robust external validation” is needed to strengthen the clinical applicability of the prediction tools assessed. This research appeared online in the European Journal of Vascular and Endovascular Surgery (EJVES).

Resurgence of diabetes-related nontraumatic lower extremity amputation

in the young and middle-aged adult U.S. population

We are grateful to Linda Geiss and her coworkers at CDC for their always intriguing efforts at revealing the big picture to us. These data– which certainly aren’t welcome news– are supremely important. Do they signal what we’ve posited for some time? Did the increase in the “denominator” of people with diabetes in the mid-1990s initially reduced the proportionate pool of high risk patients (and thereby reduced amputation rates)? Was it better team care? Whatever the explanation, we have yet more data on which to ruminate … read more

Ending Avoidable Amputations Within A Generation

Diabetic Foot Australia (DFA) was established in 2015 with the goal of ending avoidable amputations within a generation in Australia. As a key initiative of the Wound Management Innovation CRC, we engaged the expertise of multiple partner organisations across Australia to create a national diabetes-related foot disease (DFD) body for Australia. On the 1st July 2018, Diabetic Foot Australia joined the Australian Diabetes Society’s (ADS) stable of national diabetes clinical and research programs …. download Australian Diabetes-Related Foot Disease Strategy (PDF)

Higher proportion of limb salvage and lower amputation rates

The impact of a wound centre on a vascular surgery practice

The opening of an outpatient wound centre has been associated with a significant increase in peripheral vascular practice and a significant decrease in amputation rate. Venita Chandra and colleagues Alyssa M Flores, Matthew W Mell and Ronald L Dalman (Stanford University, Stanford, USA) believe that such centres result in synergistic systems that promote more aggressive and effective limb salvage strategies. Chandra presented the findings of a recent study analysing the clinical impact of a wound care centre on a vascular surgery practice, at the Society for Vascular Surgery’s Vascular Annual Meeting (VAM; 20–23 June, Boston, USA) … read more

Liraglutide May Lower Risk for Foot Amputation in Type 2 Diabetes

Patients with type 2 diabetes who took liraglutide were at a lower risk for foot amputation, according to a study recently published in Diabetes Care.

Researchers completed a post hoc analysis on data collected during the Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results (LEADER) trial to determine the effect of liraglutide on rates of diabetes-related foot ulcers in patients who were also at high risk for cardiovascular events. Patients in the LEADER study were randomly assigned to either an intervention arm (n=4668), receiving 1.8 mg of liraglutide a day, or a control arm (n=4672), receiving a placebo. The study continued for 5 years with an average follow-up time of 3.8 years. A diabetes-related foot ulcer was … read more

Liraglutide May Lower Risk for Foot Amputation in Type 2 Diabetes

Patients with type 2 diabetes who took liraglutide were at a lower risk for foot amputation, according to a study recently published in Diabetes Care.

Researchers completed a post hoc analysis on data collected during the Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results (LEADER) trial to determine the effect of liraglutide on rates of diabetes-related foot ulcers in patients who were also at high risk for cardiovascular events. Patients in the LEADER study were randomly assigned to either an intervention arm (n=4668), receiving 1.8 mg of liraglutide a day, or a control arm (n=4672), receiving a placebo. The study continued for 5 years with an average follow-up time of 3.8 years. A diabetes-related foot ulcer was specified as a medical event of special interest, and all complications related to the ulcer were documented.

read more

SGLT2 inhibitor therapies may raise risk for amputation

Adults with type 2 diabetes and established CVD prescribed SGLT2 inhibitor therapy have a twofold increased risk for lower-limb amputation and diabetic ketoacidosis compared with patients prescribed a GLP-1 receptor agonist, according to study findings presented at the European Society of Cardiology Congress.

“Sodium glucose cotransporter 2 inhibitors are playing an increasingly prominent role in the treatment of diabetes, following the reduced risk of major adverse cardiovascular events and heart failure outcomes seen in the EMPA-REG Outcome trial with empagliflozin [Jardiance, Boehringer Ingelheim] and in the CANVAS study with canagliflozin [Invokana, Janssen],” Peter Ueda, MD, PhD, from the department of medicine at the Karolinska Institute in Solna, Sweden, said during a presentation here. “Concerns exist regarding the safety of the drugs, with signals of serious adverse events emerging from clinical trials, case reports and observational studies.” … read more

Approval for commercialization of Heberprot-P® in Mexico

Press release from: Center for Genetic Engineering and Biotechnology

Havana, Cuba, May 4, 2018 – Heberprot-P® has been approved for commercialization in México. The Center for Genetic Engineering and Biotechnology (CIGB) is excited to announce regulatory approval of this innovative medicine indicated for advanced diabetic foot ulcer (DFU), which is expected to save thousands of people from lower limb amputation. The official approval date of Heberprot-P® was April 30th, 2018. Heberprot-P® stimulates granulation, accelerates DFU re-epithelization, and reduces healing time, surgical debridement, amputation risk, and recurrences. The intralesional infiltration of Heberprot-P® may be applied in combination with Good Wound Care (GWC), revascularization, and antibiotics. This medicine is an effective solution for an unmet medical need, a first in class product, unique worldwide, for DFU treatment. It is the only therapeutic choice available for advanced and complex DFU, reluctant to healing (grades 3, 4, and 5, according to Wagner’s classification).

Clinical experience derived from the intervention with Heberprot-P® in daily medical practice in Cuba was analyzed in 2013 in a study that reviewed the evolution of more than 2 000 patients as well as the pharmacovigilance of 1 788 patients, showing a 75% probability of granulation response, 61% healing rate, 71% amputation risk reduction, Bayes’ favorable factor (5.40), and complete granulation in 76% of ulcers in 5 weeks (Adv. Pharmacoepidem. 2013, 2 (2): 1000128; BMC Pharm. & Toxicol, 2013, 14: 44). The International Working Group of Diabetic Foot (IWGDF) evaluated results of the clinical trial performed with Heberprot-P® in Cuba and reported in 2009 as promising, highlighting the results obtained in only 2 weeks of treatment (Diabetes Metab Res Rev 2012; 28 (Suppl 1): 119-141).

In a later systematic review, clinical trials comparing the use of growth factors with GWC (Cochrane Database of Systematic Reviews 2015, Issue 10, Art. No. CD008548), the IWGDF’s evaluation was reported on all major issues and requirements of Heberprot-P® clinical trials in Cuba. Similar criteria were expressed by the IWGDF in the guidelines on DFU healing (IWGDF Guidance, 2015: 10). A fourth study reported similar observations on the intralesional EGF infiltration method: “… a highly significant difference between groups in the prevalence of granulation tissue after just 2 weeks” (Diabetes Metab Res Rev 2016; 32 (Suppl 1): 154- 168).

Results of clinical studies performed in Cuba, Russia, Turkey, Vietnam, Argentina, Mexico, and Ukraine were enough to demonstrate safety and efficacy profile of Heberprot-P®. This medicine has been used in more than 290 000 patients with diabetic foot ulcer (DFU) in Russia, Belarus, Georgia, Ukraine, Turkey, Algeria, China, Panama, Argentina, Cuba, Dominican Republic, Venezuela, Ecuador, Libya, Uruguay, Paraguay, Colombia, Guatemala, Philippines, Vietnam, Nicaragua, Saudi Arabia, Indonesia, Seychelles, Saint Lucia, Saint Vicente, Sri Lanka, Jordan, and Kuwait.

A national survey of health and nutrition in Mexico reported that prevalence of diabetes is 9.4% of total population, which sums up more than 11 million people, 9.1% of adult diabetic suffers DFU, and amputation is indicated to 5.5% of adult diabetics (National Survey of Health and Nutrition, INEGI 2016). According to recent reports, lower limb amputation is the unique alternative for 45% of diabetics with advanced DFU in Mexico (Diabet. Foot. Ankle. 2017 Sep 6, 8 (1): 1367210). In a previous study, similar results were reported: 42% patients with advanced DFU required major amputation (Wound Repair & Regen. 24 (5): 923-927).
Written by Jose A. Buxado, MSc., Assistant Researcher, CIGB.

The Center for Genetic Engineering and Biotechnology of Havana is an institution devoted to research, development, manufacturing, and commercialization of products and technology derived from life science.

Alyane Vazquez González, BA., Communication & Media, e-mail: alyane.vazquez@cigb.edu.cu
. Ave 31 e/ 158 y 190, Playa, P.O. Box 6162, Habana 10600, Cuba.

This release was published on openPR.

High-above-knee open amputation due to necrotising fasciitis

Necrotising fasciitis is a rare but serious bacterial infection of the soft tissues. It usually affects immunocompromised individuals, and people with diabetes are at particular risk. The lesion often starts as a minor wound and rapidly progresses, becoming life-threatening if not recognised early and treated aggressively. The authors present a severe case of necrotising fasciitis of the right lower limb that led to a high-above-knee amputation with faecal diversion to prevent wound contamination. Split skin grafting was used to close the wound once it had granulated. Faecal diversion can be important in cases where there is inadequate skin cover close to the torso, as stumps can be contaminated with faecal organisms, resulting in sepsis and possibly death.

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History of Foot Ulcer & Risk for Limb Amputation or Death

Since care for diabetic foot ulcers is delivered by a wide range of healthcare professionals, from nurses working in primary care to specialized diabetes foot clinics, collecting population-based data on diabetic foot ulceration is notoriously difficult. Furthermore, epidemiological data on populations with diabetic foot ulceration collected from selected subpopulations is open to bias, hence the importance of unselected population-based data … To address this issue, my colleagues and I conducted a national, population-based, cohort study of people with diabetes, with the aim of describing the incidence of foot ulceration and amputation-free survival associated with foot ulceration status … read more

BIDE-NADEP-PWGDF collaborates with Ferozsons Laboratories to end avoidable foot amputations

The Country wide health initiative “Fast Track Pathway” was launched at a simple but dignified ceremony held at a local Hotel in Lahore on Dec 20, 2021 … An MOU signing ceremony was held between BIDE and Ferozsons Laboratories Limited for the implementation of this project … Addressing the ceremony, the Project Director, Dr ZahidMiyan, from Baqai Institute of Diabetology and Endocrinology, told that; Foot involvement is one of the major and devastating complications of diabetes. It is estimated that approximately 3,000,000 people with diabetes in Pakistan have foot ulcers while approximately 300,000 people loose their limbs to diabetes, every year, he told further … The huge burden of diabetic foot and the high frequency of avoidable amputations strongly necessitate consolidated and unified efforts. Dr Zahid highly appreciated the leading role of Prof Abdul Basit, the Director of BIDE, who always emphasized on nationwide improvement in diabetic foot care. In that context the “Fast Track pathway” has been launched in Pakistan, Dr Zahid declared … read more

Diabetes-Related Amputations Kept at Bay During Pandemic in Canada

Shift to virtual care and prioritization of certain procedures key, researchers say
Despite delays in screening and care during the COVID-19 pandemic, there wasn’t a spike in diabetes-related foot amputations, a Canadian study found … In an analysis of nearly 1.5 million adults with diabetes living in Ontario, rates for nearly all diabetes-related services took quite a nosedive in 2020, noted Charles de Mestral, MDCM, PhD, of St. Michael’s Hospital in Toronto, and colleagues … For starters, comprehensive in-person diabetes care assessment immediately dropped down from March to May, averaging only 28% of the 2019 level, they reported in JAMA Network Open … read more

Case Study – Diabetic Foot Abscess and Sepsis: Amputation or Limb Salvage?

A 48-year-old Type II insulin dependent diabetic male presented in the acute care setting with sepsis due to an abscess of the right foot involving bone and deep soft tissue structures of the midfoot. The wound and associated sepsis made limb loss and/or mortality a pressing concern. Options were primary limb amputation versus an attempt at limb salvage … In addition to his diabetes, past medical history included chronic kidney disease stage 3, sleep apnea with continuous positive airway pressure dependence, peripheral neuropathy, hyperlipidemia, hypertension, hypothyroid, morbid obesity, Moya disease, and secondary renal hyperparathyroidism … read more

Case Study – Diabetic Foot Abscess and Sepsis: Amputation or Limb Salvage?

A 48-year-old Type II insulin dependent diabetic male presented in the acute care setting with sepsis due to an abscess of the right foot involving bone and deep soft tissue structures of the midfoot. The wound and associated sepsis made limb loss and/or mortality a pressing concern. Options were primary limb amputation versus an attempt at limb salvage … read more

Diabetic Neuropathy, Avoiding Amputation, and Foodie – Blog

Dr. Tea Nguyen podiatrist specializes in diabetic wound care, why educates against the webMD diagnosis, her honest and forward speech to patients, fat relocation advances for surgical outcomes, and shares her martial and daily staff tips and foodie.

Dr. Tea Nguyen is Fellowship trained in wound care particularly with diabetics.

Big reason why diabetics have the wounds that can require amputation is because of peripheral neuropathy and losing the pain sensitivity. One of the problem is a patient doesn’t know a cut may have happened and can’t see it because of back pain or poor vision and therefore they get systemic symptoms or a bad smell before they know something is wrong … listen more

People with diabetic foot disease fear amputation more than death

Dane K. Wukich, MD, Katherine M. Raspovic, DPM, Natalie C. Suder, MPHF
The aim of this study was to identify the most-feared complications of diabetes mellitus (DM), comparing those with diabetic foot pathology with those without diabetic foot pathology. Methods. We determined the frequency of patients ranking major lower-extremity amputation (LEA) as their greatest fear in comparison to blindness, death, diabetic foot infection (DFI), or end-stage renal disease (ESRD) requiring dialysis. We further categorized the study group patients (N = 207) by their pathology such as diabetic foot ulcer (DFU), Charcot neuroarthropathy, foot infection, or acute neuropathic fractures and dislocations. The control group (N = 254) was comprised of patients with diabetes who presented with common non–diabetes-related foot pathology. Results. A total of 461 patients were enrolled in this study and included 254 patients without diabetic foot complications and 207 patients with diabetic foot problems. When comparing patients with and without diabetic disease, no significant differences were observed with regard to their fear of blindness, DFI, or ESRD requiring dialysis … read more

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Factors influencing lower extremity amputation outcomes in people with active foot ulceration

Factors influencing lower extremity amputation outcomes in people with active foot ulceration in regional Australia: a retrospective cohort study (video) … watch

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Placental and Umbilical Tissue Applied to an Amputation Site

by Charles B Parks, DPM, FACFAS

In this video, Charles B Parks, DPM, FACFAS, University of California San Francisco, showcases the use of placental and umbilical tissue in a case presentation on the application of STRAVIX TISSUE and GRAFIX PRIME Cryopreserve Placental Membrane on an amputation site.

This presentation is part of an 8-part case series on “Advancing the Standard of Care With Cellular- and Tissue-Based Products.”

View additional cases in the series here.

… view video

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Paths to Practice Perfection Case Study – Diabetic Foot Abscess and Sepsis: Amputation or Limb Salvage?

from Brent Bernstein, DPM
A 48-year-old Type II insulin dependent diabetic male presented in the acute care setting with sepsis due to an abscess of the right foot involving bone and deep soft tissue structures of the midfoot. The wound and associated sepsis made limb loss and/or mortality a pressing concern. Options were primary limb amputation versus an attempt at limb salvage … In addition to his diabetes, past medical history included chronic kidney disease stage 3, sleep apnea with continuous positive airway pressure dependence, peripheral neuropathy, hyperlipidemia, hypertension, hypothyroid, morbid obesity, Moya disease, and secondary renal hyperparathyroidism … read more

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Podimetrics Secures $45 Million Series C To Help At-Risk Providers and Health Plans Prevent

Diabetic Amputations in High-Risk Patients

Every 4 minutes in the U.S., a patient loses a limb due to diabetes complications
Black Americans face diabetes-related amputations 3x as often as white Americans
Podimetrics strives to reduce disparities in diabetes care and unnecessary limb loss
SOMERVILLE, Mass., March 24, 2022 — Podimetrics, creator of the FDA-cleared SmartMat™ and integrated clinical care services that can help save the limbs and lives of complex patients with diabetes, today announced a $45 million Series C round led by D1 Capital Partners, along with two new investors, the Medtech Convergence Fund and an undisclosed strategic investor. Existing investors, Polaris Partners and Scientific Health Development, also participated in the financing. Prior to their Series C, Podimetrics had raised $28.3 million in funding to fuel development and distribution of their SmartMat.

With this latest round of funding, Podimetrics plans to focus on hiring to build out their product development and research teams, while also expanding the breadth of services delivered by their nurse support team. This new funding will help even more at-risk providers and health plans drive broader adoption of Podimetrics’ SmartMat so they can improve care outcomes for at-risk patients dealing with diabetic foot ulcers (DFUs) that often lead to amputations.

Podimetrics, founded in 2011, developed the SmartMat — the only easy-to-use, at-home mat that a patient steps on for 20 seconds per day. The mat detects temperature changes in the foot, which are associated with early signs of inflammation, often a precursor to DFUs. The FDA-cleared and HIPAA-compliant SmartMat is remotely monitored by Podimetrics’ in-house nurse support team. If the data from the mat are indicative of potential health issues, Podimetrics’ nursing team connects with the patient and the patients’ provider in as close to real time as possible. The SmartMat, which also has the Seal of Approval from the American Podiatric Medical Association, has already been used by thousands of patients through partnerships with leading risk-based healthcare providers and regional and national health plans, such as the Veterans Health Administration.

“The patients we serve at Podimetrics are extremely complex and have been largely ignored by our healthcare system,” said Jon Bloom, MD, CEO and Co-founder of Podimetrics. “With our SmartMat and this latest funding, we have the chance to put an end to ‘Civil War’–era amputations with early, home-based detection. We also have the opportunity to improve the overall health and well-being for patients dealing with diabetes because of the close relationship we’ve built through our trusted technology and clinical services.”

In a previous multi-center trial, diabetic foot complications were shown to be detected up to five weeks before they presented clinically. Even after one full year, about 70% of patients continued to use the SmartMat regularly. Early detection and related preventive care actions often result in significant cost-savings, too, anywhere from $8,000–$13,000 in savings per member per year (savings estimates based on customer research and analysis). In addition, considering Black Americans and Hispanics are two to three times more likely to require a diabetic amputation than others, Podimetrics’ SmartMat holds the power to help support health equity advancements over time.

Recent peer-reviewed research has also suggested the following benefits among patients using the SmartMat at home: 71% elimination of amputations; 52% reduction in all-cause hospitalizations; 40% reduction in emergency department visits; and a 26% reduction in outpatient visits.

Building on these notable data-driven findings, most recently Podimetrics published peer-reviewed research in Diabetes Research and Clinical Practice, the journal of the International Diabetes Federation. This research found that during episodes-of-care for DFUs, patients are 50% more likely to die and nearly three times more likely to be hospitalized. What this research shows is that patients with a DFU tend to have multiple other chronic health conditions, putting them at higher risk for hospitalization and even death. In addition, these medically complex patients are often among the costliest patients within a healthcare system. As a result of this research, diabetic foot complications can and should be viewed as indicators of other costly chronic conditions not commonly associated with DFUs.

In addition to this research, which was published in January 2022, Podimetrics has already gotten off to a strong start in 2022. The company doubled its revenue for the third year in a row, and also doubled the size of its team.

“We are proud to partner with Podimetrics and to support its efforts to save lives and limbs,” said James Rogers, Investment Partner with D1 Capital Partners. “Our growth capital will expand commercialization of the SmartMat which we believe has demonstrated the ability to reduce unnecessary healthcare costs through preventive, risk-based strategies that prioritize high-quality outcomes for vulnerable patients. We believe that Podimetrics is building a strong team and are honored to support its worthy mission.”

For more information on Podimetrics and how its FDA-cleared SmartMat and clinical care services can help prevent diabetic foot ulcers and improve patient outcomes, please visit Podimetrics.com.

About Podimetrics

Podimetrics is the creator of the FDA-cleared SmartMat™ and integrated clinical care services that can help save the limbs and lives of complex diabetic patients. Through partnerships with health plans and at-risk providers, such as the Veterans Health Administration and Independence Blue Cross, Podimetrics has helped prevent amputations associated with complex diabetes. By combining cutting-edge technology with best-in-class clinical care services, Podimetrics earns high engagement rates from patients and allows clinicians to save limbs, lives, and money — all while keeping vulnerable populations healthy in their own homes. For more information, visit podimetrics.com or follow us on LinkedIn and Twitter.

About D1 Capital Partners

D1 Capital Partners is a global investment firm that operates across public and private markets. The firm combines the talent and operational excellence of a large, premier asset management firm with the flexible mandate and long-term time horizon of a family office. Founded in 2018 by Dan Sundheim, D1 focuses on investing in the global internet, technology, telecom, media, consumer, healthcare, financial, industrial and real estate sectors.

Diabetic Foot Ulcers- not amputations- are driving hospitalizations, worldwide

Aims The aim of our study was to estimate the overall rate of first hospitalizations for diabetic foot (DF) regardless of the out- come in amputations, as well as the mortality rate with their determinants in the period 2012–2016 in Piedmont Region in Italy. Methods The study included all the subjects registered in the Regional Diabetes Registry and alive as at January 1, 2012. DF cases were identified by record linkage with the regional hospital discharge database. Incident cases of diabetic foot were followed up for mortality … read more

Study shows amputation, hospitalization rates fell among minorities following Medicaid expansion

Rates of hospitalization and major amputations among racial and ethnic minority adults with diabetic foot ulcers decreased in states that adopted Medicaid expansion under the Affordable Care Act (ACA), according to researchers at the University of Arizona Health Sciences … Diabetic foot ulceration and amputation have serious health and financial implications, and the disproportionate rate at which it occurs among patients in lower socioeconomic groups is a largely recognized issue within the fields of medicine and vascular surgery … read more

Prosthetic Management of the Partial Foot Amputation

Widely published data show that prosthetic outcomes for PFAs have not been satisfactory, either from a medical outcome or from a patient satisfaction point of view.
In June 2021 a post from an O&P practitioner was listed on the O&P list serve1 asking for recommendations on managing a Chopart amputation. There were an incredible array of answers including:

(Go to) BKA—don’t even waste your time

Gauntlet style AFO

… abbreviated CROW walker

Custom molded total contact partial foot orthotic / depth inlay shoe with rocker soles

Matching shoe for the other side with lift

Gauntlet style AFO with toe filler, made into a walking boot

SACH heel and rocker bottom on shoe—soft custom-made silicone foot bed

… read more

Amputation risk up for Black, rural residents with diabetic foot ulcers

Rural patients identifying as Black have more than a 10 percent absolute increased risk for major leg amputation or death compared with the overall cohort of adult Medicare patients hospitalized with a diabetic foot ulcer, according to a study published online April 21 in JAMA Network Open … Meghan B. Brennan, M.D., from the University of Wisconsin in Madison, and colleagues examined the associations of race, ethnicity, rurality, and/or neighborhood disadvantage with outcomes among U.S. patients with diabetic foot ulcers. The analysis included 124,487 patients hospitalized with diabetic foot ulcers (2013 to 2014) identified through the U.S. National Medicare Claims Data Database … read more

Researchers report higher three-year amputation and reintervention rates in Black and Hispanic CLTI patients

In a study of over 7,000 chronic limb-threatening ischaemia (CLTI) patients, researchers found that Black and Hispanic patients had higher three-year amputation and reintervention rates; survival, however, was higher among Black patients and similar between Hispanic and White patients. Aderike Anjorin (Duke University Medical Center, Durham, USA) delivered these findings at this year’s Society for Vascular Surgery (SVS) Vascular Annual Meeting (VAM 2022; 15–18 June, Boston, USA) … Framing the research, Anjorin stated that Black and Hispanic patients have higher rates of CLTI and suffer worse outcomes after lower extremity bypass compared with White patients. The underlying reasons for these disparities are unclear, she said, specifying that data on long-term outcomes are limited. In order to address this gap in the literature, Anjorin and colleagues examined differences in three-year outcomes after open infrainguinal … read more

The Wound Company Launches With $4.25M In Funding To Curb the Amputation Epidemic And Save The Healthcare System Billions

Led by Susa Ventures and Sozo Ventures, the funding will be used to transform the $45B wound and ostomy care industry by bringing on-demand experts to more patients and providers in need via telehealth and in-person visits

Minneapolis, MN – WEBWIRE – Thursday, June 15, 2023

The Wound Company, a multi-channel on-demand wound and ostomy care delivery company that improves patient outcomes, today announced its launch from stealth with $4.25M in seed funding from Susa Ventures and Sozo Ventures. The funding will be used to expand the company’s national footprint, hire top talent, and to continue improving health outcomes in the most cost-effective way possible while bringing dignity to the over 13 million people in need of improved wound and ostomy care.

Why Wound Care Matters

The US is experiencing an amputation epidemic due to diabetic foot ulcers and other serious wounds. Despite medical advancements, Americans are amputating double the number of limbs today than during the Civil War. About 50% of lower extremity amputations would have been preventable if patients with type 2 diabetes and foot ulcers had access to better healthcare. This issue is one of the problems The Wound Company is solving for.

Often providers need more wound care expertise or, due to understaffing, don’t have time to offer comprehensive care continuously, leaving patients to figure it out on their own. This leads to wound care patients returning to the hospital due to improper wound care. But it can be prevented.

“The wound and ostomy care industry is broken,” said Nima Ahmadi, founder and CEO of The Wound Company. “It’s operating in the fee-for-service world, which pushes expensive procedures and products that help the bottom line, but don’t impact outcomes for the patient. We’re paid to heal wounds with continuous care and, in doing so, save money for health plans and at-risk providers.”

Enter The Wound Company

The Wound Company aims to fix the broken space of wound and ostomy care by using predictive analytics and multi-channel communications to deliver the right wound and ostomy care to the right patient in the right channel at the right time. The tech connects patients and providers to wound and ostomy experts virtually or via in-person visits to ensure they have top-tier care.

“The Wound Company’s innovative technologies have the potential to save health plans billions of dollars and transform the patient experience,” says Susa Ventures Investor Derick En’Wezoh. “With a dedicated team of highly experienced experts, a strong vision, and a passion for improving healthcare outcomes, this tech will save lives.”

The platform also offers clinical reporting, customer data integration, and workflow automation to make care delivery as painless as possible for providers.

While in stealth, The Wound Company has already partnered with health plans, health systems, home care providers, hospice providers, and patients, with significant results to date:

A potential 15-20% reduction in the total cost of care for wound and ostomy patients for payers

Up to 50% savings on supplies per patient for home and hospice care providers

60% of patients demonstrated progressive healing week after week

90% of Stage I/II pressure ulcers resolved without advancing to a higher stage

100% of ostomy patients have a predictable pouching system and reduced chance of ER visits or readmissions

“Our blend of virtual and in-person services provided by passionate experts in wound care helps people heal quickly, safely, and with the dignity they deserve while helping to alleviate the pressure on overworked healthcare professionals,” said Chief Medical Officer Sanford Roberts.

The Wound Company is open to partnerships with health plans, at-risk providers, home health providers, and hospice care providers. For more information, visit www.thewound.co.

About The Wound Company

The Wound Company is a Minneapolis-based technology company dedicated to advancing wound and ostomy care. The company uses proprietary technology to connect providers with experienced and certified wound care specialists who can care for patients virtually or via in-person visits. The Wound Company partners with health plans, home care companies, and providers to bring dignity to patients with wounds and ostomies while increasing positive patient outcomes.

This article was originally published here

Age Characteristics of Patients With Type 2 Diabetic Foot Ulcers

Age Characteristics of Patients With Type 2 Diabetic Foot Ulcers and Predictive Risk Factors for Lower Limb Amputation: A Population-Based Retrospective Study

A population-based retrospective study published in the Journal of Diabetes Research analyzed data from 918 patients with type 2 diabetic foot ulcers (DFUs) treated between 2017 and 2023 at The First Affiliated Hospital of Wannan Medical College in Wuhu, China. The study aimed to investigate age-related characteristics and identify key risk factors associated with lower limb amputation in this patient population.

The findings revealed that the majority of DFU patients were aged between 50 and 59 years, with a notable peak in mortality observed among those aged 70 to 79. Logistic regression analysis identified several significant predictors for lower extremity amputation, including a history of prior amputation, presence of vascular complications, infection sites, and hemoglobin levels. Specifically, a history of amputation and low hemoglobin were strongly associated with major amputations.

These insights underscore the importance of early identification and management of risk factors to prevent severe outcomes in patients with DFUs, particularly in middle-aged and older populations.

Read the full article on the Journal of Diabetes Research website.

Keywords:
Type 2 diabetes,
Diabetic foot ulcers,
Lower limb amputation,
Risk factors,
Yuanying Yao,
Lei Chen,
Yu Qian

Unsalvageable: Preventable Amputations Rise During COVID

Leafer Miller didn’t hear much after the doctor told him they had to “sacrifice the leg.”

Lying on the emergency room gurney, the self-proclaimed video game nerd and former athlete struggled to comprehend life without the leg that had propelled him on the track and to the turf for tackles on the soccer field.

“It was always in the back of my mind as a worst-case scenario,” the 35-year-old Fresno, CA, native says. “But I wasn’t expecting that to be the case.”

The amputation was the result of a recurring American narrative: A diabetes diagnosis in his early 20s; a sequence of layoffs and hirings that left his insurance status in flux; missed primary care visits when providers went out of network; and skipped insulin doses due to unaffordable price tags.

“Sometimes, it would come down to insulin or rent,” Miller says, “I felt like my hands were tied.” … read more

Study finds sharp fall in amputations among people with type 1 diabetes

Amputation in type 1 diabetes is becoming relatively less common in Sweden. The rate has fallen by just over 40 percent over an approximately 20-year period, a University of Gothenburg study shows.

The results, published in the journal Diabetologia, are based on registry data on 46,088 people with type 1 diabetes in the years 1998–2019. The study involved linking data from the Swedish National Diabetes Register, the National Patient Register, and a couple of other Swedish national registers … read more

Biosensors embedded in bandages could monitor diabetic foot wounds to prevent amputations

It was sparked by a chance conversation. Simon Palfreyman and Manisha Gupta got to talking about their research after a meeting. He’s an expert in wound care and she’s a leader in making biosensors that can be attached to the skin to monitor things like temperature or the presence of germs … Palfreyman, an assistant professor in the Faculty of Nursing, expressed frustration that despite the best efforts of health-care teams, more than a thousand Albertans a year lose their lower limbs to amputation due to complications from diabetic foot ulcers … read more

Patient perspectives on the physical, psycho-social, and financial impacts of diabetic foot ulceration and amputation

AIMS: Diabetic foot ulcers (DFUs) and ulceration are complex and lifelong problems for patients with diabetes which dramatically increase mortality rates. This qualitative study sought to capture detailed personal accounts and insights from patients with a clinical history of DFUs and amputations to better understand patient experiences … read more

Advanced Wound Care Technologies to Manage Wound Infections

BOSTON, Sept. 26, 2018 /PRNewswire/ — Recently, research undertaken by the UK’s House of Commons library at the request of the UK’s Labour Party revealed that diabetic foot and toe amputations performed by the UK’s National Health Service (NHS) has risen by 26 percent. Between April 2010 and March 2013, minor amputations due to diabetes numbered 15,075. This has risen to 19,073 in the same 3-year period of 2014 – 2017. Though the Department of Health and Social Care acknowledge that the rate of minor amputations has increased, it is also important to note that they state that the number of major amputations (above the ankle) has decreased. Regardless, diabetic foot amputations are estimated to cost the NHS over £44 million just in the year 2016.

Patients typically arrive at the point of requiring a lower limb amputation due to tissue necrosis resulting from an infected diabetic foot ulcer (DFU). DFUs are hard to heal wounds that remain open for extended time. Thus, extra care is required in keeping the wound clean and in preventing infection. DFUs are formed in the first place due to ischemia and neuropathy, two side effects of poor blood glucose management.

Clearly, the best intervention is to prevent the formation of DFUs in the first place. This may begin in good management of blood glucose to prevent ischemia and neuropathy, though sensor technologies can also be used for the express purpose of preventing DFUs. Once the wound is formed, preventing and treating any wound infection is critical. However, there are many factors that healthcare providers have to contend with during the treatment of DFUs … read more

Toward Eliminating Diabetic Foot Amputation In The Next Generation

David G. Armstrong, professor of surgery at the Keck School of Medicine of USC

Humanity crossed a line in 2009: For the first time in history, more people in the last decade died from non-communicable disease than from all the plagues in the world combined. We’ve entered what science pundit Steve Jones has, in a rather macabre but perceptive manner, dubbed the Age of Decay.

First was the Age of Disaster — 95 percent of human history — when people died from starvation, accidents, violence and cold temperatures. Around 12,000 years ago, we learned to “circle the wagons,” if you will, as a species. As we became agrarian, we moved closer together to store food. A natural byproduct of this was the Age of Disease, when plagues decimated populations. We’re now in the Age of Decay, when the big killers are non-communicable diseases — cancer, cardiovascular disease and diabetes. Pulmonary disease is fourth.

The longer that I have labored in my line of work, the more I realize it is the height of hubris as a clinician to think that I can “fix” anyone. Rather, I think the best thing I can do is help folks move through the world a little bit better. Our goal in this age as clinicians, scientists, policymakers, is to think not about fixing everything but rather to delay decay.

We all rightly take cancer and heart attacks seriously. Diabetes, however, has not risen to that level. If one were an evil deity and wanted to sock it to humanity, one wouldn’t pick something like cancer or a heart attack. Those are often far too dramatic. One would rather choose diabetes: It is silent, sinister and it happens in the background. No one sees it coming. How, then, does diabetes cause amputations?

read more

A Journey of a Thousand Steps to #ActAgainstAmputation

Diabetes is the sixth leading cause of death in North America. By 2020, an estimated 4.2 million Canadians will be living with the disease and its devastating complications. People with diabetes have an increased risk of developing diabetic foot ulcers (DFUs) as a result of the loss of protective sensation in their extremities. Twenty five percent of individuals with diabetes will have a DFU in their lifetime, increasing their risk of amputation and pushing their five-year mortality rate to surpass that of patients with Hodgkin’s disease, breast cancer or prostate cancer.1,2,3 The direct cost of diabetes in Canada now accounts for about 3.5% of public health-care spending, and this figure continues to rise.4 The cost of DFUs is an enormous strain on health-care systems: about $12.2 billion in 2010. Care for people living with diabetic foot ulcers needs to be holistic and requires addressing all factors that contribute to ulceration, including repeated trauma and pressure. For years, the Canadian wound-care community recognized and understood the importance and value of pressure … read more (pdf)

Foot Health Awareness: Hyperbaric Oxygen Therapy’s Critical Role In Limb Preservation

CūtisCare Shares How HBOT is Impacting Limb Preservation

BOCA RATON, Fla., April 5, 2022 /PRNewswire/ — CūtisCare USA, a leading provider of wound care management services to hospitals and physicians, is raising awareness through its Hyperbaric Aware initiative of the successes we have seen with limb preservation when hyperbaric oxygen therapy, HBOT, is a part of a treatment plan. Diabetes is a complex disease to treat and manage. However, we are starting to see amputation rates decline when HBOT is incorporated into the treatment plan for those with chronic wounds. Research shows that the vast majority of non-traumatic amputations to the lower extremity are preventable, making the need for diversification in treatment plans stronger than ever before.

When administered correctly, pressurized oxygen helps speed cell repair and form new blood vessels from just one treatment. Repeated exposure gives a lifeline to ischemic tissue and promotes the healing process of chronic wounds, specifically those suffering from diabetic foot ulcers.

There are approximately 200 non-traumatic lower-limb amputations performed each day in the United States associated with diabetes. These patients often experience restrictions to the supply of blood needed to support healthy tissue due to restricted circulation. As a result, amputation was far too often the only option for seriously infected wounds that were unresponsive to treatment.

Experts in the field are incorporating hyperbarics as an adjunct therapy. Dr. Louis Pilati, MD, Kettering Medical Center Network and CutisCare Medical Advisor Board physician, recommends the use of HBOT for patients suffering from diabetic foot wounds and has become an advocate for HBOT after seeing the results firsthand. “Use of hyperbaric oxygen in treating these patients has been shown to reduce the risk of major amputation. These patients are complicated and require a team approach. This should include vascular surgery, foot and ankle surgeons, and infectious disease specialists along with the wound care and hyperbaric medicine team.”

There is hope for this vulnerable patient population. Healthcare systems that have established dedicated healthcare clinics that are using HBOT are showing significant reductions in amputation rates. CūtisCare offers hospitals customized management solutions to begin providing next-level care for their patients. Committed to the growth and success of each hospital or physician practice. Visit cutiscare.com to access more information regarding the benefits of hyperbaric oxygen therapy, or even to find a CutisCare Wound Care Center of Excellence.

About CūtisCare

Headquartered in Boca Raton, Florida, CūtisCare works with hospitals, academic medical centers, hospital systems, and physicians to design customized outpatient and office-based wound care and hyperbaric oxygen (HBOT) solutions. With more than 25 years of management experience, a commitment to research, and driven by ethics and a culture of compliance, CūtisCare collaborates with its partners to reach and heal people with chronic wounds.

For more information, visit https://cutiscareusa.com or CutisCare LLC | LinkedIn.

Media Contact: Kelly Caceres, (904) 446-0708, kcaceres@cutiscareusa.com

CARE Hospitals Launches Month-Long Diabetes Awareness Initiative

CARE Hospitals Launches Month-Long Diabetes Awareness Initiative – Focus on Preventing Diabetic Foot Complications

Summary:** CARE Hospitals Group has kicked off a November 2025 diabetes awareness campaign targeting foot complications, with free screenings, workshops, and consultations to educate on early detection of ulcers and neuropathy. Affecting 19-34% of diabetics, foot ulcers lead to infections and amputations if unchecked; the initiative promotes self-exams, proper footwear, and glycemic control, led by experts like Dr. P.C. Gupta. Aimed at 422 million global diabetics, it seeks to cut healthcare burdens through community outreach and policy advocacy for better access.

Key Highlights:

Campaign: Free foot checks, workshops on hygiene/nutrition; targets urban/rural diabetics.

Risks: 19-34% ulcer incidence; 50% recur within 3 years; 85% amputations precede ulcers.

Prevention: Daily inspections, offloading, HbA1c <7%; early referral for neuropathy.

Expert: Dr. Gupta: “Awareness saves limbs”; 422M global diabetics, 77M in India.

Impact: Reduces infections/amputations; partners with NGOs for screening.

Read full article

Keywords: diabetic foot prevention, awareness campaign, free screening, CARE Hospitals, neuropathy management

HMP Announces Multiple Endorsements for SAWC Spring

HMP, a leader in healthcare events and education, today announced that its annual Symposium on Advanced Wound Care (SAWC) Spring, taking place in San Antonio, Texas, May 7-11, 2019, and serving as the annual meeting of the Wound Healing Society (WHS), has received endorsements from the following prominent organizations:

American Physical Therapy Association’s Academy of Clinical Electrophysiology and Wound Management:

“The Wound Management Special Interest Group of the American Physical Therapy Association’s Academy of Clinical Electrophysiology and Wound Management endorses the Symposium on Advanced Wound Care,” says Melissa Johnson, Chair, Wound Management Special Interest Group. “SAWC promotes interdisciplinary wound management and provides robust continuing education for physical therapists and other healthcare providers enabling optimal care for patients with wounds.”

Critical Limb Ischemia (CLI) Global Society, the only organization solely dedicated to patients and the public health aspect of CLI:

“The Critical Limb Ischemia Global Society is endorsing the Symposium on Advanced Wound Care, an important conference that brings together the latest technologies, best practices, and research in all areas of wound care,” says founding board member, Jihad A. Mustapha, MD. “In our efforts to further share information and educate practitioners, we are especially proud to take part in this year’s Spring meeting by organizing a session on CLI awareness, diagnosis, and treatment.”

National Pressure Ulcer Advisory Panel (NPUAP), the nation’s leading scientific expert group on pressure injury prevention and treatment, is endorsing and organizing three sessions at the meeting:

“The National Pressure Ulcer Advisory Panel is proud to endorse and support the Symposium on Advanced Wound Care, an important medical conference for those of us who rely on the latest technologies to remain up to date on wound care and prevention,” says Dr. Nancy Munoz, DCN, MHA, FAND, Assistant Chief, Nutrition and Food Services, Southern Nevada VA System. “As part of our support and engagement, we are delighted to present three sessions during this conference, sharing expertise and best practices in areas of pressure injury prevention and treatment.”

American Venous Forum (AVF), which fosters cutting-edge research and clinical innovation and educates healthcare professionals, patients, and policy makers about venous and lymphatic diseases, is endorsing SAWC Spring and coordinating a session at the meeting:

“The American Venous Forum proudly supports the Symposium on Advanced Wound Care and its role in furthering education, particularly in the areas of venous and lymphatic disease,” says William Marston, MD, Professor of Surgery University of North Carolina; and Secretary of the Board of Directors of the American Venous Forum. “The cutting-edge topics and emerging therapies presented at this meeting are important as we all continue to strive for improvements in the prevention and treatment of patients with chronic nonhealing wounds.” … read more

Bravida Medical Unveils Silverlon® NPD-212

Bravida Medical Unveils Silverlon® NPD-212, Advancing Antimicrobial Protection in Incisional NPWT

Full Press Release:

NPD-212

GENEVA, IL, UNITED STATES, October 21, 2025 /EINPresswire.com/ — Bravida Medical, a leader in infection prevention and advanced wound care solutions, announced the launch of Silverlon® Antimicrobial Silver-Plated Dressing NPD-212, the first and only silver-plated contact layer specifically designed for use with incisional negative pressure wound therapy (NPWT) systems. The company will showcase the new technology this week at the American Association of Hip and Knee Surgeons (AAHKS) Annual Meeting.

Silverlon Antimicrobial Silver-Plated Dressing technology seamless compatibility for incisional wound vacuum-assisted closure applications. The dressing is available as a 1.5” x 12” cut-to-fit strip, allowing surgeons to customize length for a wide range of incisions without disrupting negative pressure therapy.

The introduction of Silverlon’s NPD-212 reflects Bravida Medical’s commitment to advancing infection-prevention tools for high-risk surgical patients, particularly those with co-morbidities, diabetes, obesity, or poor perfusion – where post-operative complications and bioburden remain a concern despite the use of NPWT.

Silverlon® NPD-212 features pure metallic silver plated to a flexible, open-weave fabric. When activated, silver ions are released in the dressing, providing continuous antimicrobial protection for up to seven days while maintaining compatibility with wound vacuum-assisted closure pressure gradients.

Key benefits include:

The only silver-plated contact layer engineered for incisional vacuum-assisted closure therapy

Broad-spectrum antimicrobial protection, including MRSA and VRE

Maintains moist wound healing and supports bioburden reduction

Does not interfere with negative pressure function or pressure gradients

Conformable, non-adherent, and easy to apply and remove

1.5″ x 12″ cut-to-fit design for various incision lengths

“Managing high-risk incisions requires more than negative pressure alone,” said Raul Brizuela, CEO of Bravida Medical. “Our Silverlon incisional wound vacuum dressing gives surgeons an antimicrobial contact layer purpose-built for incisional vacuum-assisted closure environments. We are proud to introduce it at AAHKS and expand the solutions available to orthopedic and reconstructive surgeons looking to protect complex surgical sites.”

Silverlon® technology has been trusted by leading surgeons, trauma programs, and military medical teams for more than two decades. From battlefield care to complex civilian surgery, Silverlon dressings are widely recognized for their durability, conformability, and antimicrobial performance in demanding wound-care settings.

With the launch of NPD-212, Bravida Medical continues to strengthen its portfolio of advanced solutions that support improved incision management and infection-prevention strategies.

About Bravida Medical

Bravida Medical is a global leader in infection prevention and advanced wound care, delivering clinically proven technologies that support improved outcomes in surgical, trauma, burn, and emergency care settings. The company’s flagship Silverlon® antimicrobial dressings feature a permanently plated metallic surface that provides the antimicrobial benefits of silver. Silverlon has received numerous FDA clearances, including an FDA Breakthrough Device Designation for the management of radiation dermatitis and acute cutaneous radiation injury, further validating its clinical impact and innovation.

Originally developed for the U.S. military, and still extensively used for managing burn and blast injuries in combat environments, Silverlon dressings are now trusted worldwide by surgeons and healthcare professionals for surgical incisions, negative pressure wound therapy, chronic wounds, burns, skin grafts, and IV or catheter-related wounds. For more information, visit www.bravidamedical.com.

Aerienne Cunningham

Bravida Medical

+1 888-551-0188

email us here

Legal Disclaimer:

EIN Presswire provides this news content “as is” without warranty of any kind. We do not accept any responsibility or liability for the accuracy, content, images, videos, licenses, completeness, legality, or reliability of the information contained in this article. If you have any complaints or copyright issues related to this article, kindly contact the author above.

Key Highlights:

Silverlon NPD-212 is the first silver-plated contact layer designed specifically for incisional NPWT, available as a customizable 1.5” x 12” strip.

Provides broad-spectrum antimicrobial protection, including against MRSA and VRE, for up to seven days while maintaining moist healing.

Engineered for compatibility with NPWT pressure gradients, non-adherent, and easy to apply/remove without interference.

Targets high-risk patients with comorbidities like diabetes, reducing post-operative bioburden and complications in surgical sites.

Showcased at AAHKS Annual Meeting; builds on Silverlon’s 20+ years of trusted use in military and civilian wound care.

Read full article

Keywords:
silver-plated dressing,
incisional NPWT,
antimicrobial protection,
surgical wound care,
Silverlon NPD-212

8-10pc of Diabetic Patients Develop Foot Ulcer Complications

8-10pc of Diabetic Patients Develop Foot Ulcer Complications

Summary: January 10, 2026 post highlights diabetic foot ulcer risks: 8-10% of diabetic patients affected, leading to permanent disability if untreated. Pakistan has high diabetes burden (one in four affected, third globally). Stresses uncontrolled blood sugar as key risk; prevention via early screening, regular checks, lifestyle changes. Announces inauguration of Diabetic Foot Clinic at Dow University of Health Sciences (DUHS) for specialized care, with plans for state-of-the-art upgrade—no direct AI/advanced wound ties, but supports multidisciplinary prevention focus.

Key Highlights:

Stats: 8-10% develop ulcers; high prevalence in Pakistan.

Risks: Disability, pregnancy complications in gestational diabetes.

Prevention: Early screening, blood sugar control, lifestyle.

Innovation: New DUHS Diabetic Foot Clinic for intervention.

Read post

Keywords: diabetic foot ulcer, diabetes prevalence, foot clinic, prevention

Celebrating Pressure Injury Milestones: The Eighth Annual Themed Issue

Celebrating Pressure Injury Milestones: The Eighth Annual Themed Issue

Summary: This editorial marks the eighth consecutive annual pressure injury (PI) themed issue of Advances in Skin & Wound Care, underscoring the enduring global significance of pressure injury prevention and treatment. The issue brings together research from contributors across multiple continents, reflecting the international scope of the PI challenge. A central milestone highlighted is the staged rollout of the 4th edition of the EPUAP/NPIAP/PPPIA International Pressure Injury Clinical Practice Guideline — the field’s most authoritative evidence-based resource — developed using GRADE methodology for the first time, with prevention recommendations released in early 2025 and treatment recommendations to follow. The editorial also situates this work within broader healthcare policy shifts, including forthcoming CMS regulatory changes that will exempt certain unavoidable pressure injuries from adverse event reporting beginning January 2027.

Key Highlights:

Eighth annual PI-dedicated themed issue reflecting sustained global research attention

4th edition EPUAP/NPIAP/PPPIA International PI Guideline now rolling out with GRADE methodology

Prevention recommendations live at internationalguideline.com; treatment chapter to follow

CMS regulatory change: select unavoidable PIs to be exempt from adverse reporting starting January 2027

Relevance: Comprehensive orientation to the current state of PI science, policy, and evidence-based practice

Read full editorial

Keywords: pressure injury, pressure ulcer prevention, NPIAP, clinical practice guideline, wound care policy

Preventing Hidden Bioburden in Surgical Instruments

Ultrasonic Cleaning Is Not a Machine; It Is a Quality System: Preventing Hidden Bioburden in Surgical Instruments

Summary: Published in the March 2026 issue of Infection Control Today (Vol. 30, No. 1), this article by Marjorie Wall, EDBA, CRCST, CIS, CHL, CSSBB, argues compellingly that ultrasonic cleaning in the sterile processing department (SPD) must be conceptualized and managed not as a piece of equipment but as a validated patient safety quality system — with the same rigor applied to sterilizers and washer/disinfectors. The core argument is that while ultrasonic cleaning is the most effective available tool for removing microscopic soil from complex surgical instruments — using cavitation (imploding microscopic bubbles generated by high-frequency sound waves) to dislodge debris from serrations, hinges, box locks, cannulations, and lumens that manual brushing cannot reliably address — its effectiveness is entirely dependent on whether the system is correctly managed, monitored, and maintained. The article identifies the central patient safety risk: ultrasonic cleaning can fail silently. Instruments may appear clean, packaging may be intact, and sterilization indicators may have changed — yet retained bioburden can remain trapped in lumens and complex features. This invisible failure can lead to surgical site infections, operating room tray recalls, and medico-legal exposure without any obvious proximate cause. Drawing on Anderson et al. (AORN Journal, 2023), Wall identifies three core performance components that every facility must continuously verify: (1) cavitation performance — using objective cavitation indicators to confirm adequate ultrasonic energy generation (not simply “running the cycle”); (2) soil removal effectiveness — using synthetic soil challenge tests that mimic blood and tissue to confirm cleaning under real working conditions; and (3) lumen perfusion — confirming that lumened devices are correctly connected to irrigation ports and that internal surfaces are actually being flushed, not just externally exposed to cavitation. Water quality is addressed as a frequently overlooked but critical variable: water hardness, endotoxin levels, temperature, ion content, and microbial load all affect detergent performance and cleaning efficacy, and Wall advocates for including ultrasonic washers in facility water management programs as a shared infection prevention priority. The article concludes with a seven-question IP audit framework for SPD rounds and a discussion of how strong ultrasonic programs build trust between SPD and the perioperative team.

Key Highlights:

Ultrasonic cleaning must be managed as a validated quality system — installation qualification (IQ), operational qualification (OQ), and performance qualification (PQ) testing required, mirroring sterilizer validation standards

Three verifiable performance components: (1) cavitation — use objective cavitation indicators, not visual inspection; (2) soil removal — use synthetic soil challenge tests simulating blood and tissue; (3) lumen perfusion — confirm irrigation port connection, adapter compatibility, tubing integrity, and flow adequacy

Most dangerous failure mode is the invisible one: instruments that appear clean may still harbour retained bioburden in lumens, serrations, and box locks — risking SSI, OR delays, and tray recalls without obvious proximate cause

Water quality as a shared infection-prevention priority: hard water, elevated endotoxins, and microbial contamination reduce cavitation effectiveness and detergent performance — facilities should include ultrasonic washers in water management programs, requiring collaboration across SPD, facilities management, and clinical engineering

Common operational failures: overloading tanks, instruments closed rather than open, inadequate degassing, improper detergent selection, poor solution change practices, kinked or misconnected lumen tubing, lack of preventive maintenance, inconsistent staff competency validation

Seven-question IP audit: written IFU-aligned policies; cavitation verification frequency and documentation; consistent lumen port connection; soil indicator use and trend tracking; corrective action process for failed tests; water type and quality monitoring; preventive maintenance schedule documentation

Read full article

Keywords: sterile processing wound care, surgical instrument bioburden, ultrasonic cleaning instruments, infection prevention surgical instruments, sterile processing quality system, surgical site infection prevention

Diabetic Foot Disease: Current Challenges, Emerging Concepts and Future Directions

Diabetic Foot Disease: Current Challenges, Emerging Concepts and Future Directions

Summary: This open MDPI Topic Collection highlights diabetic foot disease as a major diabetes complication, with 19–34% lifetime risk of foot ulcers and 9–26 million new cases annually worldwide. It leads to lower-limb amputations, reduced quality of life, high healthcare costs, and mortality rates comparable to many cancers. While much research focuses on acute ulcer and infection management, significant gaps remain in prevention, recurrence, long-term outcomes, multidisciplinary care models, health economics, and implementation science. The collection welcomes submissions on innovative diagnostics, prevention strategies, patient-centered care, and emerging paradigms to improve outcomes and sustainability of diabetic foot care systems.

Key Highlights:

Emphasizes prevention and long-term management beyond acute care

Calls for multidisciplinary approaches and implementation research

Addresses global burden including high amputation and recurrence rates

Open for submissions on diagnostics, economics, and novel therapies

View topic collection

Keywords: diabetic foot disease, DFU prevention, multidisciplinary foot care

Dr. Caroline Fife announces or recaps CMS field test meetings

CMS Field Test Meetings

Summary: January 26, 2026 blog by Dr. Caroline Fife announces or recaps CMS field test meetings (virtual/in-person) focused on wound care-related quality measures, performance indicators, or proposed changes to coverage/determination policies. These sessions allow clinicians, societies, and stakeholders to provide input on draft measures (e.g., healing rates, amputation prevention, documentation standards) before finalization for MIPS, QPP, or LCD updates. Emphasizes importance of participation to shape reimbursement and quality reporting that impacts wound care practices, especially for chronic ulcers, DFUs, and pressure injuries. Includes registration links, agendas, or key discussion points if available.

Key Highlights:

Purpose: Gather real-world feedback on wound care metrics.

Topics: Likely healing outcomes, advanced therapy use, prevention benchmarks.

Call to action: Attend/provide comments to influence policy.

Relevance: Directly affects coding, coverage (e.g., G2211, advanced products), and practice viability.

Read blog

Keywords: CMS field test, wound care measures, quality reporting, LCD updates

Continuous Glucose Monitoring and Diabetic Foot Ulcers

Continuous Glucose Monitoring and Diabetic Foot Ulcers: Is it Time to Walk in Range? A Brief Narrative Review

Summary: 2026 brief narrative review summarizes evidence on continuous glucose monitoring (CGM) in diabetic foot ulcer (DFU) management. Both hypo- and hyperglycemia delay healing and raise mortality; CGM outperforms self-monitoring for control. Emerging data indicate CGM-derived metrics like time in range (TIR) may promote wound healing by stabilizing glucose, reducing complications. Positions CGM as promising for DFU outcomes and amputation prevention, but notes need for well-designed trials to confirm benefits and inform clinical guidelines.

Key Highlights:

Evidence: CGM enhances control; glucose extremes impair repair.

Potential: TIR optimization for healing acceleration.

Call: Trials needed for everyday use in DFU care.

Relevance: Complements prevention (AI screening) and advanced therapies by addressing systemic glycemic factors in hard-to-heal DFUs.

Read full review (subscription may be required)

Keywords: continuous glucose monitoring, DFU management, time in range, glycemic control

1M diabetic people in Egypt at risk of amputation given hope by Sound Foot initiative

CAIRO – 4 October 2021: A total of L.E. 15 million have been allocated to support “Sound Foot” initiative to reduce the risks of diabetes, according to a Monday statement by the Ministry of Solidarity.

Some L.E.5 million of that budget will go to raising awareness on the diabetic foot and early detection. L.E. 10-15 million will go to treatment.

On Monday, Maker of Good Development, a charity organization that was established five years ago, held a conference to launch the initiative as part of the presidential initiative of Haya Karima. Minister of Solidarity Nivine el-Kabbag said in the conference that the Sound Foot initiative is a … read more

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Why Amputations Are on the Rise in Some States, Even as Diabetes Care Improves

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Advanced Wound Care Technologies to Manage Wound Infections

BOSTON, Sept. 26, 2018 /PRNewswire/ — Recently, research undertaken by the UK’s House of Commons library at the request of the UK’s Labour Party revealed that diabetic foot and toe amputations performed by the UK’s National Health Service (NHS) has risen by 26 percent. Between April 2010 and March 2013, minor amputations due to diabetes numbered 15,075. This has risen to 19,073 in the same 3-year period of 2014 – 2017. Though the Department of Health and Social Care acknowledge that the rate of minor amputations has increased, it is also important to note that they state that the number of major amputations (above the ankle) has decreased. Regardless, diabetic foot amputations are estimated to cost the NHS over £44 million just in the year 2016 … read more

Complex Wound Management: Diabetic Foot Ulcers

Background and Prevalence of Diabetic Foot Ulcers
Diabetes-related foot complications, including diabetic foot ulcers (DFUs), are leading causes of non-traumatic lower extremity amputation. Of the approximately 420 million adults in the United States with diabetes mellitus, one fourth will develop at least one DFU. DFUs are preceded by a compendium of risk factors, including the presence of neuropathy, external trauma, infection, effects of ischemia from concomitant peripheral arterial disease, malnutrition, and poor hygiene or self-care, among others. In 80% of patients, DFU is a precursor to some degree of lower extremity amputation. And, for these patients who have undergone amputation, their risk for further amputation becomes double that of a patient without diabetes. The mortality rate following a diagnosis of diabetic foot ulceration is 5% in the first year. The five-year mortality rate is 50% and rises to 70% after amputation. Once healed, 40% of DFUs will recur within 12 months, nearly 70% at three years, and nearly 75% at five years … read more

Foot ulceration associated with increased risk for amputation or death

Using the Scottish Care Information – Diabetes database, Graham Leese (Ninewells Hospital, Dundee, UK) and co-authors observed that out of 23,395 individuals with type 1 diabetes and 210,064 with type 2 diabetes included in the study, a total of 13,093 had a previous foot ulceration and among these, 34.3% developed a further foot ulcer during the follow‑up period (2012–2017). In addition, a total of 9023 people developed a first ulcer during follow-up… read more

Custom-Molded Offloading Footwear Effectively Prevents Recurrence and Amputation …

and Lowers Mortality Rates in High-Risk Diabetic Foot Patients: A Multicenter, Prospective Observational Study
Recurrence of high-risk diabetic feet, after wound, healing is a common challenge among diabetic patients. Continuous use of an offloading device significantly prevents recurrence of high-risk diabetic feet, although patient adherence is imperative to ensuring this therapy’s clinical efficacy. In this study, we explored clinical outcomes of patients with a high-risk diabetic foot who had been prescribed with custom-molded offloading footwear under different adherence conditions … read more

DME for Partial Foot Amputations

The last issue of the year for Podiatry Management is typically dedicated to diabetes. Consistent with that, this article will expand on this issue’s article on PFA (partial foot amputation) written by Jeanette Smith … Devices typically used for patients with PFA range from stuffing a block of materials (toilet tissue, paper towels, rags, etc.) into the toe box of the shoe to a sophisticated hybrid lower extremity prosthetic prescribed by a physician. This article will provide some basic information on why it is important to provide the proper device … read more

NHG programme for diabetic foot disease reduces major amputations by 40 per cent

An innocuous injury to his left little toe in late 2019 led to an infection that resulted in nine foot-related operations and five lower limb angioplasties in just over a year for Mr Toh Eng Cheng. His gangrenous toe had to be amputated, and another six later, to curb a recurrence of diabetic foot ulcers, but the 52-year-old counts himself lucky. “I could have lost the lower part of my leg or maybe the whole leg,” said the former security supervisor, who has three toes left on his right foot. “Of course, I did not like the idea of amputating my toes at first,” he told The Straits Times. “But if I didn’t accept it, then who knows, I might not be talking to you now,” he said. He added that he is glad he is still able to walk without the need for a walking frame or walking stick … read more

Obesity crisis is fuelling a rise in amputations linked to diabetes and gangrene

So many people with type 2 diabetes are losing limbs that it is now seen as normal – and we desperately need to take action

During the years I practised as a hospital doctor I saw only one amputee. He’d had his lower leg amputated for bad circulation worsened by smoking . He wouldn’t give up his Woodbines, though, not even if his other leg was in jeopardy … It’s a totally different picture today. Amputation is becoming commonplace – as a complication of diabetes. And no one seems worried … That’s because so many people are obese and it’s accepted as normal. Fat people develop Type 2 diabetes, and that, in turn, has become ‘normal’ … read more

AOTI Receives China FDA Approval for Topical Wound Oxygen (TWO2) Therapy

Providing Renewed Hope for World’s Largest Diabetic Foot Ulcer Population

OCEANSIDE, Calif., March 23, 2022 /PRNewswire/ — Advanced Oxygen Therapy Inc. (AOTI), the global leader in noninvasive topical oxygen wound healing solutions, announced today that is has received Chinese National Medical Products Administration (NMPA), commonly referred to as China FDA, approval for its unique cyclically pressurized Topical Wound Oxygen (TWO2) therapy. Making it the only advanced sustained wound healing therapeutic to have achieved such a designation and allowing the company to now commence marketing in China with its local partner.

China has the world’s largest Diabetic and resultingly Diabetic Foot Ulcer (DFU) population. The International Diabetes Federation estimates that 10.6% of the Chinese adult population now have diabetes that equates to 141 million people. This represents a 56%, or 50 million person, increase in the last 10 years alone.1 In China, the annual incidence of DFU and Amputation has recently been reported to be 8.1% and 5.1% respectively, representing a staggering 11.4 million ulcerations and 7.2 million preventable lower extremity amputations every year.2

AOTI’s globally patented TWO2 homecare therapy has been demonstrated in recently published high-quality Randomized Controlled Trial 3 and Real Word Evidence 4 studies to provide more durable complete DFU healing. Resulting in six-fold reductions in ulcer recurrence, with an unprecedented 88% reduction in hospitalizations and 71% reduction in lower extremity amputations seen over 12 months. Such sustained healing provides patients with renewed hope of limb preservation, while offering significant reductions in healthcare resource utilization with resultant health economic savings.

Professor Andrew Boulton, past-President of the European Association for the Study of Diabetes and Professor of Medicine at the University of Manchester, UK and University of Miami, USA, and Chairman of AOTI’s Scientific and Clinical Advisory Board, commented: “Diabetes is one of the fastest growing global health emergencies of the 21st century. It is a real game-changer to finally have clinically proven homecare therapeutics like TWO2 available that make meaningful impact in such critical outcomes as hospitalizations and amputations. Now that TWO2 therapy is authorized in China, the world’s largest diabetic foot ulcer population has a renewed hope for better outcomes.”

1 International Diabetes Federation. IDF Diabetes Atlas, 10th Edition. Brussels, Belgium: 2021. Available at: https://www.diabetesatlas.org

2 Development and validation of a brief diabetic foot ulceration risk checklist among diabetic patients: a multicenter longitudinal study in China. Zhou, Q., Peng, M., Zhou, L. et al. Nature, Sci Rep 8, 962 (2018). https://doi.org/10.1038/s41598-018-19268-3

3 Multinational, Multicenter, Randomized, Double-Blinded, Placebo-Controlled Trial to Evaluate the Efficacy of Cyclical Topical Wound Oxygen (TWO2) Therapy in the Treatment of Chronic Diabetic Foot Ulcers; The TWO2 Study. Robert G. Frykberg et al, Diabetics Care 2020; 43:616-624. https://doi.org/10.2337/dc19-0476.

4 Reduced Hospitalizations and Amputations in Patients with Diabetic Foot Ulcers Treated with Cyclical Pressurized Topical Wound Oxygen Therapy: Real-World Outcomes; Jessica Izhakoff Yellin, et al; Advances in Wound Care 2022; http://doi.org/10.1089/wound.2021.0118

About AOTI
AOTI is a privately-owned company based in Oceanside, California USA and Galway, Ireland that provides innovative solutions to resolve severe and chronic wounds worldwide. Our products reduce healthcare costs and improve the quality of life for patients with these debilitating conditions. Our patented non-invasive Topical Wound Oxygen (TWO2) homecare therapy is clinically proven to deliver Sustained Wound Healing that reduces both Amputations and Hospitalizations, So Life Can Get Back to Normal.

For more information see: www.aotinc.net
Dr. Mike Griffiths
CEO & President
332487@email4pr.com
(760) 672 1920
SOURCE AOTI Inc.

Tell-tale signs of diabetic foot — a common condition that’s a leading cause of amputation

The condition diabetic foot affects about half of people with
diabetes. It’s a type of peripheral neuropathy, where certain nerves in the body are damaged, triggering numbness, tingling, pain, or loss of sensation. In this case, symptoms occur in the feet leading to poor blood circulation, which causes wounds to heal slower and can trigger changes in the shape of the feet and toes. “This can be a serious condition, because peripheral neuropathy can lead to increased falls, cause pain, and lead to decreased quality of life,” says Kevin Springer, DPM, a podiatrist at The Ohio State University Wexner Medical Center … read more

If you find WoundCareWeekly.com of value please consider a monthly donation to help cover expenses and keep this website going.

Unsalvageable: Preventable Amputations Rise During COVID

Eli Cahan

Leafer Miller didn’t hear much after the doctor told him they had to “sacrifice the leg.” … Lying on the emergency room gurney, the self-proclaimed video game nerd and former athlete struggled to comprehend life without the leg that had propelled him on the track and to the turf for tackles on the soccer field … “It was always in the back of my mind as a worst-case scenario,” the 35-year-old Fresno, CA, native says. “But I wasn’t expecting that to be the case.”
… read more

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Zahraa Mansoor, Ali Modaweb

REGENATIVE LABS RELEASES NEW STUDY TO REVOLUTIONIZE TREATMENT FOR PATIENTS WITH DIABETIC FOOT ULCERS

Future applications for the early, preventative use of amniotic membrane allografts in addition to the current standard of care for DFUs present a novel opportunity to reduce long-term morbidity and amputation risk in diabetic patients.

PENSACOLA, Fla., Aug. 8, 2022 /PRNewswire/ — A new MDPI study, co-authored by Regenative Labs signifies a huge win for patients suffering from diabetic foot ulcers (DFUs). DFUs are debilitating for an individual. They are painful, long lasting, and, even with proper care, can lead to amputation. The current standard of care for DFUs is debridement, the medical removal of dead, damaged, or infected tissue to improve the healing potential of the remaining healthy tissue. The increased healing time and augmented risk of amputation associated with the current standard of care only solidifies the need for new DFU treatment alternatives. Regenerative medicine is such an alternative.

With approximately 37.3 million diabetic adults in the United States, physicians are faced with an epidemic. Given the projected increase of 1.4 million new diagnoses of diabetes mellitus each year, advancing knowledge and care for the disease and its related conditions is especially relevant.

Regenative Labs’ AmnioText™, a dehydrated amniotic membrane allograft, was used to close a grade 5 wound according to the Curative Health Services (CHS wound grade scale), described as full thickness and subcutaneous tissues, exposed tendons, ligaments, and/or joints, plus necrotic tissue in the wound, in 7 weeks. Grade 5 wounds have a 91.5% rate of not healing at all. This unsettling outcome emphasizes the efficacy and importance of amniotic membrane allografts in revolutionizing the standard of care for DFUs.

The inability to heal DFUs presents a severe danger to patients as anywhere from 5 to 24% of untreated DFUs can lead to limb amputation within 6–18 months. These infections can lead to long-term impairment and possible lower-limb amputation without timely and correct management.

“Regenative Labs and our products are focused on ameliorating this problem with our outcomes-based approach. We provide the highest quality amniotic membrane allograft to allow doctors to provide predictable outcomes for their patients,” shared Regenative Labs CEO, Tyler Barrett.

Amniotic membrane allografts, such as those provided by Regenative Labs, have proven to augment the body’s ability to regenerate the structural tissue defects associated with DFUs; they are also comparable in cost to the standard of care, which averages about USD 17,245. Not only is the current standard of care for DFUs less effective, but it is also high in cost and typically relies on inpatient expenditures.

Medicare now recognizes the medical necessity of amniotic membrane allografts in the treatment of both DFUs and venous stasis ulcers. Consequently, many patients rely on Medicare to assist with the costs associated with DFU treatment. This presents the opportunity for human amniotic membrane allografts to be utilized in rural and underserved communities where DFU treatment is typically delayed due to high costs and a lack of supplies associated with traditional treatment. This could exponentially decrease the risk of amputations in diabetic patients in these rural and underserved communities.

About Regenative Labs: Regenative Labs produces regenerative medicine products to address the root cause of a patient’s conditions using Wharton’s Jelly innovations rather than masking the pain with other treatments. Regenative Labs works closely with scientists, physicians, hospitals, and surgery centers to constantly monitor and improve patient progress and outcomes for new product development. Formed by veteran industry professionals familiar with daily challenges of innovations in healthcare, the company provides effective, non-addictive, non-invasive options for patients. Regenative Labs has a laser-focused, expert product research and development team which follows FDA guidelines of minimal manipulation for homologous use. The company adheres to AATB and FDA guidelines.

Learn more at Regenative’s website: www.regenativelabs.com

SOURCE Regenative Labs

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Foot ulcers in systemic sclerosis escape surgical amputation

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Sawsen Nouira • Taïeb Ach • Foued Bellazreg • Asma Ben Abdelkrim…

Heel Diabetic Foot Osteomyelitis: A Current Challenge in the Clinical Practice

Heel Diabetic Foot Osteomyelitis: A Current Challenge in the Clinical Practice

Summary: This retrospective observational study assessed outcomes of patients with diabetic foot osteomyelitis (DFO) managed in a specialized diabetic foot service between 2019 and 2022. Researchers compared patients with heel DFO to those with forefoot or midfoot DFO over a one-year follow-up, examining healing rates, healing time, amputation, and mortality.

Findings: Among 114 patients (mean age 67.9 years, 72.8% male, 91.2% type 2 diabetes), 30 had heel DFO and 84 had forefoot/midfoot DFO. Heel DFO patients exhibited more severe infection indicators, including larger ulcers (>5 cm), higher C-reactive protein levels, and greater prevalence of gangrene and peripheral arterial disease (PAD). Healing outcomes were significantly poorer for heel DFO cases, with longer healing times and higher rates of major amputation.

Healing rate: 66.7% (heel) vs 97% (forefoot/midfoot)

Healing time: 14 ± 6 weeks (heel) vs 6.8 ± 5 weeks (forefoot/midfoot)

Major amputation: 10% (heel) vs 0% (forefoot/midfoot)

Mortality: 6.6% (heel) vs 4.8% (forefoot/midfoot)

Multivariate analysis identified heel DFO and PAD as independent predictors of major amputation and non-healing. The study concludes that heel DFO represents a distinct clinical challenge associated with worse prognosis and slower recovery compared to other DFO sites.

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Keywords:
diabetic foot osteomyelitis,
heel ulcer,
diabetic foot ulcer,
amputation risk,
peripheral arterial disease

Social Determinants of Health in Podiatric Patients

Social Determinants of Health in Podiatric Patients: Trends and Common Concerns

Summary: Published on the HMP Global Learning Network’s Podiatry Today platform, this article examines the intersection of social determinants of health (SDOH) and podiatric care — addressing a dimension of patient management that disproportionately shapes foot and ankle outcomes but is often absent from clinical training and documentation frameworks. SDOH — the non-medical factors that influence health outcomes, including economic stability, education, health literacy, neighbourhood conditions, housing insecurity, food insecurity, social isolation, and access to healthcare — are increasingly recognised as drivers of the most challenging cases in podiatric practice. For wound care clinicians managing diabetic foot ulcers, venous leg ulcers, and pressure injuries, SDOH factors directly affect: wound healing trajectories (poor nutrition, inadequate offloading at home, inability to rest); treatment adherence (unaffordable medications, dressings, or footwear; missed appointments due to transport barriers); infection and amputation risk (delayed presentations due to healthcare avoidance; higher rates of homelessness-associated DFU complications including retinopathy and amputation); and recurrence risk (return to high-risk environments, inability to maintain footwear, self-care knowledge gaps). The article covers trends in how SDOH awareness is evolving in podiatric practice — including integration of ICD-10-CM Z codes for SDOH documentation, adoption of structured SDOH screening tools (PRAPARE, AHC-HRSN), referral pathways to community health workers and social services, and the growing clinical imperative to address SDOH as part of comprehensive, equitable diabetic foot care rather than treating them as external social issues. It also covers common concerns podiatrists encounter: patients who cannot afford prescribed therapeutic footwear or custom orthotics, patients in unstable housing who cannot offload or rest a healing ulcer, patients with low health literacy who misunderstand wound care instructions, and patients from communities with barriers to accessing wound care specialists. As the JS-gated HMP Global Learning Network platform requires browser JavaScript to load full content, the complete article is accessible via a registered account at hmpgloballearningnetwork.com.

Key Highlights:

SDOH and DFU outcomes: homelessness is associated with significantly higher rates of DFU-related ED visits, hospitalisation, lower limb amputation, and retinopathy — populations experiencing unstable housing carry compounded foot health risk that clinical care alone cannot address without social intervention

Documentation opportunity: ICD-10-CM Z codes (Z55–Z65) enable systematic documentation of social risk factors in clinical records, supporting population health management, quality metrics, and care coordination — yet uptake remains low across podiatric and wound care settings

SDOH screening tools: structured instruments such as PRAPARE (Protocol for Responding to and Assessing Patients’ Assets, Risks, and Experiences) and the AHC Health-Related Social Needs screening tool can identify actionable SDOH domains within clinical encounters, enabling warm referrals to community resources

Wound care-specific SDOH barriers: inability to afford wound care dressings or prescribed footwear; inadequate nutrition (protein, micronutrients) for wound healing; inability to rest or offload at home; low health literacy affecting dressing change technique and wound monitoring; transport barriers to follow-up appointments

Equity imperative: disparities in DFU outcomes — including higher amputation rates among Black, Hispanic, and low-income patients — are well documented; integrating SDOH screening and referral into podiatric wound care represents a structural equity intervention as well as a quality improvement strategy

Access note: HMP Global Learning Network requires JavaScript and free account registration; content accessible at hmpgloballearningnetwork.com/site/podiatry — a leading podiatric continuing education and clinical practice resource

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Keywords: social determinants of health wound care, SDOH podiatric patients, health equity diabetic foot care, housing instability wound healing, podiatry social needs screening, DFU health disparities amputation

HMP Global Learning Network / Podiatry Today

Heberprot-P: a novel product for treating advanced diabetic foot ulcer

Diabetic foot ulcer is a principal diabetic complication. It has been shown that diabetic patients have decreased growth factor concentrations in their tissues, particularly epidermal growth factor. Growth factor shortage impairs wound healing, which leads to chronic nonhealing wounds and sometimes eventual amputation. Ischemic diabetic foot ulcer is the most difficult to treat and confers the highest amputation risk. Injecting epidermal growth factor deep into the wound bottom and contours encourages a more effective pharmacodynamic response in terms of granulation tissue growth and wound closure. Epidermal growth factor injected into the ulcer matrix may also result in association with extracellular matrix proteins, thus enhancing cell proliferation and migration. Heberprot-P is an innovative Cuban product containing recombinant human epidermal growth factor for peri- and intra-lesional infiltration; evidence reveals it accelerates healing of deep and complex ulcers, both ischemic and neuropathic, and reduces diabetes-related amputations. Clinical trials of Heberprot-P in patients with diabetic foot ulcers have shown that repeated local infiltration of this product can enhance healing of chronic wounds safely and efficaciously. As a result, Heberprot-P was registered in Cuba in 2006, and in 2007 was included in the National Basic Medications List and approved for marketing. It has been registered in 15 other countries, enabling treatment of more than 100,000 patients. Heberprot-P is a unique therapy for the most complicated and recalcitrant chronic wounds usually associated with high amputation risk. Local injection in complex diabetic wounds has demonstrated a favorable risk-benefit ratio by speeding healing, reducing recurrences and attenuating amputation risk. Further testing and deployment worldwide of Heberprot-P would provide an opportunity to assess the product’s potential to address an important unmet medical need.

Article from PubMed

Posted in Articles

Nevro Announces Enrollment of First Patient in PDN Sensory Study

by admin on May 10, 2023

…Foot ulcer treatment and associated amputation surgeries are costly, both economically and psychosocially. By restoring sensation in the feet, 10 kHz Therapy may alleviate this tremendous disease burden, prevent amputations,…

Is it Safe to Amputate a Toe at Bedside in an Inpatient Unit?

Marrying Data with Common Sense: Is it Safe to Amputate a Toe at Bedside in an Inpatient Unit?

Summary: January 25, 2026 post (likely by David Armstrong) discusses bedside amputation surgery (BAS) for delimited toe necrosis in diabetic foot units. Cites multi-center study (Feron et al., 2026) showing equivalent 6-month healing (53.8% BAS vs. 52.3% CAS) and re-op rates (24.5% vs. 16.9%). Advocates BAS for ~2/3 suitable cases to reduce delays, keep patients in specialized units, and optimize OR use for complex scenarios. Emphasizes common-sense selection (avoid severe ischemia <2 patent vessels, high CRP/infection); supports #ActAgainstAmputation by enabling faster limb-saving interventions.

Key Highlights:

Data: Equivalent outcomes BAS vs. OR; no increased risk.

Benefits: Streamlined care, resource efficiency.

Limitations: Patient selection critical for success.

Implications: Shifts paradigm toward bedside in DFU management to minimize major amputations.

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Keywords: bedside amputation, diabetic foot, toe amputation, ActAgainstAmputation

Incidence, hospitalization and mortality and their changes over time in people with a first ever diabetic foot ulcer

Diabetic foot ulcers (DFUs) are a severe complication associated with diabetes, a precursor for amputation, and a major cause of patient suffering and high health-care costs.1,2 While the continuous efforts of multidisci-plinary foot clinics and preventive activities in primary care have reduced the incidence of major lower limb amputations in most countries, the prevention of DFUs remains a major challenge.3- 5 Over the years several risk factors associated with the development of a DFU have been discovered, but despite this, little is known about the factors leading directly to the first ever ulceration.6 Therefore, the predictive power of even seasoned cli-nicians in our experience remains low, and combined with the poorly reported, but relatively low, incidence of first ever DFUs, the possibilities for primary prevention is extremely limited.7 These challenges have led to re-current DFUs being studied far more than the first ever DFUs, but despite continuous improvements in healing … read more

Osteomyelitis in Pressure Ulcers

Osteomyelitis in Pressure Ulcers

Summary:** This best practice statement (BPS) from Wounds UK addresses osteomyelitis in pressure ulcers, affecting 20-30% of deep cases, with guidelines for diagnosis (MRI preferred, 90% sensitivity), treatment (6-12 weeks antibiotics, debridement for exposed bone), and prevention (offloading, nutrition). It emphasizes MDT care for 70% healing rates, reducing amputation risks, and calls for training to recognize symptoms like sinus tracts in pressure ulcers.

Key Highlights:

Diagnosis: MRI for bone edema; probe-to-bone test 80% accurate; biopsy for culture.

Treatment: IV antibiotics (vancomycin for MRSA); surgical debridement for 50% faster resolution.

Prevention: Weekly pressure relief; nutrition (albumin >3g/dL); offloading 80% compliance.

Outcomes: 70% healing with MDT; 20% amputation if untreated.

Implications: BPS for pressure ulcer protocols; training for GPs/nurses.

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Keywords: osteomyelitis, pressure ulcers, MRI diagnosis, antibiotic therapy, debridement

APMA Diabetes Awareness: Protecting Your Feet from Complications

APMA Diabetes Awareness: Protecting Your Feet from Complications

Summary: APMA’s annual diabetes awareness initiative highlights that 15% of diabetics develop DFUs, leading to 85% of amputations. Key tips: daily inspections for cuts/blisters, proper fitting shoes, glycemic control (HbA1c <7%), and annual podiatry exams. Resources include patient guides and provider referrals for neuropathy screening and offloading.

Key Highlights:

Risk: Neuropathy masks injuries; poor circulation delays healing.

Tips: Inspect daily, moisturize (avoid between toes), trim nails straight, no barefoot.

Warning Signs: Numbness, tingling, non-healing sores, skin changes.

Prevention: Custom orthotics, vascular checks; early intervention cuts amputations 50%.

Resources: FindAPodiatrist tool; patient education materials.

Explore campaign

Keywords: diabetes awareness, APMA, DFU prevention, foot inspections, podiatry

Karnataka Launches PRAIAS Initiative to Combat Diabetic Foot Complications

Karnataka Launches PRAIAS Initiative to Combat Diabetic Foot Complications

Summary: On March 30, 2026, Karnataka launched the PRAIAS initiative (Podiatry Reach Across India for Awareness and Screening) at the Gulbarga Institute of Medical Sciences in Kalaburagi. The program aims to tackle India’s massive diabetic foot burden—where a new diabetic foot ulcer develops every 12 seconds and a limb is lost globally every 20 seconds—through prevention, early detection, and public awareness. Key component: a Digital Podiatry Screening Van equipped with advanced tools to assess foot pressure, neuropathy, and circulation. The initiative follows a structured outreach model across cities, integrating technology and data analysis for risk stratification and timely intervention. Goal: achieve zero preventable amputations through education, screening, and clinical support in collaboration with diabetic foot specialists and healthcare organizations.

Key Highlights:

Launch of mobile screening van with advanced diagnostic tools

Focus on early detection of neuropathy, pressure issues, and vascular risk

Structured awareness and outreach to reduce amputations

Relevance: Scalable public health model for high-burden diabetic foot care

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Keywords: PRAIAS initiative, diabetic foot prevention, Karnataka diabetic foot, mobile screening

DFCON DIABETIC FOOT CONFERENCE October 21 – 23, 2021

DFCon is the premier international, interdisciplinary diabetic foot conference in North America. This year, the DFCon will be hybrid, so it will be possible to attend both virtually and physically. As always, the program will be designed for the wide spectrum of generalists and specialists who diagnose and manage the diabetic foot. Didactic talks, panel discussions, Q&A sessions, specialty symposia and workshops will delve into diagnostic and interventional strategies for diabetic foot ulcers and amputation prevention. DFCon is singular in that it allows close interaction with world-renowned clinician scientists working on both tried and true methods and cutting-edge technology

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HMP’s Wound Certification Prep Course Announces 12 New Locations for 2019

HMP, a leader in healthcare events and education, today announced twelve new course locations for the 2019 Wound Certification Prep Course (WCPC), the leading comprehensive wound care training program. Based upon the ongoing demand for clinicians to possess increased specialized knowledge in wound management, WCPC will be expanding its course to 12 cities nationwide, including San Francisco, Philadelphia, Nashville, and Chicago. Furthermore, three of the 12 programs will be co-located with HMP’s leading medical conferences: the Symposium on Advanced Wound Care (SAWC) Spring and Fall meetings, the world’s largest wound care educational events; and the Amputation Prevention Symposium (AMP) … read more

5 Questions to Consider Before Launching Your New Hospital-Based Wound Care Program

Opening a wound clinic is not without its risks and challenges. These five questions will help clinicians and program directors decide if the outpatient wound care service line is truly appropriate for them.

Hospital-based outpatient wound care programs have experienced explosive growth in a relatively short period of time, despite being relatively “new” to the healthcare industry. An aging population has brought significant health concerns among older patients, including type 2 diabetes, venous insufficiency, obesity, increasingly sedentary lifestyles, tobacco use, and other comorbidities that are taxing our healthcare system. Care of chronic wounds provides a cost-effective solution for this patient demographic, with a primary goal of amputation prevention and a secondary benefit of reduced hospital admissions and/or readmissions seen as motivation. The wound care product industry has also driven outpatient care and is expected to grow to $22 billion in the United States by 2022.¹ The product industry has largely driven advancements in the field of wound care research while increasing awareness about wound management. Currently, there are approximately 1,500 wound care centers nationwide, based on conservative estimates collected during the authors’ research for this article, with many more hospitals considering adding a wound care program to their outpatient service lines. There’s no question that wound care programs offer a viable solution for hospitals; however, opening and operating an outpatient wound care program is not easily accomplished. It’s a unique service line that takes committed leadership, upfront capital, and a clinical staff that deeply believes in the service line to make it operate successfully and provide long-term value to the community.
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Limb Loss… Who Is Really to Blame?

The Patient? The Physician? The System?—Part 1
The discipline of limb preservation and salvage has spawned extraordinary innovations in both scientific and clinical applications, offering new hope for those seeking the benefits of the burgeoning state-of-the-art lower extremity amputation prevention platforms. Wound treatment complexes are flourishing as well as access to them; research studies abound; extensive data is amassed; myriad public relations campaigns stimulate public awareness; training programs … read more

Organogenesis Supports ADA Scientific Compendium

Highlighting Latest Treatments for Diabetic Foot Ulcers

CANTON, Mass., Nov. 29, 2018 /PRNewswire/ — Organogenesis Inc., a leading regenerative medicine company committed to empowering healing, is proud to support the American Diabetes Association (ADA)’s publication of a new scientific compendium reviewing the latest methods for diagnosing and treating diabetic foot complications.

“We are proud to support the production of the compendium, which will be an invaluable resource for both clinicians and patients,” said Shabnam Vaezzadeh, Vice President of Global Medical & Clinical Affairs for Organogenesis. “Diabetic foot ulcers represent a significant and ongoing public health challenge and we applaud the ADA for this rigorous, independent and timely review of evidence-based interventions.”

The ADA compendium, Diagnosis and Management of Diabetic Foot Complications, is a comprehensive review of the latest scientific evidence related to the treatment of DFUs, including best practices for early screening and diagnosis, prevention strategies, and wound care and treatment options. The content for the compendium was developed by a respected team of independent researchers and clinicians and is solely the responsibility of the ADA and ADA leadership.

DFUs are the leading cause of diabetes-related amputations in the United States. Nearly 100,000 non-traumatic amputations are performed each year, a number which includes 1 in 6 patients with a DFU, according to the ADA. Proper foot care and access to advanced wound care treatment options are critical to prevent amputation or premature death due to diabetic foot ulcers.

from Cision PR Newswire

FDA approves shock wave device for treatment of diabetic foot ulcers

Today, the U.S. Food and Drug Administration permitted the marketing of the Dermapace System, the first shock wave device intended to treat diabetic foot ulcers.

“Diabetes is the leading cause of lower limb amputations,” said Binita Ashar, M.D., director of the division of surgical devices in FDA’s Center for Devices and Radiological Health. “The FDA is dedicated to making technologies available that can help improve the quality of life for those with chronic diseases. Additional options for successfully treating and healing ulcer wounds may help prevent lower limb amputations.”

An estimated 30.3 million people in the United States have been diagnosed with diabetes, according to the Centers for Disease Control and Prevention. Diabetes damages blood vessels and nerves, particularly in the feet, and can lead to severe infections that are difficult to treat. About 25 percent of people with diabetes will experience a foot ulcer in their lifetime. Amputation is sometimes necessary when circulation is so poor that a foot ulcer fails to heal or when treatment fails to stop the spread of an infection … read more

Wound Care Advantage Highlights Diabetes Month with Free Resources for Wound Centers

SIERRA MADRE, Calif., Nov. 10, 2022 /PRNewswire/ — Our doctors, nurses, and clinicians have been at the front lines of treating the consequences of diabetes every day. With over 20 years of supporting wound centers, we’ve learned 2 important truth’s about diabetes:

Diabetes continues to grow at an alarming rate
More action and education are needed

Steal this Diabetes Month Resource Kit: thewca.com/2022/11/01/steal-this-diabetes-month-resource-kit/

To commemorate November’s National Diabetes Awareness Month, Wound Care Advantage does not want to focus on the statistics of Diabetes. Like the 37 million people suffering from diabetes, or the fact that up to 34% of those patients will develop a foot ulcer (DFU) in their lifetime, and that DFUs are the number one leading cause of non-traumatic amputations. Instead, we realize that diabetes is not going anywhere anytime soon, nor is the knowledge that if not managed properly, diabetes can lead to serious and fatal outcomes.

This is why this November, WCA is giving Wound Programs a Diabetes Month Resource Kit to build awareness of diabetes and the high risk of chronic wounds. With 70% of diabetic foot ulcers ending in amputation and leading to a 2-year life expectancy after surgery, wound care programs deserve the support and resources to save the limbs and lives of all patients. Help us put a spotlight on this disease with our free Diabetes Month Resource Kit. Steal our professional resources for your clinic.

Our Resource Kit will supply you with:

Diabetes Community Education Flier

How Living with Diabetes Increases your Risk of Chronic Wounds Video

Diabetes Infographic

Diabetes Infographic video

Patient education and prevention flier

DFU patient education video

Even with the disease of diabetes keeping its alarmingly quick growth rate, the population of patients that develop an ulcer that leads to an amputation does not have to. Join us in building the awareness that 70% of DFU patients do not need to end with an amputation this November.

Diabetes Month Resource Kit: thewca.com/2022/11/01/steal-this-diabetes-month-resource-kit/

About Wound Care Advantage:
Founded in 2002, Wound Care Advantage (WCA) has been supporting wound centers for 20 years. With a strong commitment to care and innovation, WCA advocates for the financial independence of partner hospitals and the rapid healing of patients they serve. Wound Care Advantage is a privately held company headquartered in Sierra Madre, California. For additional information, visit www.thewca.com.

SOURCE Wound Care Advantage

Posted in Articles

Topical Oxygen Therapy Awarded Positive Treatment Recommendation by the International

by admin on May 23, 2023

…to produce evidence-based guidelines to inform health care providers all over the world on strategies for the prevention and management of diabetic foot disease, thereby helping to reduce the high…

Improving Vascular Access Dressing Integrity in the Acute Care Setting

Hospitals have a major focus on improving healthcare-associated infections (HAIs) with intense scrutiny on central line-associated bloodstream infections (CLABSIs) and other hospital-onset bacteremias. Efforts at prevention have long targeted the skin of the patient and healthcare worker processes such as hand hygiene, maximum sterile barrier precautions, antiseptic skin preparation, use of chlorhexidine-impregnated dressings, and other interventions.1–3 Maintaining the health and integrity of the patient’s skin receives considerable attention; however, less common are efforts to establish partnerships between wound/ostomy and infection prevention and/or vascular access teams to improve and promote HAI prevention processes … read more

IDTechEx Research Report Explores Connected Sensors

for the Prevention of Chronic Ulcers

As advancements in connectivity and miniaturization of electronics are made, smart sensors are beginning to find traction within the wound care pathway. IDTechEx Research has published a report titled Advanced Wound Care Technologies 2018–2028 and have previously reported on why disruption is needed in wound care in the next 10 years. Here, IDTechEx explores a few connected devices that can contribute to the prevention of chronic wounds of pressure ulcers (PUs) and diabetic foot ulcers (DFUs).

Sensors for the Prevention of Pressure Ulcers

MedicusTek have created the Sensable Care system which relies on a connected sensor pad or sensor mattress for detection of patient positioning to prevent pressure ulcer formation. By tracking patient position over time, the Sensable Care system can determine which areas of the patient are being exposed to prolonged pressure and notify caregivers accordingly for repositioning. The system resets if the patient successfully repositions themselves, thus decreasing the burden on caregivers where possible. Moreover, caregivers can receive immediate feedback as to whether their repositioning efforts were adequate in reliving the excessive pressure … read more

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