The UCSF Center for Limb Preservation & Wound Care, led by vascular surgeon Michael S. Conte, M.D. and podiatric surgeon Alexander M. Reyzelman, D.P.M., the first of its kind in the Bay Area, pools the expertise of vascular surgeons, podiatrists, reconstructive microsurgeons, and other specialists to provide integrated, multidisciplinary, care for patients at high risk of foot and leg amputation, particularly diabetic patients.
The Center treats patients with foot ulceration, peripheral artery disease (PAD) and those at risk for developing these conditions. The Center also coordinates care with other UCSF specialists in infectious diseases, endocrinology, cardiology, orthopedics, rehabilitation, and physical therapy. Because foot ulcers are the most common pathway leading to amputation, the team is focused on their prevention, treatment, avoidance of recurrence, and return of patients to independent walking.
Diabetic Foot Ulcers
A non-healing diabetic foot ulcer adversely affects the patient's quality of life. When a complex long-term non-healing wound is left untreated or becomes unresponsive to treatment, an infection may result that may ultimately require amputation to prevent systemic infection throughout the body. The UCSF Center for Limb Preservation & Wound Care specializes in treating these non-healing wounds of the foot, ankle and leg with the goal of preserving the affected area.
Any non-healing ulcer or can quickly become a limb-threatening situation. Patients with circulation problems, such as peripheral arterial disease (PAD) or ischemia associated with diabetic small vessel disease, are especially susceptible to the risk of amputation because wounds lacking blood flow cannot heal on their own. In addition, nerve damage from diabetic peripheral neuropathy results in a loss of sensation to the extremities leading to the formation of open wounds. The lack of pain protection and inadequate stimulation of the immune system impacts an ulcer's ability to be heal. Any open wound can lead to infection of the tissue or osteomyelitis, infection of the bone.
Our Center is dedicated to the functional preservation of limbs. Our multidisciplinary team provides the skill, expertise, and advanced technology to assess each patient's situation and develop an individualized treatment plan.
State-of-the-Art Limb Preservation Techniques
The specialists at the UCSF Center for Limb Preservation & Wound Care provide state-of-the-art Advanced Limb Preservation techniques including:
- Minimally invasive vascular procedures such as balloon angioplasty and stenting
- Limb-sparing with advanced fixation
- Bone transplants and bone graft substitutes
- Bone growing proteins
- Tissue grafting
Treatment of Charcot Foot
The specialists on our medical staff are also experts at treating Charcot Foot, a condition affecting people with neuropathy in which the bones and joints in the foot become susceptible to break down because of nerve damage (neuropathy). Charcot Foot can lead to limb threatening deformities if untreated, which eventually may lead to amputation.
Treatments for Charcot Foot may include surgery or the use of external fixators. External fixation and the Ilizarov method are used to immobilize the leg and foot and help realign deformities. External fixation uses a scaffold-like device secured to the leg and foot to keep it from moving. The device holds the bones in place to facilitate healing.
Following successful treatment for Charcot Foot, many patients experience better mobility and fewer wound problems. The UCSF Center for Limb Preservation & Wound Care is one of a handful of centers in the area offering this complex and innovative approach to Charcot Foot.