2023-2024 Cardiovascular Institute Annual Report CVI | Page 21

DIABETIC FOOT ULCERS
HIGHLIGHTS

LIMB PRESERVATION

UAB Medicine ’ s vascular and podiatric specialists within the Division of Vascular Surgery and Endovascular Therapy provide expert treatment of multiple circulatory conditions using a broad range of services that include medical therapy , endovascular therapy , and surgical reconstruction / bypass .
The UAB Limb Preservation Program aims to seamlessly integrate vascular and podiatric surgery in both the outpatient and inpatient settings , with the goal of reducing amputations in patients with diabetes and peripheral artery disease . It is the only program of its kind in Alabama .
LIMB PRESERVATION

DIABETIC FOOT ULCERS

An estimated 1.6 million people in the United States suffer from diabetic foot ulceration each year . The mortality rate following the development of a foot ulcer or a lower limb amputation is worse than with most cancers . The etiology of foot ulceration includes peripheral neuropathy with loss of plantar sensation in the foot , structural abnormalities of the foot resulting in increased pressure , poorly controlled diabetes , and peripheral vascular disease .
The UAB Limb Preservation Program is the only one of its kind in Alabama . Utilizing the so-called “ toe and flow model ”, vascular and podiatric surgeons work collaboratively and perform timely interventions in an attempt to prevent major amputations . Some 60 % of individuals with a diabetes-related foot complication also have some level of vascular disease . Other members of the team include infectious disease experts , endocrinologists , hospitalists , plastic surgeons , and trauma and orthopaedic surgeons .
Multidisciplinary care is provided to chronic limb-threatening ischemia ( CLTI ) patients through the toe and flow model , as illustrated below .
Wound Care
Plastic Surgery
Infectious Disease
Podiatry
TOE
CLTI Patient
FLOW
Vascular Surgery
Endocrinology Orthopaedic Surgery
Cardiology Nephrology

HIGHLIGHTS

• Direct collaboration between vascular surgeons and vascular and diabetic podiatry experts on every patient with CLTI
• Advanced endovascular techniques , including atherectomy ( laser and mechanical ), balloon angioplasty and stenting , peripheral arterial bypass , thrombolysis and thrombectomy , and peripheral and visceral aneurysm repair
• Non-invasive arterial testing and diagnostic imaging in a state-of-the-art vascular lab
• Vascular medical evaluation , including risk factor assessment and non-operative management options
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