In this episode of The PODdoctors podcast, Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, a fellowship-trained foot and ankle surgeon, discuss a surgical case of a gangrenous toe amputation in a patient with severe peripheral arterial disease and diabetes. The patient had dry gangrene and underwent vascular treatment to open up two vessels, but the tibialis anterior vessel remained blocked, leading to tissue death in the big toe. The doctors talk about the potential use of bone marrow aspirate concentrate injections to stimulate collateralization and neovascularization in patients with severe vascular disease.

QUOTES:

"The tibialis anterior vessel was the one that they were not able to open up. And that was his downfall because the tibialis anterior is the one that comes and perfuses the top half of your big toe. Kind of important when you have blood flow problems, you don't have blood flow coming in, you're losing that toe or whatever part of the body." -Dr. Damien Dauphinee

“Anytime we can get collateralization or new tributaries to grow into an area that is not getting enough blood flow, we can improve pain.” -Dr. Raafae Hussain

Top Takeaways:

• Considerations for patients with severe vascular disease
• Importance of incision placement and goal of restoring healthy blood flow

What You Will Learn:

• Gangrenous toe amputation case
• Bone marrow aspirate concentrate injections
• Potential use of BMAC for staving off major amputations

Resources:

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