Directed by Dr. David Armstrong and co-directed by Dr. Joseph Mills (Chief of Vascular Surgery), SALSA is based at the University Medical Center in Tucson, Arizona and provides a unique treatment paradigm whereby a patient can be rapidly assessed from both a podiatric and vascular standpoint upon initial presentation to the limb salvage clinic. This partnership between vascular and podiatric surgery (both in and out of the operating room) is affectionately referred to by Armstrong and Mills as the "toe and the flow," and as a consequence of this interdisciplinary model patients have access to rapid evaluation and treatment of both the vascular and podiatric sequellae from diabetes. Considering the significant morbidity and mortality associated with development of diabetic ulcerations and the subsequent amputations, providing patients with rapid access to high quality care can literally save their limbs and their lives.
I found my visit to SALSA to be an exhilarating and eye-opening experience on many levels. As a resident, it is always a great opportunity to work along side residents and fellows from other specialties –the interaction broadens everyone’s horizon—and allows for substantial give and take of information and techniques which will further characterize the type of physician and surgeon that each will become. During my time at SALSA, I had the opportunity to participate in several research projects as well being involved “in the trenches” of the day-to-day medical and surgical management of the SALSA patients. In this way, I had the opportunities to test and evaluate a variety of up-and-coming wound healing and surgical products, as well as learning new treatment modalities and techniques for patients with lower extremity ulcerations and potentially limb-threatening conditions.
At SALSA, there is tremendous opportunity for both students and residents, and I would encourage each of you with an interest in diabetes care, limb salvage, and research to seriously consider trying to spend some time in the “SALSA” bowl. Students have the opportunity to visit for one month as part of a clinical clerkship in their fourth year of training. During this clerkship, students will receive comprehensive introduction to vascular and podiatric medicine and surgery of the lower extremities and foot as well as a robust exposure to wound healing and tissue repair technique, and exposure to intraoperative treatment, and post operative care of reconstructive surgical patients (see below).
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...a great segway to a brand new eTalk from our very own Residency Insight Editor, John Steinberg, DPM. Read John's brief synopsis on the challenges of limb salvage surgery and then click on the 'Add to Topic' button to contribute to this discussion—taking place on the NEW PRESENT Diabetes right now. (Learn more about the NEW PRESENT Diabetes at the conclusion of this article.)
For incoming residents there is even greater opportunity, SALSA, and the University of Arizona, is now forming with the Phoenix VA Podiatric Surgery residency program. As such, residents from the Phoenix VA (under the direction of Dr. Frykberg) will have the opportunity to rotate with SALSA as part of their core training. They also get exposure to both medical and surgical management of complex limb salvage patients, as well as exposure to a variety of advanced wound healing techniques—in addition to having the opportunity to participate in on-going research. You may know that Armstrong and Lavery have podiatry's first major NIH funding and—that is just the beginning of what's going on at SALSA.
For those of you who find yourself in the position that I found myself (no longer a student, and not a resident in the program), I would still encourage you to consider coming out to Arizona for your own taste of SALSA. Many residency programs allow for elective rotations, or you can do as I did, and use some vacation time. Regardless, the good people at SALSA will make every effort to help you achieve the Toe and Flow experience. To work with two of the world leaders in their respective disciplines at such close quarters at the same time is, quite literally, unprecedented in our profession.
It is difficult to truly characterize my full SALSA experience in such a short piece. However, I am a strong believer that you have the opportunity to learn from everything that you do as a resident –sometimes you are learning a surgical technique, or at other times you may be learning how to deal with a difficult, frustrating patient –and I believe that the best way to describe my time in Arizona with Dr. Armstrong, Dr. Mills, and the rest of the SALSA team is to say that I was ALWAYS learning. There was no pause, no lull. Each day provided a multitude of opportunities to strengthen my knowledge base and surgical skill-set, as well as opportunity to be an advocate for podiatric surgery –to help members of other specialties come to a greater understanding of what it is that we, as podiatric surgeons, do.
While the learning process certainly does not end at our residency graduation, our time spent in residency offers each of us the very best opportunity to learn everything that we can—for this will determine the type of physician we will become. It is vital that you seek out every opportunity available to you to broaden your horizons. Knowledge is like water, and you must thirst for it–be parched! Come visit SALSA, and you’ll find yourself drinking from a fire-hose.
For those of you interested in obtaining more information regarding the great opportunities at SALSA, please contact:
Sandy Perry, SALSA Program Manager
University of Arizona College of Medicine
1501 N. Campbell Avenue, Room 4325
Tucson AZ 85724-5072
United States of America
1 (520) 626-1349
....also, please check out the new PRESENT Diabetes. It's NEW VERSION is quite AMAZING. They really have brought Facebook and LinkedIn networking to diabetes care professionals. After you fill out your brief profile, they show you all of the other members with training, interests and experiences similar to your own. You can then connect with them with a simple click. You can develep a very powerful network in a short time, and it's not only podiatrists. They already have over 57,000 physician, nursing and dietitian members. Go to https://presentdiabetes.com and make sure to add me to your colleague list!
As always, we love hearing from YOU. Please contact us, with any questions or for further information. I look forward to hearing from you!
