David G. Armstrong

Last updated
David G. Armstrong
Armstrong Headshot USC 2018.main.jpg
Born (1969-02-18) February 18, 1969 (age 55)
Santa Maria, California, U.S.
Occupation Physician, Researcher
Notable worksUniversity of Texas Wound Classification System, [1] the Instant Total Contact Cast, [2] the Diabetic Foot Surgery Classification System, [3] the Team Approach to Amputation Prevention and Comprehensive Diabetic Foot Assessment Guidelines [4] The concept of "the diabetic foot in remission" in an effort to maximize ulcer-free, hospital-free and activity-rich days. [5]

David G. Armstrong (born February 18, 1969) is an American podiatric surgeon and researcher most widely known for his work in amputation prevention, the diabetic foot, and wound healing. He and his frequent collaborators, Lawrence A. Lavery and Andrew J.M. Boulton, have together produced many key works in the taxonomy, classification and treatment of the diabetic foot. He is Professor of Surgery with Tenure and director of the Southwestern Academic Limb Salvage Alliance (SALSA) [6] at the Keck School of Medicine of the University of Southern California and has produced more than 700 peer reviewed manuscripts and more than 115 book chapters.

Contents

Early life and education

Armstrong was raised with his younger brother, the late Darrin B. Armstrong, a former schoolteacher, in Santa Maria, California. His father, Leo N. Armstrong, was a noted podiatrist in California and figures into many of Armstrong's anecdotes, lectures, and writings. [7] As a child, he traveled worldwide with his family and a core group of physicians, mostly podiatrists. This influenced his later career as an ambassador for diabetic foot care and Podiatry.

After attending the Dunn School in Los Olivos, California, Armstrong attended Occidental College in Los Angeles and later the California College of Podiatric Medicine, where he graduated with honors. [8] It was during his college years that he met his future wife, Tania C. Armstrong, on a family trip to Egypt. It is in honor of this that their first child Alexandria A. Armstrong, later received her name.

Armstrong performed his residency at the Kern Hospital for Special Surgery in Detroit, where much of his interest in the diabetic foot emerged. [9] Additionally, it was where he became aware of the works of two influential clinician-researchers, Andrew JM Boulton, of the University of Manchester, and Paul Wilson Brand, of the Hansen's Disease Center in Carville, Louisiana.

Following his surgical training in Detroit, Armstrong was prepared to return to Santa Maria to work in his father's practice. Days before graduation, he was handed a letter inviting him to apply for a fellowship at the University of Texas Health Science Center at San Antonio. His visit and subsequent acceptance into the program brought him into close proximity of the next two important members of his development, Lawrence A. Lavery, then a junior faculty member, and Professor Lawrence B. Harkless, Armstrong's chief.

Armstrong's relationship with Lavery was, by all accounts, strong from the beginning. Lavery and Armstrong wrote an astonishing 28 manuscripts in the first nine months of his fellowship. Many of those became important foundational works in epidemiology, classification and treatment of the diabetic foot. Since that time, Armstrong and Lavery, nicknamed “the Lennon and McCartney of the Diabetic Foot”, have written more than 150 manuscripts, books and book chapters including the American Diabetes Association's Clinical Care of the Diabetic Foot ( ISBN   1-58040-223-2), now in its fourth edition. The two researchers credit Harkless for providing the environment for this to occur, as there had previously never existed a full-time academic podiatry faculty of this kind in an American medical school.

Following Lavery's departure to develop a private nationwide diabetic foot program, Armstrong remained prolific, but soon grew interested in new challenges.

Armstrong subsequently received an invitation from Dr. Brent P. Nixon to start his own research service at the Southern Arizona VA Healthcare System in Tucson Arizona. This program, is responsible for producing many key works in the area of diabetes care and amputation prevention. Some of the most notable were the ability to accurately monitor activity and the refinement of offloading the diabetic foot wound. Additionally, Armstrong began a close transatlantic working relationship with Professor Andrew JM Boulton in Manchester. This mentorship led to a period of intense activity and a PhD and MD from the University of Manchester College of Medicine as well as a Master of Science in Tissue Repair of Wound Healing at Professor Keith Harding's University of Wales College of Medicine.

It was also during this time that Armstrong was reacquainted with George Andros, a prominent vascular surgeon. This renewed friendship led to the development of the Diabetic Foot Global Conference, (DFCon). This meeting, the largest annual diabetic foot gathering in the world, hosts delegates from 50 countries and all 50 U.S. states in more than 10 medical and surgical disciplines.

During his cross-country move from Tucson to Chicago, Armstrong's father and greatest influence died. This led to an increasing determination by Armstrong to further advance the specialty that had literally nurtured him.

Following his tour in Tucson, Armstrong accepted an offer to serve as Professor of Surgery and Associate Dean at Scholl College of Podiatric Medicine at Rosalind Franklin University of Medicine and Science. He founded the Center for Lower Extremity Ambulatory Research (CLEAR), which rapidly became the most productive podiatric research group in the world. This program produced or recruited several key members of the field including Stephanie C. Wu, James Wrobel, Lee C. Rogers, Nicholas J. Bevilacqua, Bijan Najafi, Manish Bharara and Vickie Driver. This group produced many key works in the literature, becoming amongst the first podiatrists to be published in JAMA and the Lancet. [10] [11] Armstrong also became the first tenured podiatrist in the history of Rosalind Franklin University and the Scholl College.

Armstrong, responding to his love of the Desert Southwest, the rampant diabetic epidemic there, and his long-standing friendship with renowned vascular surgeon Professor Joseph Mills, was recruited again to Tucson and the University of Arizona. It was there he founded, with Mills, the Southern Arizona Limb Salvage Alliance (SALSA). This program serves as a model for interdisciplinary care, worldwide. [12] It was also here that Armstrong and Mills coined the term the “Toe and Flow” team. This implies the “irreducible minimum” requirements for a foot specialist and a vascular specialist in order to run a successful amputation prevention service. [13] Working side by side in the same clinic and surgical service led to the development of the Society for Vascular Surgery's Wound, Ischemia and Foot Infection (WIfI) system, which has now been widely validated. [14] This has helped many units develop a "common language" to describe the risk of limb threat.

As with Rosalind Franklin University, at the University of Arizona, he became the first ever podiatrist to be appointed as a tenured professor. It was also here that his interests in a merger between consumer electronics and health care began to flourish. He and Mills became the first surgeons to document a real-time surgical consultation via iPhone's FaceTime [15] with their colleague (and Armstrong's former fellow), Lee C. Rogers. Additional firsts of this kind include the first documented use of Google Glass in the operating room, [16] the first use of Apple Vision Pro in the operating room, [17] and the first home-based Whatsapp driven application of medicinal maggots during the COVID pandemic. [18] The SALSA vision for merging man and machine was further outlined in his UA College of Science Lecture "Repair, Regeneration and Replacement Revisited".

In 2012, Armstrong recruited Dr. Bijan Najafi from Rosalind Franklin University to help lead a mobile health program to, as he put it, "measure how we all move through and interact with our world". Dr. Najafi, previously at Rosalind Franklin University and Harvard, embarked on development of a broad-based program called the Interdisciplinary Consortium on Advanced Motion Performance (iCAMP). [19] In 2017, Armstrong was honored as a University Distinguished Outreach Professor of Surgery- the first ever in the history of the University of Arizona's Department of Surgery. [20]

After the better part of a decade at the University of Arizona, Dr. Armstrong was recruited back to his home state of California to, in his words, "help develop a program for amputation prevention spanning Southern California and beyond." The program, centered in the Keck School of Medicine of the University Southern California's Department of Surgery [21] but spanning a characteristically wide interdisciplinary remit, continued the well-known SALSA acronym, was now the Southwestern Academic Limb Salvage Alliance. The goal was to continue to drive care to better "measure and manage how people move through their world."

As part of this program, he has made efforts to develop interdisciplinary links between hospitals and clinics within the Los Angeles County Department of Health System. Most specifically, his efforts at the world-renowned National Rehabilitation Center at Rancho Los Amigos have led to the program having Diabetic Limb Preservation taken on as a focused area of clinical and research excellence. This led to the first-ever county-wide limb preservation working group in the United States. [22]

In 2020, Armstrong and his frequent collaborators Joseph Mills (now of Baylor College of Medicine) and Michael Conte of UCSF worked to develop an interdisciplinary society with the goal of advancing science and clinical care in association with limb preservation and to develop the next generation of clinicians, scientists and clinician scientists in this field. This society took the "Alpine" acronym ALPS and symbolized the difficult task of interdisciplinary limb preservation. That task—compared by Armstrong and Mills with the Greek mythical figure Sisyphus—could be made easier if there were more than one person rolling a figurative boulder up a mountain. [23] The American Limb Preservation Society was created on October 9, 2020 during the DFCon 2020 symposium—nicknamed DFCONline because of its peri-pandemic virtual format. The founding leadership team of ALPS included the aforementioned Armstrong, Mills and Conte along with Stephanie Wu, Dean of the Scholl College of Podiatric Medicine at Rosalind Franklin University as Vice President. Ryan Crews of Scholl and Brian Lepow of Baylor College of Medicine served as founding Secretary and Treasurer, respectively.

The Comparison of Diabetic Foot Complications to Another Chronic Disease-- Cancer-- and Movement Toward the Diabetic Foot in Remission

Armstrong has been widely credited with popularizing the comparison of the diabetic foot to cancer. In collecting data from mortality, [24] [25] cost, [26] and recurrence. [27] [28] [29] Specifically, regarding remission, Armstrong and colleagues have made the case that the goal should not be to eliminate every single event, but rather to make each event as uncomplicated as possible. This popularized the idea of diabetic foot "ulcer-free days" "hospital-free days" and "activity-rich days". [30] This also paved the way for remote patient monitoring (RPM) to become more popular in care in this and other areas. This was also further illustrated in manuscripts in New England Journal of Medicine, [31] Circulation, [32] and the Journal of the American Medical Association (JAMA). [33]

Recognition and awards

During the course of his career, Armstrong has been acknowledged with awards by numerous organizations. In response to his hundreds of lectures in more than 40 nations, worldwide, Armstrong was selected as one of the first six International Wound Care Ambassadors. He was honored with the inaugural Georgetown Distinguished Award for Diabetic Limb Salvage. [34] [35] In 2010, he was the youngest ever recipient of the Roger Pecoraro Award [36] and Lectureship from the American Diabetes Association, widely viewed as a lifetime achievement award in the field of the diabetic foot. That same year, he was also named the 2010 Honorary Fellow of the American College of Certified Wound Specialists as well as the inaugural recipient of the William S. Baer Award for Advances in Biosurgery/Biotherapy by the International Conference on Biotherapy. He was the first podiatric surgeon to become a member of the Society for Vascular Surgery and the first American podiatric surgeon to be named fellow of the Royal College of Physicians and Surgeons, Glasgow. [37] He frequently offers that these awards are more "recognitions of the importance of the problem" and of "the acknowledgement of the occupation in the care of people at risk." Armstrong is past Chair of Scientific Sessions for the ADA's Foot Care Council, and a past member of the National Board of Directors of the American Diabetes Association. He sits on the Infectious Diseases Society of America’s Diabetic Foot Infection Advisory Committee. In 2011, he was appointed Chair of the World Diabetic Foot Commission of the FIP, representing clinicians from more than 30 nations. Dr. Armstrong has also been conferred the title of Visiting Professor at the University of Manchester College of Medicine, the University of Cardiff College of Medicine, the Raine Visiting Professor (first to be named twice) at University of Western Australia, [38] University of Cincinnati during its 200th anniversary [39] and the Complutense University of Madrid.

In 2023, Armstrong was honored with the Karel Bakker Limb Preservation Award at the International Symposium on the Diabetic Foot in The Hague, Netherlands for a lifetime of achievement in limb preservation. [40] Also in 2023, Armstrong received the Distinguished Investigator Award from the Association for Clinical and Translational Science (ACTS) for his innovative research and education leadership that has had a major impact on clinical and translational science, specifically in the realm of implementation and dissemination of translational solutions to illness and clinical problems. [41] He is the leading researcher in the diabetic foot and wound healing as measured by h-index [42] and impact by bibliometric studies and expertscape. [43] [44] [45]

In 2006, Armstrong was awarded the Father of the Year Award by the National Father's Day Council and the Chicago Area American Diabetes Association. [46] [47]

Personal life

He lives in Los Angeles with his wife Tania. They have three daughters. Alexandria is now a third generation podiatric surgeon at the University of Texas Health Science Center, San Antonio. Natalie, a Fulbright alumna (Greenland, 2021), now serves at the National Academies of Science, Engineering and Medicine. Nina, graduated from Georgetown University in 2023 with a Bachelors and in 2024 with a Masters in Russian and Political Science.

Related Research Articles

<span class="mw-page-title-main">Amputation</span> Medical procedure that removes a part of the body

Amputation is the removal of a limb by trauma, medical illness, or surgery. As a surgical measure, it is used to control pain or a disease process in the affected limb, such as malignancy or gangrene. In some cases, it is carried out on individuals as a preventive surgery for such problems. A special case is that of congenital amputation, a congenital disorder, where fetal limbs have been cut off by constrictive bands. In some countries, judicial amputation is currently used to punish people who commit crimes. Amputation has also been used as a tactic in war and acts of terrorism; it may also occur as a war injury. In some cultures and religions, minor amputations or mutilations are considered a ritual accomplishment. When done by a person, the person executing the amputation is an amputator. The oldest evidence of this practice comes from a skeleton found buried in Liang Tebo cave, East Kalimantan, Indonesian Borneo dating back to at least 31,000 years ago, where it was done when the amputee was a young child.

<span class="mw-page-title-main">Gangrene</span> Type of tissue death by infection or lack of blood supply

Gangrene is a type of tissue death caused by a lack of blood supply. Symptoms may include a change in skin color to red or black, numbness, swelling, pain, skin breakdown, and coolness. The feet and hands are most commonly affected. If the gangrene is caused by an infectious agent, it may present with a fever or sepsis.

<span class="mw-page-title-main">Podiatrist</span> Medical professional devoted to the medical treatment of disorders of the foot

A podiatrist is a medical professional devoted to the treatment of disorders of the foot, ankle, and related structures of the leg. The term originated in North America but has now become the accepted term in the English-speaking world for all practitioners of podiatric medicine. The word chiropodist was previously used in the United States, but it is now regarded as antiquated.

<span class="mw-page-title-main">Peripheral artery disease</span> Abnormal narrowing of arteries other than those that supply the heart or brain

Peripheral artery disease (PAD) is a vascular disorder that causes abnormal narrowing of arteries other than those that supply the heart or brain. PAD can happen in any blood vessel, but it is more common in the legs than the arms.

Diabetic neuropathy includes various types of nerve damage associated with diabetes mellitus. The most common form, diabetic peripheral neuropathy, affects 30% of all diabetic patients. Symptoms depend on the site of nerve damage and can include motor changes such as weakness; sensory symptoms such as numbness, tingling, or pain; or autonomic changes such as urinary symptoms. These changes are thought to result from a microvascular injury involving small blood vessels that supply nerves. Relatively common conditions which may be associated with diabetic neuropathy include distal symmetric polyneuropathy; third, fourth, or sixth cranial nerve palsy; mononeuropathy; mononeuropathy multiplex; diabetic amyotrophy; and autonomic neuropathy.

<span class="mw-page-title-main">Podiatry</span> Medicine branch focusing on the human lower extremities

Podiatry, or podiatric medicine and surgery, is a branch of medicine devoted to the study, diagnosis, and treatment of disorders of the foot, ankle and lower limb. The healthcare professional is known as a podiatrist. The US podiatric medical school curriculum includes lower extremity anatomy, general human anatomy, physiology, general medicine, physical assessment, biochemistry, neurobiology, pathophysiology, genetics and embryology, microbiology, histology, pharmacology, women's health, physical rehabilitation, sports medicine, research, ethics and jurisprudence, biomechanics, general principles of orthopedic surgery, plastic surgery, and foot and ankle surgery.

In medical and surgical therapy, revascularization is the restoration of perfusion to a body part or organ that has had ischemia. It is typically accomplished by surgical means. Vascular bypass and angioplasty are the two primary means of revascularization.

Neuropathic arthropathy refers to a progressive fragmentation of bones and joints in the presence of neuropathy. It can occur in any joint where denervation is present, although it most frequently presents in the foot and ankle. It follows an episodic pattern of early inflammation followed by periarticular destruction, bony coalescence, and finally bony remodeling. This can lead to considerable deformity and morbidity, including limb instability, ulceration, infection, and amputation.

<span class="mw-page-title-main">Maggot therapy</span> Wound care by maggot therapy

Maggot therapy is a type of biotherapy involving the introduction of live, disinfected maggots into non-healing skin and soft-tissue wounds of a human or other animal for the purpose of cleaning out the necrotic (dead) tissue within a wound (debridement), and disinfection.

<span class="mw-page-title-main">Venous ulcer</span> Skin sore sustained by a vasculatory disease

Venous ulcer is defined by the American Venous Forum as "a full-thickness defect of skin, most frequently in the ankle region, that fails to heal spontaneously and is sustained by chronic venous disease, based on venous duplex ultrasound testing." Venous ulcers are wounds that are thought to occur due to improper functioning of venous valves, usually of the legs. They are an important cause of chronic wounds, affecting 1% of the population. Venous ulcers develop mostly along the medial distal leg, and can be painful with negative effects on quality of life.

A chronic wound is a wound that does not heal in an orderly set of stages and in a predictable amount of time the way most wounds do; wounds that do not heal within three months are often considered chronic. Chronic wounds seem to be detained in one or more of the phases of wound healing. For example, chronic wounds often remain in the inflammatory stage for too long. To overcome that stage and jump-start the healing process, a number of factors need to be addressed such as bacterial burden, necrotic tissue, and moisture balance of the whole wound. In acute wounds, there is a precise balance between production and degradation of molecules such as collagen; in chronic wounds this balance is lost and degradation plays too large a role.

<span class="mw-page-title-main">Diabetic shoe</span> Shoes intended to reduce the risk of skin breakdown in diabetics

Diabetic shoes are specially designed shoes, or shoe inserts, intended to reduce the risk of skin breakdown in diabetics with existing foot disease and relieve pressure to prevent diabetic foot ulcers.

<span class="mw-page-title-main">Arterial insufficiency ulcer</span> Skin sore on the hands and feet due to insufficient blood flow

Arterial insufficiency ulcers are mostly located on the lateral surface of the ankle or the distal digits. They are commonly caused by peripheral artery disease (PAD).

<span class="mw-page-title-main">Lawrence B. Harkless</span>

Lawrence B. Harkless is and American physician who is founding Dean and Professor of Podiatric Medicine and Surgery at the College of Podiatric Medicine, Western University of Health Sciences, Pomona, California, United States. He is a retired Professor, Department of Orthopaedics and former Louis T. Bogy Professor of Podiatric Medicine and Surgery at the University of Texas Health Science Center at San Antonio (UTHSCSA).

<span class="mw-page-title-main">Diabetic foot</span> Medical condition

A diabetic foot disease is any condition that results directly from peripheral artery disease (PAD) or sensory neuropathy affecting the feet of people living with diabetes. Diabetic foot conditions can be acute or chronic complications of diabetes. Presence of several characteristic diabetic foot pathologies such as infection, diabetic foot ulcer and neuropathic osteoarthropathy is called diabetic foot syndrome. The resulting bone deformity is known as Charcot foot.

<span class="mw-page-title-main">Lee Rogers (podiatrist)</span> American podiatrist (born 1978)

Lee Christopher Rogers is an American podiatrist from San Antonio, Texas. He is most known for his work preventing amputations in diabetes and treating Charcot foot and he has helped define the qualifications of doctors of podiatric medicine and the privileging process for hospitals and surgery. He is the vice president of the International Federation of Podiatrists and he served as the president of the American Board of Podiatric Medicine (2021-2023). He was the Democratic nominee for US Congress in California's 25th district in 2012, and lost in California's top-two primary in June 2014. Rogers is also known as a film producer.

<span class="mw-page-title-main">Diabetic foot ulcer</span> Medical condition

Diabetic foot ulcer is a breakdown of the skin and sometimes deeper tissues of the foot that leads to sore formation. It may occur due to a variety of mechanisms. It is thought to occur due to abnormal pressure or mechanical stress chronically applied to the foot, usually with concomitant predisposing conditions such as peripheral sensory neuropathy, peripheral motor neuropathy, autonomic neuropathy or peripheral arterial disease. It is a major complication of diabetes mellitus, and it is a type of diabetic foot disease. Secondary complications to the ulcer, such as infection of the skin or subcutaneous tissue, bone infection, gangrene or sepsis are possible, often leading to amputation.

Chronic limb threatening ischemia (CLTI), also known as critical limb ischemia (CLI), is an advanced stage of peripheral artery disease (PAD). It is defined as ischemic rest pain, arterial insufficiency ulcers, and gangrene. The latter two conditions are jointly referred to as tissue loss, reflecting the development of surface damage to the limb tissue due to the most severe stage of ischemia. Compared to the other manifestation of PAD, intermittent claudication, CLI has a negative prognosis within a year after the initial diagnosis, with 1-year amputation rates of approximately 12% and mortality of 50% at 5 years and 70% at 10 years.

Total contact casting (TCC) is a specially designed cast designed to take weight off of the foot (off-loading) in patients with diabetic foot ulcers (DFUs). Reducing pressure on the wound by taking weight off the foot has proven to be very effective in DFU treatment. DFUs are a major factor leading to lower leg amputations among the diabetic population in the US with 85% of amputations in diabetics being preceded by a DFU. Furthermore, the five-year post-amputation mortality rate among diabetics is estimated at 45% for those with neuropathic DFUs.

<span class="mw-page-title-main">Diabetic foot infection</span> Medical condition

Diabetic foot infection is any infection of the foot in a diabetic person. The most frequent cause of hospitalization for diabetic patients is due to foot infections. Symptoms may include pus from a wound, redness, swelling, pain, warmth, tachycardia, or tachypnea. Complications can include infection of the bone, tissue death, amputation, or sepsis. They are common and occur equally frequently in males and females. Older people are more commonly affected.

References

  1. ↑ Armstrong DG, Lavery LA, Harkless LB (May 1998). "Validation of a diabetic wound classification system. The contribution of depth, infection, and ischemia to risk of amputation" . Diabetes Care. 21 (5): 855–9. doi:10.2337/diacare.21.5.855. PMID   9589255. S2CID   29264040.
  2. ↑ Armstrong DG, Lavery LA, Wu S, Boulton AJ (March 2005). "Evaluation of removable and irremovable cast walkers in the healing of diabetic foot wounds: a randomized controlled trial". Diabetes Care. 28 (3): 551–4. doi: 10.2337/diacare.28.3.551 . PMID   15735186.
  3. ↑ Armstrong DG, Lavery LA, Frykberg RG, Wu SC, Boulton AJ (September 2006). "Validation of a diabetic foot surgery classification". International Wound Journal. 3 (3): 240–6. doi:10.1111/j.1742-481X.2006.00236.x. PMC   7951747 . PMID   16984580. S2CID   43131393.
  4. ↑ Boulton AJ, Armstrong DG, Albert SF, et al. (August 2008). "Comprehensive foot examination and risk assessment: a report of the task force of the foot care interest group of the American Diabetes Association, with endorsement by the American Association of Clinical Endocrinologists". Diabetes Care. 31 (8): 1679–85. doi:10.2337/dc08-9021. PMC   2494620 . PMID   18663232.
  5. ↑ Khan, T; Armstrong, DG (1 April 2018). "Ulcer-free, hospital-free and activity-rich days: three key metrics for the diabetic foot in remission". Journal of Wound Care. 27 (Sup4): S3–S4. doi: 10.12968/jowc.2018.27.Sup4.S3 . PMID   29641340.
  6. ↑ "Arizona Public Media | Video Shorts | Limb Salvage". Ondemand.azpm.org. 2009-02-11. Retrieved 2010-07-26.
  7. ↑ "Treating the absence of pain while keeping people moving: worth a life’s work: An Interview with David G. Armstrong", Diabetic Management, 3:1-5, 2013
  8. ↑ "Doctor of Podiatric Medicine | Samuel Merritt University".
  9. ↑ "Diabetic Foot". Archived from the original on 2011-07-10. Retrieved 2010-08-24.
  10. ↑ Lipsky BA, Armstrong DG, Citron DM, Tice AD, Morgenstern DE, Abramson MA (November 2005). "Ertapenem versus piperacillin/tazobactam for diabetic foot infections (SIDESTEP): prospective, randomised, controlled, double-blinded, multicentre trial". Lancet. 366 (9498): 1695–703. doi:10.1016/S0140-6736(05)67694-5. PMID   16291062. S2CID   11927488.
  11. ↑ Armstrong, David G.; Lavery, Lawrence A.; Diabetic Foot Study Consortium (2005-11-12). "Negative pressure wound therapy after partial diabetic foot amputation: a multicentre, randomised controlled trial". Lancet. 366 (9498): 1704–1710. doi:10.1016/S0140-6736(05)67695-7. ISSN   1474-547X. PMID   16291063. S2CID   23589067.
  12. ↑ "Taking a team approach to diabetic limb salvage | Lower Extremity Review Magazine". 7 March 2012.
  13. ↑ Armstrong DG, Bharara M, White M, Lepow B, Bhatnagar S, Fisher T, Kimbriel HR, Walters J, Goshima KR, Hughes J, Mills JL (2012). "The impact and outcomes of establishing an integrated interdisciplinary surgical team to care for the diabetic foot". Diabetes Metab. Res. Rev. 28 (6): 514–8. doi:10.1002/dmrr.2299. PMID   22431496. S2CID   46294196.
  14. ↑ Mills Jl, Sr; Conte, M. S.; Armstrong, D. G.; Pomposelli, F. B.; Schanzer, A.; Sidawy, A. N.; Andros, G.; Society for Vascular Surgery Lower Extremity Guidelines Committee (2014). "The Society for Vascular Surgery Lower Extremity Threatened Limb Classification System: Risk stratification based on wound, ischemia, and foot infection (WIfI)". Journal of Vascular Surgery. 59 (1): 220–34.e1–2. doi: 10.1016/j.jvs.2013.08.003 . PMID   24126108.
  15. ↑ Armstrong DG, Giovinco N, Mills JL, Rogers LC (2011). "FaceTime for Physicians: Using Real Time Mobile Phone-Based Videoconferencing to Augment Diagnosis and Care in Telemedicine". ePlasty. 11: e23. PMC   3087505 . PMID   21559249.
  16. ↑ Armstrong, David G.; Rankin, Timothy M.; Giovinco, Nicholas A.; Mills, Joseph L.; Matsuoka, Yoky (September 2014). "A Heads-Up Display for Diabetic Limb Salvage Surgery: A View Through the Google Looking Glass". Journal of Diabetes Science and Technology. 8 (5): 951–956. doi:10.1177/1932296814535561. ISSN   1932-2968. PMC   4455368 . PMID   24876445.
  17. ↑ Armstrong, David G.; Bazikian, Sebouh; Armstrong, Alexandria A.; Clerici, Giacomo; Casini, Andrea; Pillai, Anand (2024-03-04). "An Augmented Vision of Our Medical and Surgical Future, Today?" . Journal of Diabetes Science and Technology. 18 (4): 968–973. doi:10.1177/19322968241236458. ISSN   1932-2968. PMID   38439541.
  18. ↑ Armstrong, David G.; Rowe, Vincent L.; D'Huyvetter, Karen; Sherman, Ronald A. (October 2020). "Telehealth-guided home-based maggot debridement therapy for chronic complex wounds: Peri- and post-pandemic potential". International Wound Journal. 17 (5): 1490–1495. doi:10.1111/iwj.13425. ISSN   1742-481X. PMC   7948734 . PMID   32558362.
  19. ↑ "Interdisciplinary Consortium on Advanced Motion Performance (ICAMP) | Department of Surgery". surgery.arizona.edu. Archived from the original on 6 January 2013. Retrieved 12 January 2022.
  20. ↑ "SALSA's Armstrong Named University of Arizona Distinguished Outreach Professor @UAMedTucson". 18 March 2017.
  21. ↑ "Surgery". Surgery. Retrieved 2023-06-22.
  22. ↑ "Health Services Forms New Limb-Preservation Workgroup @WeAreLAHealth @HarborUCLA_VS @RanchoRehab @LACUSCMedCenter @KeckSchool_USC @USC #ActAgainstAmputation @ALPSLimb - DF Blog". diabeticfootonline.com. 2022-10-02. Retrieved 2023-06-22.
  23. ↑ Mills Jl, Sr; Armstrong, D. G.; Andros, G. (2010). "Rescuing Sisyphus: The team approach to amputation prevention". Journal of Vascular Surgery. 52 (3 Suppl): 1S–2S. doi: 10.1016/j.jvs.2010.06.001 . PMID   20804926.
  24. ↑ Armstrong, DG; Wrobel, J; Robbins, JM (December 2007). "Guest Editorial: are diabetes-related wounds and amputations worse than cancer?". International Wound Journal. 4 (4): 286–7. doi: 10.1111/j.1742-481X.2007.00392.x . PMID   18154621. S2CID   38444068.
  25. ↑ Armstrong, DG; Boulton, AJM; Bus, SA (15 June 2017). "Diabetic Foot Ulcers and Their Recurrence". The New England Journal of Medicine. 376 (24): 2367–2375. doi:10.1056/NEJMra1615439. PMID   28614678. S2CID   205117844.
  26. ↑ Barshes, NR; Sigireddi, M; Wrobel, JS; Mahankali, A; Robbins, JM; Kougias, P; Armstrong, DG (10 October 2013). "The system of care for the diabetic foot: objectives, outcomes, and opportunities". Diabetic Foot & Ankle. 4: 21847. doi:10.3402/dfa.v4i0.21847. PMC   3796020 . PMID   24130936.
  27. ↑ Armstrong, DG; Mills, JL (2013). "Toward a change in syntax in diabetic foot care: prevention equals remission". Journal of the American Podiatric Medical Association. 103 (2): 161–2. doi:10.7547/1030161. PMID   23536510.
  28. ↑ Armstrong, D. G.; Boulton AJM; Bus, S. A. (2017). "Diabetic Foot Ulcers and Their Recurrence". The New England Journal of Medicine. 376 (24): 2367–2375. doi:10.1056/NEJMra1615439. PMID   28614678. S2CID   205117844.
  29. ↑ Miller, J. D.; Salloum, M.; Button, A.; Giovinco, N. A.; Armstrong, D. G. (2014). "How can I maintain my patient with diabetes and history of foot ulcer in remission?". The International Journal of Lower Extremity Wounds. 13 (4): 371–7. doi:10.1177/1534734614545874. PMID   25143315. S2CID   33727521.
  30. ↑ Khan, T; Armstrong, DG (1 April 2018). "Ulcer-free, hospital-free and activity-rich days: three key metrics for the diabetic foot in remission". Journal of Wound Care. 27 (Sup4): S3–S4. doi: 10.12968/jowc.2018.27.Sup4.S3 . PMID   29641340.
  31. ↑ Armstrong, David G.; Boulton, Andrew J. M.; Bus, Sicco A. (2017-06-15). "Diabetic Foot Ulcers and Their Recurrence". The New England Journal of Medicine. 376 (24): 2367–2375. doi:10.1056/NEJMra1615439. ISSN   1533-4406. PMID   28614678. S2CID   205117844.
  32. ↑ Allison, Matthew A.; Armstrong, David G.; Goodney, Philip P.; Hamburg, Naomi M.; Kirksey, Lee; Lancaster, Kristie J.; Mena-Hurtado, Carlos I.; Misra, Sanjay; Treat-Jacobson, Diane J.; White Solaru, Khendi T.; American Heart Association Council on Peripheral Vascular Disease; Council on Hypertension; and Council on Lifestyle and Cardiometabolic Health (2023-06-15). "Health Disparities in Peripheral Artery Disease: A Scientific Statement From the American Heart Association". Circulation. 148 (3): 286–296. doi:10.1161/CIR.0000000000001153. ISSN   1524-4539. PMC   11520198 . PMID   37317860. S2CID   259162957.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  33. ↑ Armstrong, David G.; Tan, Tze-Woei; Boulton, Andrew J. M.; Bus, Sicco A. (2023-07-03). "Diabetic Foot Ulcers: A Review" . JAMA. 330 (1): 62–75. doi:10.1001/jama.2023.10578. ISSN   0098-7484. PMC   10723802 . PMID   37395769.
  34. ↑ "Dr. David G. Armstrong Receives Georgetown Distinguished Achievement Award in Diabetic Limb Salvage" (Press release). Center for Lower Extremity Ambulatory Research. 30 September 2007. Archived from the original on 10 July 2011. Retrieved 12 July 2009.
  35. ↑ "PM Hall of Fame Luncheon Shatters Records". PM News. 3309. Podiatry Management Online. 28 July 2008. Retrieved 12 July 2009.
  36. ↑ "Professional Membership Award Recipients | American Diabetes Association". professional.diabetes.org. Retrieved 2023-06-22.
  37. ↑ "@UofA David G. Armstrong becomes first US podiatric surgeon named to and keynoting Royal College of Physicians and Surgeons, Glasgow". 15 January 2015.
  38. ↑ "Visiting Professor Awards". Raine Medical Research Foundation. Retrieved 2023-06-22.
  39. ↑ "@USC Prof. David G. Armstrong gives inaugural Copeland-Meier Surgery Professorship and Lecture at 200th Anniversary year of University of Cincinnati". 17 January 2019.
  40. ↑ "Professor David G. Armstrong Awarded Karel Bakker Limb Preservation Award at ISDF, The Hague, 2023". 12 May 2023.
  41. ↑ "Armstrong awarded ACTS Distinguished Investigator". 18 April 2023.
  42. ↑ "David G. Armstrong". scholar.google.com. Retrieved 2024-03-14.
  43. ↑ Zhao, Xiao-Peng; Li, Da; Li, Cui-Liu; Zhang, Yun-Na; Zhao, Nai-Rui; Xu, Jin-Xiu (2023-06-30). "Knowledge mapping of diabetic foot research based on Web of Science database: A bibliometric analysis". Medicine. 102 (26): e34053. doi:10.1097/MD.0000000000034053. ISSN   1536-5964. PMC   10313247 . PMID   37390232.
  44. ↑ "@USC Podiatric Surgeon Armstrong Named World's Top Ranked Expert on Diabetic Foot From 2011-2021 by Expertscape - DF Blog". diabeticfootonline.com. 2021-11-10. Retrieved 2024-03-14.
  45. ↑ Deng, Pin; Shi, Hongshuo; Pan, Xuyue; Liang, Huan; Wang, Shulong; Wu, Junde; Zhang, Wei; Huang, Fasen; Sun, Xiaojie; Zhu, Hanjie; Chen, Zhaojun (2022-01-27). "Worldwide Research Trends on Diabetic Foot Ulcers (2004–2020): Suggestions for Researchers". Journal of Diabetes Research. 2022: e7991031. doi: 10.1155/2022/7991031 . ISSN   2314-6745. PMC   8813288 . PMID   35127951.
  46. ↑ "Notable & Quotable". Advances in Skin & Wound Care. 19 (5): 240. June 2006. doi:10.1097/00129334-200606000-00005.
  47. ↑ "Chicago Honorees". American Diabetes Association. Archived from the original on June 2, 2007. Retrieved 12 July 2009.
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