Cert results

[GreenHousePub]

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I wonder if you guys are arguing different things. There’s a difference between timing on when to operate on elective Charcot recon on a stable foot that has no wound but is preulcerative and a bit painful vs infected acute Charcot

Probably are, but that takes the fun out of an Internet argument

 

[Bored Snorlax]

I wonder if you guys are arguing different things. There’s a difference between timing on when to operate on elective Charcot recon on a stable foot that has no wound but is preulcerative and a bit painful vs infected acute Charcot

Charcot recon? More like reconstructing what was said through an emoji6 minefield

 

[Adam Smasher]

It’s not dicey.

Everyone in the room knows these patients are gonna lose their leg if they’re not dealt with surgically for offloading or reconstructive surgery. But people like to hide behind an A1c.

If this is how you practice then do not do limb salvage surgery because you’re doing a grave disservice to the patient .

This is what bugs me about podiatry because we have so many different podiatrist. Who say they do Wound Care and limb salvage, but it really is just debridement and skin substitutes and no surgery because they are too afraid to operate if the A1C is not perfect.

Learn MIS

Not sure if this is directed at me personally or just a broadside against more conservative DPMs. But it is a fact that there is increased risk with high HgA1c. So yes, it's dicey. That doesn't mean never do it, you just weigh risks and benefits.

I like doing MIS bumpectomies and tendon releases because I just need the patient to heal a 5mm skin portal, and nothing needs to fuse no matter how much they ignore my instructions. I don't do your Charcot heroics; I send those pts to a certain elite podiatry residency in my metro, where the DPMs there have published on this and some were formerly on the ABFAS board. They have turned away patients of mine because of...high HgA1c.

PLUS, even if I wanted to, the anesthesia dept at my hospitals/surgery center won't allow me to schedule an elective case if the HgA1c is too high.

 

[air bud]

Not sure if this is directed at me personally or just a broadside against more conservative DPMs. But it is a fact that there is increased risk with high HgA1c. So yes, it's dicey. That doesn't mean never do it, you just weigh risks and benefits.

I like doing MIS bumpectomies and tendon releases because I just need the patient to heal a 5mm skin portal, and nothing needs to fuse no matter how much they ignore my instructions. I don't do your Charcot heroics; I send those pts to a certain elite podiatry residency in my metro, where the DPMs there have published on this and some were formerly on the ABFAS board. They have turned away patients of mine because of...high HgA1c.

PLUS, even if I wanted to, the anesthesia dept at my hospitals/surgery center won't allow me to schedule an elective case if the HgA1c is too high.

Bro, 5mm is MIS? Check the meme thread

 

[Adam Smasher]

Bro, 5mm is MIS? Check the meme thread

Elaborate, please

 

[Bored Snorlax]

Elaborate, please

Bro, 5mm is MIS? Check the meme thread

Maximally invasive surgery vs Minimally invasive surgery 😏

 

[MicroPod]

I used to joke in residency that we did MIS… Maximally Invasive Surgery

 

[air bud]

I used to joke in residency that we did MIS… Maximally Invasive Surgery

My director used to say "small incisions small brains"