BEFORE CHARCOT WITH OSTEOMYELITIS

DEBRIDEMENT

STAGED RECONSTRUCTION

6 MONTHS POST-DEBRIDEMENT

LIMB SALVAGE S Y M P O S I U M

This activity has been planned and implemented in accordance with the standards and requirements for approval of providers of continuing education in podiatric medicine through A joint provider agreement between Kent State University and Cardiovascular Innovations Foundation. Kent State University College of Podiatric Medicine is approved by the Council on Podiatric Medical Education as a provider of continuing education in podiatric medicine. Kent State University College of Podiatric Medicine has approved this activity for a maximum of 8.0 continuing education contact hours.

ACCREDITATION STATEMENT

R E G I S T E R A T :www.cvinnovations.org

Bio-engineered Tissue Skin Graft

July 27–28, 2018Grand Hyatt Hotel | Denver, CO

LIMB SALVAGE SYMPOSIUMJULY 27 – 28, 2018

FRIDAY, JULY 27EDUCATIONAL GOALS & OBJECTIVES After completing this module, the participating podiatric physician will be able to:

3:00 – 5:00

Clinical Correlation3:30 Case studies: Residency competition

In order to facilitate learning, this session will be interactive. Case presentations will vary from surgical to non-surgical management, common and bizarre pathologic diagnoses with respect to disorders that present with respect to limb salvage.

» Via a series of case presentations and abstracts involving diabetic foot infections, ulcers and chronic wound discuss and defend management strategies for the treatment thereof

SATURDAY, JULY 287:00 – 7:30 Sign-in and Welcome – Continental breakfast provided

7:30 – 8:00

Limb Salvage 2018: Introduction 7:30 Multidisciplinary approach

Jeff Shook, DPM 7:45 Current state of CLI diagnosis

Mehdi Shishehbor, DO

» Discuss the necessity and benefits for approaching limb salvage from a multidisciplinary approach and relate the efficacy of this model.

» Define the intricacies of hemodynamic evaluation in the critical limb ischemia patient

8:00 – 9:30

Infectious Disease8:00 Emergent diabetic foot infections

TBD8:15 Utilization of inflammatory markers for diabetic foot infections

Jeff Manway, DPM 8:30 MRI evaluation of the infected foot

Larry Osher, DPM8:45 Making an accurate diagnosis of osteomyelitis

TBD9:00 Local antibiotic therapy in the management of osteomyelitis

Allen Jacobs, DPM9:15 Osteomyelitis of the 1st metatarsophalangeal joint

Elliot Walters, MD

» Present an organized approach to evaluation and management principles of diabetic foot infection

» Describe the basic objective and subjective tools and advanced techniques in the diagnosis of infection

» Offer effective strategies for the emergent treatment of diabetic foot infections

» Elucidate current trends and recommendations for the diagnosis of osteomyelitis

» Debate the different approaches for the management of osteomyelitis

» Discuss approach to the treatment of osteomyelitis of 1sy MPJ and the ramification of such treatment.

» Illustrate the efficacy of both medical and surgical management of digital osteomyelitis.

» List MRI findings suggestive and consistent with soft tissue and bone infections of the infected foot and ankle

9:30 – 10:00 Break

10:00 – 12:00

Limb Salvage: Wound Care / Wound Healing / Wound Coverage

10:00 ESRD and lower extremity ulceration Allen Jacobs, DPM

10:10 Glucose control and the limb salvage patient Jeremy Christensen, DPM

10:20 Wound care ethics: when ethical and legal are not the same Allen Jacobs, DPM

10:30 Wound Biofilm: Current perspectives & strategies on biofilm disruption and treatment Brian Lepow, DPM

10:40 Update on biologics and wound care Brian Lepow, DPM

10:50 Grafix and the healing rate of DFU’s Georgeanne Botek, DPM

11:00 Medical Management of PAD Teresa Carmen, MD

11:10 Split thickness skin grafting forcoverage of diabetic wounds Elliot Walters, MD

11:20 Equinus and the limb salvage patient TBD

11:30 Effectiveness of clinic based vs OR based debridement Elliot Walters, MD

11:40 Is TMA the definitive resolution for forefoot ulceration Allen Jacobs, DPM

11:50 Reverse sural flap for wound coverage Kenneth Morgan, DPM

» Elucidate modalities for the non-surgical management and evaluation of peripheral artery disease

» Defend the importance of glucose » Enumerate factors which impede wound healing » List etiologies for the recidivism of wounds/ulcers with

respect to patient adherence » Discuss the indications and utility of advance wound care

products » Depict the “universal efficacy” of a transmetatarsal

amputation in the limb salvage patient » Describe simple and novel surgical approaches to address

the persistence or recurrence of wounds/ulcers » Illustrate ortoplastic techniques for wound coverage

problems in the limb salvage patient

12:00 – 1:00 Lunch

1:00 – 3:00

Limb Salvage: Charcot Neuroarthropathy 1:00 Charcot: Where are we now?

TBD1:15 Non-reconstructive operative management of Charcot

Jeff Shook, DPM1:30 Bone Healing in Charcot

Larry Osher, DPM 1:45 Pan foot arthrodesis

Jeff Manway, DPM2:00 Midfoot reconstruction with plantar plate

Kenneth Morgan, DPM2:15 Lesser tarsal approach: Medial Fusion / Lateral Arthroplasty

Jeff Shook, DPM2:30 Superconstructs for Charcot

Jeremy Christensen, DPM2:45 Technique and positioning for IM nails

Jeff Manway, DPM

» Recognize the important role of glucose control and the effects of uncontrolled hyperglycemia on limb salvage

» Elucidate the psychological ramifications of the diabetic/Charcot process and the effect on decision making process in regards to treatment

» Define the indications and procedures involved in the non-reconstructive surgical approach to Charcot deformity and its sequelae

» Differentiate between normal and diabetic bone healing and the effects on treatment protocols

» List the objective signs for the recognition of the early Charcot process in order to avoid end stage Charcot deformity.

» Elucidate surgical treatment protocols for the reconstruction of deformities related to Charcot neuroarthropathy

» Defend a variety of different fixation techniques implemented for Charcot reconstruction