Podiatry Commons^™

Successful Limb Salvage In A Severe Diabetic Foot Infection: A Case Study Of Aggressive Surgical Intervention And Grafting Technique, Stephanie N. Campbell, Amanda Killeen, Michael Sobolevsky

School of Podiatric Medicine Publications

A 53-year-old male with uncontrolled diabetes (A1c 7.9%), housing insecurity, food insecurity presented with severe necrotizing diabetic foot infection with ascending cellulitis, infectious hemorrhagic bullae, multi-compartment abscesses of the foot and anterior leg. It is known that patients with diabetes are at increased risk of both amputation and surgical interventions than patients without diabetes. This patient underwent aggressive surgical intervention to avoid primary below knee amputation.

Investing In Limb Preservation: A Case Report In Avoiding Bilateral Amputation In A Vasculopathy Patient, Stephanie N. Campbell, Craig J. Verdin, Heather V. Tran, Nikita Gambhir

School of Podiatric Medicine Publications

Limb salvage and prosthetics play vital roles in restoring function and mobility for patients with severe injuries or metabolic conditions. Limb salvage involves surgical techniques aimed at preserving a limb rather than resorting to amputation, while prosthetics provide artificial devices to replace lost limbs. Key considerations for limb salvage include restoring a functional foot, maintaining patient independence, minimizing hospitalizations, and avoiding bilateral lower limb amputations.

Synovial Chondromatosis: Unraveling The Pathogenesis, Diagnosis, And Management Of An Atypical Benign Tumor, Francois M. Lokenye Dpm, Narayan Athira Md

Oral Presentations

No abstract provided.

Prevention Of Transmetatarsal Amputation In A Diabetic Patient With A Chronic Foot Ulcer Including Osteomyelitis By Minimally Invasive Surgery Floating Lesser Metatarsal Osteotomies In Conjunction With Adipose Injectable Filler, Francois M. Lokenye Dpm, Orlexia Thomas Dpm, Lady Paula Dejesus Dpm, Facfas, Facpm, Dwsp

Posters

Problem: Diabetic foot ulcers (DFUs) complicated by osteomyelitis often result in transmetatarsal amputations, leading to significant morbidity.

Objective: To evaluate a minimally invasive surgical approach combining floating lesser metatarsal osteotomies with adipose injectable filler to prevent transmetatarsal amputation, enhance wound resolution, and improve foot biomechanics

Allograft Reconstruction For Fluoroquinolone-Induced Achilles Rupture: A Case Study, Val Haddon, Brandon Mojica, Joel Santana, Marjory Jones

West Florida Division GME Research Day 2025

No abstract provided.

Early Tissue Changes Linked To Diabetes: Insights From A Preclinical Model, Bryan Liu, Ramiro Cisneros, Estephania Garcia, Jimena Mora, Sumedha Guha, Evelin Rios, Krishna Prajapati, Danieli Rodrigues, Bhuvana Lakkasetter Chandrashekar, Claudia Biguetti

School of Podiatric Medicine - Student Research

Introduction and Hypothesis: The aim of this study is to compare soft tissue morphology and fibrosis pathology of different organs between diabetic and non-diabetic rats. Type 2 diabetes causes soft tissue remodeling in organ systems including heart, kidney, spleen, and pancreas. Fibrotic remodeling is a common pathological mechanism seen in diabetes-related organ dysfunction. By understanding fibrotic pathology in rats, it serves as a foundation to develop lower limb models applicable to podiatry. These systemic changes caused by diabetes may also play a role in lower limb changes such as diabetic ulcers and delayed wound healing.

Methodology: Male Lewis rats (6 …

New Vs. Reprocessed: A Scoping Review On Ilizarov Frame Reuse, James Hughes, Nicholas Obias, Dustin Prins, Amanda Killeen

School of Podiatric Medicine - Student Research

This review examines current literature regarding the viability of reused/reprocessed Ilizarov External Fixation (IEF) – with the end-goal of improving surgical options for complex limb pathologies in austere environments. We hypothesize this review will find no statistically significant difference between clinical outcomes of reused vs. new IEFs

IEF is an important but costly modality for complex limb pathologies, such as trauma, deformity, and nonunion (Chironga et al., 2023). Though effective, the cost of IEF is exacerbated by its single-use deployment (Chironga et al., 2023). A proposed cost-control measure is IEF reuse/reprocessing via (1) antiseptic pre-treatment, (2) structural stability assessment, (3) …

Rare Case Of Osteomyelitis Caused By Achromobacter Xylosoxidans, Christopher P. Girgis, Tyler L. Coye, Elizabeth Ansert, Amanda L. Killeen, Peter A. Crisologo

School of Podiatric Medicine Publications

Achromobacter xylosoxidans is a rare opportunistic aerobe that has rarely been documented in the literature as a causative agent for osteomyelitis. It can present with antibiotic resistance, making treatment without operative management challenging. We present the case of a 51-year-old male with a past medical history of uncontrolled type 2 diabetes. The patient presented to a clinic with a grade 2 infection to the right fifth digit, as defined by the International Working Group on the Diabetic Foot, and was subsequently admitted for intravenous antibiotics and operative management. Magnetic resonance imaging revealed abnormal signal of the phalanges of the fifth …

Comparative Effectiveness Of Conservative Versus Early Surgical Treatments On Wound Healing Outcomes Of Diabetic Foot Ulcers: A Literature Review, Paul Tran, Yasim Zafar, Andrea Piña, Stephanie N. Campbell

School of Podiatric Medicine Publications

Diabetic foot ulcers (DFUs) are a severe complication of diabetes mellitus and the leading cause of lower extremity amputations worldwide. Peripheral neuropathy and peripheral arterial disease secondary to complications of diabetes mellitus may result in ulcers going unnoticed, increasing the risk of severe osteomyelitis, necrotizing infection, hospitalization, amputation, and sepsis. While conservative management of DFUs remains the first-line approach—emphasizing wound care, infection control, glycemic management, and offloading—there is growing debate about whether delaying simple surgical interventions worsens long-term outcomes. Surgeries such as tenotomy, digital amputation, and tendo-Achilles lengthening are minimally invasive options that can correct deformities, prevent recurrence, and promote …

Demographic And Clinical Characteristics Of Patients With Charcot Neuro-Osteoarthropathy In People With Diabetes Mellitus In Six Countries: A Multicenter Observational Study From 1996 To 2022, E. B. Jude, C. Siafarikas, A. Rastogi, R. Bem, T. Tankova, M. -F. Kong, Javier La Fontaine, J. Pappachan, N. Tentolouris

School of Podiatric Medicine Publications

Aim: To describe the demographic and clinical characteristics of patients with Charcot neuro-osteoarthropathy (CNO) and to examine for differences between participants with Type 1 diabetes mellitus (DM) (T1DM) and Type 2 diabetes mellitus (T2DM).

Materials and Methods: Multicenter observational study in eight diabetic foot clinics in six countries between January 1, 1996, and December 31, 2022. Demographic, clinical, and laboratory parameters were obtained from the medical records. Analyses were performed using parametric or nonparametric statistical tests for variables with normally or nonnormally distributed values, respectively. Comparisons of the qualitative data were performed using the chi-square test.

Results: Seven hundred seventy-four …

The Effects Of Capsaicin On Vascularization In Patients With Diabetes Mellitus: A Literature Review, Karen Hernandez, Leslie Guerrero, Myra Mudassar, Amanda L. Killeen

School of Podiatric Medicine Publications

Diabetes Mellitus (DM) is a metabolic disorder affecting 11.6% of the United States population and 43.95% of the population in the Rio Grande Valley of Texas. A common complication of diabetes mellitus is neuropathy, a type of nerve damage that affects as many as half of the people with this condition. Vascular factors and metabolic interactions are major influencers of the pathogenesis of diabetic neuropathy. This literature review evaluates the therapeutic role of capsaicin, a known component of capsicum pepper, commonly used as a treatment for neuropathic pain. However, several studies show that in addition to pain management, capsaicin counters …

The Infected Diabetic Foot: Incidence And Risk Factors For Dehiscence After Surgery For Diabetic Foot Infections, Lawrence A Lavery, Mario C Reyes, Bijan Najafi, Tyler L Coye, Jayer Chung, Michael C Siah, Arthur N Tarricone

Center on Aging Staff Publications

Our objective was to assess the incidence, risk factors and clinical outcomes of dehiscence after foot surgery in diabetic patients. We used pooled patient‐level data from two randomised clinical trials with 240 diabetic patients who required foot surgery for infections. Most patients (n = 180, 75.0%) had surgical wound closure. We defined dehisced surgical wounds (DSW) when the surgical site was not completely epithelialized with no drainage after sutures/staples were removed with a 2‐week validation of healing. We evaluated the time to heal, re‐infection, re‐ulceration, hospital admissions and amputations. Moderate and severe infection was based on criteria of the …

Lipid Discovery Enabled By Sequence Statistics And Machine Learning, Priya M. Christensen, Jonathan Martin, Aparna Uppuluri, Luke R. Joyce, Yahan Wei, Ziqiang Guan, Faruck Morcos, Kelli L. Palmer

School of Podiatric Medicine Publications

Bacterial membranes are complex and dynamic, arising from an array of evolutionary pressures. One enzyme that alters membrane compositions through covalent lipid modification is MprF. We recently identified that Streptococcus agalactiae MprF synthesizes lysyl-phosphatidylglycerol (Lys-PG) from anionic PG, and a novel cationic lipid, lysyl-glucosyldiacylglycerol (Lys-Glc-DAG), from neutral glycolipid Glc-DAG. This unexpected result prompted us to investigate whether Lys-Glc-DAG occurs in other MprF-containing bacteria, and whether other novel MprF products exist. Here, we studied protein sequence features determining MprF substrate specificity. First, pairwise analyses identified several streptococcal MprFs synthesizing LysGlc-DAG. Second, a restricted Boltzmann machine-guided approach led us to discover an …

Randomized Clinical Trial To Compare Cryopreserved And Lyopreserved Umbilical Cord Tissue To Treat Complex Diabetic Foot Wounds, Lawrence A. Lavery, Mehmet A. Suludere, Matthew J. Johnson, Amanda Killeen, Katherine M. Raspovic, Peter A. Crisologo, Arthur Tarricone

School of Podiatric Medicine Publications

To compare the incidence of infection, wound closure and time to wound closure in patients treated with cryopreserved (CPUT) and lyopreserved umbilical tissue (LPUT) in complex diabetic surgical wounds. This single-blinded 12-week randomized clinical trial compared cryopreserved and lyopreserved amniotic cord tissue to treat complex diabetic foot wounds. LPUT or CRAT was applied at baseline and again after four weeks. We enrolled subjects with UT2A-D and 3A-D wounds (depth to tendon, muscle, or bone with infection and/or PAD) and excluded subjects with ABI < 0.5 or TBI < 0.3, untreated osteomyelitis, and autoimmune diseases. We used a 3-D camera to evaluate wound area and volume. The mean baseline wound areas were 12.9 ± 10.7 cm2 for CPUT and 11.7 ± 7.0 cm2 for LPUT. The mean baseline wound volume was 7.5 ± 8.1 for CPUT and 9.2 ± 10.2 cm3 for LPUT. There was no difference between CPUT and LPUT in wound closure (36.8% vs 19.0%, P = .21) or infection (10.5% vs 4.8%, P = .60). There was no difference in mean …

Successful Limb Salvage In A Severe Diabetic Foot Infection: A Case Study Of Aggressive Surgical Intervention And Grafting Technique, Stephanie N. Campbell, Heather V. Tran, Nikita V. Gambhir

School of Podiatric Medicine Publications

No abstract provided.

Investing In Limb Preservation: A Case Report In Avoiding Bilateral Amputation In A Vasculopathy Patient, Nikita Gambhir, Heather V. Tran, Craig J. Verdin, Stephanie N. Campbell, Cyaandi Dove

School of Podiatric Medicine Publications

Limb salvage and prosthetics play vital roles in restoring function and mobility for patients with severe injuries or metabolic conditions. Limb salvage involves surgical techniques aimed at preserving a limb rather than resorting to amputation, while prosthetics provide artificial devices to replace lost limbs. Key considerations for limb salvage include restoring a functional foot, maintaining patient independence, minimizing hospitalizations, and avoiding bilateral lower limb amputations. Aggressive measures in wound care and surgery are needed for patients already at single-limb status with PAD and coronary artery disease (CAD).

Enterococcus Faecium: Evolution, Adaptation, Pathogenesis And Emerging Therapeutics, Yahan Wei, Dennise Palacios Araya, Kelli L. Palmer

School of Podiatric Medicine Publications

The opportunistic pathogen Enterococcus faecium colonizes humans and a wide range of animals, endures numerous stresses, resists antibiotic treatment and stubbornly persists in clinical environments. The widespread application of antibiotics in hospitals and agriculture has contributed to the emergence of vancomycin-resistant E. faecium, which causes many hospital-acquired infections. In this Review, we explore recent discoveries about the evolutionary history, the environmental adaptation and the colonization and dissemination mechanisms of E. faecium and vancomycin-resistant E. faecium. These studies provide critical insights necessary for developing novel preventive and therapeutic approaches against vancomycin-resistant E. faecium and also reveal the intricate interrelationships …

Shooter’S Abscess: Foot Infections In People Who Inject Drugs, Amanda L. Killeen, Randi Heming, Peter A. Crisologo, Michael C. Siah, Lawrence A. Lavery

School of Podiatric Medicine Publications

Musculoskeletal infections are common among people who inject drugs. Little is known about the prevalence and characteristics of skin and soft-tissue infections in this patient population, especially in the lower extremity. The aim of this study is to describe the clinical characteristics, bacterial pathogens, and clinical outcomes in adults with foot infections due to intravenous drug use. Nine patients for whom the podiatric service was consulted for lower-extremity abscess secondary to intravenous drug use were included in this study. Most infections (66.7%) were located on the dorsal foot. Two of the abscesses (22.2%) resulted in amputation, with one toe amputation …

Use Of A Borate-Based Bioactive Glass Matrix On Infected, Exposed Hardware, Stephanie N. Campbell, Cyaandi Dove, Connor V. Krolikowski

School of Podiatric Medicine Publications

A dreaded complication of implanting surgical hardware is a wound dehiscence resulting in hardware exposure; which places the wound at risk for infection and biofilm formation. Once established, biofilms are difficult to eradicate, with a high rate of recurrence even after surgical debridement. As such, there exists a significant need for novel technologies that can help us expedite healing in wounds with exposed hardware. Here we evaluate a borate-based bioactive glass matrix* in this challenging setting.

Management Of Group B Streptococcus Necrotizing Fasciitis Secondary To Puncture Wound In Diabetic Patient Using Xenograft* Therapy, Nikita V. Gambhir, Heather V. Tran, Stephanie N. Campbell

School of Podiatric Medicine Publications

Necrotizing soft tissue infection (NSTI) is a rapidly progressive skin and soft tissue infection that primarily affects deeper layers of adipose tissue, fascia and muscle. Once a patient becomes symptomatic, the disease typically progresses within hours. The standard treatment consists of broad-spectrum IV antibiotics, serial debridement and supportive care. However, long-term goals should include prevention of atherosclerotic disease, cardiovascular and cerebrovascular events, and ultimately, a reduction in mortality rates. Following debridement for NSTI, it is not uncommon for patients to require multiple surgeries and secondary wound healing given the extent of soft tissue loss.