Considering Function When Evaluating Threatened Limbs

At the Southwestern Academic Limb Salvage Alliance (SALSA), we have long nicknamed our program “Toe and Flow,” highlighting the central nature of podiatric and vascular surgery to the interdisciplinary team. However, this may be inadequate to describe what we actually do. “Toe, Flow and Go” might better describe what we are doing in clinic, on the hospital wards, and on our research team.

As we get more and more adept at technique and technology for limb preservation and limb salvage, what we’re faced with often is a much more fundamental question, which is just because we can do something to preserve a limb, should we? I know people have discussed and talked about this over the years but we are really doing our best to live at it SALSA and USC.

To that end, we are presently working to modify the limb threat Wound, Ischemia and foot Infection (WIfI) score to include a measure of function. This function category would entail asking simple questions. Is the patient able to get out of bed? Is the patient able to transfer? Is the patient able to walk around the home? Is the patient able to walk in the community?

These are simple questions that may lead to a whole lot more improvements in how we can customize and provide precise care for our patients.