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Podiatric surgery

Timothy Wu, Rabih A Chaer, Nichol L Salvo
Both vascular surgeons and podiatric physicians care for patients with diabetic foot ulcerations (DFUs), one of today's most challenging health-care populations in the United States. The prevalence of DFUs has steadily increased, along with the rising costs associated with care. Because of the numerous comorbidities affecting these patients, it is necessary to take a multidisciplinary approach in the management of these patients. Such efforts, primarily led by podiatric physicians and vascular surgeons, have been shown to effectively decrease major limb loss...
July 2016: Journal of the American Podiatric Medical Association
Robert M Yoho, Vassilios Vardaxis, Kelsey Millonig
BACKGROUND: Student self-assessment is viewed as an important tool in medical education. We sought to identify the relationship between student academic performance and third-year clinical performance self-assessment. No such study exists in podiatric medical education. METHODS: Third-year podiatric medical students from the classes of 2012 through 2014 completed a self-assessment of their performance for each of five broad clinical podiatric medical domains (Professionalism, Medicine, Radiology, Surgery, and Biomechanics/Orthopedics)...
May 2016: Journal of the American Podiatric Medical Association
Nathaniel J Jellinek, Nicole F Vélez
Nail surgery is a fundamental component of podiatric surgery. Nail disorders are common and may cause significant morbidity and occasionally mortality. Diagnosis of inflammatory and infectious conditions, and of benign or malignant tumors, often requires a biopsy of the nail unit. Excisional surgery may also be curative for certain tumors. This article reviews key elements of nail anatomy, surgical preparation, local anesthesia, and methods to achieve and maintain a bloodless field. A familiarity with these concepts should allow clinicians to develop a surgical plan and approach when patients present with a nail disorder requiring biopsy or surgical treatment...
July 2016: Clinics in Podiatric Medicine and Surgery
Marlin W Causey, Ayman Ahmed, Bian Wu, Warren J Gasper, Alex Reyzelman, Shant M Vartanian, Jade S Hiramoto, Michael S Conte
OBJECTIVE: Clinical decision making and accurate outcomes comparisons in advanced limb ischemia require improved staging systems. The Society for Vascular Surgery Lower Extremity Threatened Limb Classification System (Wound extent, Ischemia, and foot Infection [WIfI]) was designed to stratify limb outcomes based on three major factors-wound extent, ischemia, and foot infection. The Project or Ex-Vivo vein graft Engineering via Transfection III (PREVENT) III (PIII) risk score was developed to stratify patients by expected amputation-free survival (AFS) after surgical revascularization...
June 2016: Journal of Vascular Surgery
James M Mahoney, Vassilios Vardaxis, Noreen Anwar, Jacob Hagenbucher
BACKGROUND: Direct assessment of health professional student performance of clinical skills can be accurately performed in the standardized performance assessment laboratory (SPAL), typically by health professional faculty. However, owing to time and economic considerations, nonmedical individuals have been specially trained to perform the same function (standardized patients [SPs]). This study compared the assessment scores of the history and physical examination components of a SPAL designed for second-year podiatric medical students at Des Moines University (DMU) by a podiatry medical faculty member and SPs...
March 2016: Journal of the American Podiatric Medical Association
Kevin M Smith, Simon Geletta, Travis Langan
BACKGROUND: Des Moines University College of Podiatric Medicine and Surgery (CPMS) is implementing a cultural competency program for third-year podiatric medical students. This study assessed the effectiveness of the new educational program on cultural competency at CPMS by comparing pretest and posttest scores of students from the CPMS graduating classes of 2013 and 2014. METHODS: Students from the class of 2013 completed a 10-week online course on cultural competency, and the class of 2014 students did not...
January 2016: Journal of the American Podiatric Medical Association
Anil Hingorani, Glenn M LaMuraglia, Peter Henke, Mark H Meissner, Lorraine Loretz, Kathya M Zinszer, Vickie R Driver, Robert Frykberg, Teresa L Carman, William Marston, Joseph L Mills, Mohammad Hassan Murad
BACKGROUND: Diabetes mellitus continues to grow in global prevalence and to consume an increasing amount of health care resources. One of the key areas of morbidity associated with diabetes is the diabetic foot. To improve the care of patients with diabetic foot and to provide an evidence-based multidisciplinary management approach, the Society for Vascular Surgery in collaboration with the American Podiatric Medical Association and the Society for Vascular Medicine developed this clinical practice guideline...
February 2016: Journal of Vascular Surgery
Antony H Bateman, Sara Bradford, Thomas W Hester, Igor Kubelka, Jennifer Tremlett, Victoria Morris, Elizabeth Pendry, Venu Kavarthapu, Michael E Edmonds
In this article, we describe emergency and elective pathways within our orthopedic multidisciplinary inpatient care of patients with diabetic foot problems. We performed a retrospective cohort review of 19 complex patients requiring orthopedic surgical treatment of infected ulceration or Charcot feet or deformity at our institution. A total of 30 admissions (19 emergency, 11 elective) were included. The pathways were coordinated by a multidisciplinary team and comprised initial assessment and investigation and a series of key events, which consisted of emergency and elective surgery together with the introduction, and change of intravenous antibiotics when indicated...
December 2015: International Journal of Lower Extremity Wounds
Ainslie Davies, Paul Bennett, Susan Nancarrow, Antonio Cuesta-Vargas
BACKGROUND: Ensuring efficient and effective delivery of health care to an ageing population has been a major driver for a review of the health workforce in Australia. As part of this process a National Registration and Accreditation Scheme (NRAS) has evolved with one goal being to improve workforce flexibility within a nationally consistent model of governance. In addition to increased flexibility, there have been discussions about maintaining standards and the role of specialisation...
2015: Journal of Foot and Ankle Research
Andrew J Meyr, Salil Singh, Oliver Chen, Sayed Ali
This pictorial review focuses on basic procedures performed within the field of podiatric surgery, specifically for the hallux abductovalgus or "bunion" deformity. Our goal is to define objective radiographic parameters that surgeons utilize to initially define deformity, lead to procedure selection and judge post-operative outcomes. We hope that radiologists will employ this information to improve their assessment of post-operative radiographs following reconstructive foot surgeries. First, relevant radiographic measurements are defined and their role in procedure selection explained...
June 2015: Journal of Radiology Case Reports
Xinli Li, Mark Wilson, William Nylander, Tracy Smith, Marilyn Lynn, William Gunnar
IMPORTANCE: This study analyzes and reports Clostridium difficile infection (CDI) rates, risk factors, and associations with postoperative outcomes in the Veterans Health Administration (VHA). OBJECTIVE: To report 30-day postoperative CDI rates and outcomes and identify associated risks by surgical procedures and preoperative patient demographics in a large integrated health care system. DESIGN, SETTING, AND PARTICIPANTS: In a retrospective observational study conducted from September 2014 to April 2015, the Veterans Affairs Surgical Quality Improvement Program database and the Decision Support System pharmacy database were linked to analyze the association of postoperative CDI with patients' demographics, preoperative comorbidities, operative characteristics, and preoperative medications...
April 2016: JAMA Surgery
Shari A Ochoa
BACKGROUND: Nonfacial reconstruction encompasses several anatomic locations with varied topography, skin quality, and tissue reservoirs. Patients also have varied mobility concerns and wound care needs when managing wounds in these areas. MATERIALS AND METHODS: This article includes techniques and approaches from the dermatologic surgery, plastic surgery, and podiatric surgery literature in an effort to provide a comprehensive overview of the subject matter. RESULTS AND CONCLUSION: Functionally and esthetically acceptable reconstructions of nonfacial surgical wounds can be accomplished with a variety of techniques based on the characteristics of the wound and unique needs of the patient...
October 2015: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
Jaime García-París, Manuel Coheña-Jiménez, Pedro Montaño-Jiménez, Antonio Córdoba-Fernández
BACKGROUND: The Surgical Safety Checklist (SSC) is a tool developed by the World Health Alliance for Patient Safety, to assist health professionals in improving patient safety during surgery. Numerous specialties have incorporated this into their clinical practice. The purpose of this study is to adapt and implement this tool within the field of podiatric surgery and to evaluate its impact upon safety standards and post-surgical complications. METHODS: An analytical, observational, longitudinal study has been performed retrospectively...
2015: Patient Safety in Surgery
Corine L Creech, Steven J Pettineo, Andrew J Meyr
A basic competency examination in musculoskeletal medicine has previously been administered to residents across a variety of medical specialties and has demonstrated that medical school preparation in musculoskeletal medicine might be inadequate. The objectives of the present study were to assess podiatric surgical resident performance on this examination and to assess podiatric surgical residency director opinions of the level of importance of the test subject areas. A total of 117 podiatric surgical residents from 15 residency programs completed the 25-question examination...
January 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
David Shofler, Taijung Chuang, Nina Argade
The podiatric medicine and surgery residency is currently characterized by 3 years of comprehensive training. Contemporary issues have recently influenced the direction of training in the profession of podiatric medicine. Formal investigation into the residency training experience has, nonetheless, been limited. The purpose of the present study was to conduct a learning needs assessment of podiatric residency training. An electronic survey was developed, with comparable versions for program directors and residents...
July 2015: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Magali Brousseau-Foley, Vincent Cantin
BACKGROUND: Intractable plantar keratoma is a common concern in the podiatric medical office. Different treatment options are available, ranging from trimming and padding to surgery. We sought to investigate the use of hyaluronic acid gel injections as a possible minimally invasive alternative in the treatment of intractable plantar keratomas. METHODS: Seventeen patients with intractable plantar keratomas were randomly assigned to receive a hyaluronic acid gel injection or a sterile water injection at the site of a previously trimmed plantar lesion...
January 2015: Journal of the American Podiatric Medical Association
Olivia King, Susan A Nancarrow, Alan M Borthwick, Sandra Grace
BACKGROUND: Across the Western world, demographic changes have led to healthcare policy trends in the direction of role flexibility, challenging established role boundaries and professional hierarchies. Population ageing is known to be associated with a rise in prevalence of chronic illnesses which, coupled with a reducing workforce, now places much greater demands on healthcare provision. Role flexibility within the health professions has been identified as one of the key innovative practice developments which may mitigate the effects of these demographic changes and help to ensure a sustainable health provision into the future...
2015: Journal of Foot and Ankle Research
David Shofler
Limited information exists to guide students of podiatric medicine and residency directors through the resident selection process. The present study aimed to evaluate the podiatric medicine and surgery resident selection process using an online survey. Residency directors of podiatric medicine and surgery programs across the United States and fourth-year students across all 9 colleges of podiatric medicine were contacted for participation. Two separate surveys were created, one for the directors and one for the students...
July 2015: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Jennifer Tinloy, Shailja Kaul, Jan Ulbrecht, Eric Schaefer, Robert A Gabbay
BACKGROUND: Foot self-care is key in preventing morbidity in high-risk diabetic patients. Motivational interviewing (MI) is an approach to encourage behavior change by patients that can be used in medical settings. The goal was to explore how podiatric physicians promote self-care in such patients and whether they use MI techniques. METHODS: We conducted a 19-question online survey of US-based practicing podiatric physicians. Most answers were on a 5-point scale...
July 2014: Journal of the American Podiatric Medical Association
Jayer Chung, J Gregory Modrall, Chul Ahn, Lawrence A Lavery, R James Valentine
BACKGROUND: This study was conducted to quantify the effect of multidisciplinary care (MDC) on amputation-free survival (AFS) and wound healing within a chronic critical limb ischemia (CLI) population. METHODS: We performed a retrospective, single-center cohort study of consecutive CLI patients presenting to the Vascular Surgery Service. Patients who received initial and follow-up wound care from the MDC were compared with patients who received standard wound care (SWC)...
January 2015: Journal of Vascular Surgery
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