P R O G R A M O C T O B E A R N O T E B O O K 9 T E A M - 1 1, 2 0 1 A P P R O A C H Diabetic Limb Salvage MEDSTAR GEORGETOWN UNIVERSITY HOSPITAL Conference Co-Chairmen: Christopher E. Attinger, MD Cameron M. Akbari, MD, MBA ❖ ❖ John S. Steinberg, DPM Nelson Lim Bernardo, MD 4 Welcome Image by Christopher E. Attinger, MD to DLS. Define. Assess. Manage. A T E A M A P P R O A C H Diabetic Limb Salvage MEDSTAR GEORGETOWN UNIVERSITY HOSPITAL Conference Co-Chairmen: Christopher E. Attinger, MD John S. Steinberg, DPM Cameron M. Akbari, MD, MBA Nelson Lim Bernardo, MD ■ ■ A A T T E E A A M M A A P P P P R R O O A A C C H H Diabetic Limb Salvage MEDSTAR MEDSTAR GEORGETOWN GEORGETOWN UNIVERSITY UNIVERSITY HOSPITAL HOSPITAL Exhibit Hours THURSDAY 6:00 PM - 7:30 PM October 9-11, 2014 FRIDAY 9:30 AM - 3:30 PM Thursday SATURDAY 9:00 AM - 1:30 PM Tour MedStar Georgetown University Hospital Center for Wound Healing Registration Bus departs at 8:30 AM from Penn Ave. level of JW Marriott and returns at 10:30 AM WEDNESDAY 4:30 PM - 6:00 PM PENNSYLVANIA AVENUE -1 THURSDAY 6:30 AM - 6:00 PM 6:00 – 7:30 PM Reception with Exhibitors CAPITOL BALLROOM & FOYER, GRAND FOYER -3 FRIDAY 6:30 AM - 6:00 PM SATURDAY 6:30 AM - 3:30 PM View Poster Abstracts Sponsor: ■ ACCME & ANCC Accredited by: Mezzanine Level -2 CPME Accredited,Managed and Produced by: M ED S TAR G EORGETOWN U NIVERSITY H OSPITAL D L S 2 0 1 4 FA C U LT Y C ONFERENCE C O -C HAIRMEN Christopher E. Attinger, MD John S. Steinberg, DPM Cameron M. Akbari, MD, MBA Nelson Lim Bernardo, MD Professor Division Chief Center for Wound Healing MedStar Georgetown University Hospital Associate Professor Co-Director Center for Wound Healing MedStar Georgetown University Hospital Senior Attending,Vascular Surgery Director, Vascular Diagnostic Laboratory Washington Hospital Center Co-Chair, Cardiac and Peripheral Vascular Disease MedStar Heart Institute at Washington Hospital Center MedStar Georgetown University Hospital Faculty Mark R. Abbruzzese, MD Paul S. Cooper, MD Stephen R.T. Evans, MD Dorothy Goodman, BSN, RN, CWOCN Katherine J.S. Hubley, RN, CWCN Paul J. Kim, DPM, MS Karen F. Kim Evans, MD Kerry Moose, NP M. Jeffrey Novorr, MHA Katherine Raspovic, DPM Brinder Singh, MHA Helen Turner, RN, CPHQ Edward Y. Woo, MD FA C U LT Y George Andros, MD Los Angeles Vascular Specialists Valley Presbyterian Hospital Los Angeles, CA Javier Aragón-Sánchez, MD, PhD La Paloma Hospital Las Palmas de Gran Canaria Las Palmas, Spain David G. Armstrong, DPM, MD, PhD University of Arizona Tucson, AZ Lawrence B. Colen, MD Eastern Virginia Medical School Norfolk, VA Frances Game, MD Derby Hospitals NHS FT Derby, UK Kara S. Couch, MS, CRNP, CWS Walter Reed National Military Medical Center Bethesda, MD Gary W. Gibbons, MD South Shore Hospital Boston U. School of Medicine Harvard Medical School Boston, MA D. Scott Covington, MD, FACS, CHWS Healogics Jacksonville, FL Adrian Barbul, MD, FACS Washington, DC Richard Derner, DPM Inova Fairfax Hospital Lake Ridge, VA Andrew J.M. Boulton, MD, DSc Univs. of Manchester and Miami Manchester, UK and Miami, FL Robert S. Dieter, MD Loyola University Hospital Maywood, IL David R. Campbell, MD Harvard Medical School Beth Israel Deaconess Hospital Boston, MA Michael Edmonds, MD Kings College Hospital London, UK Emil I. Cohen, MD MedStar Washington Hospital Center Washington, DC William J. Ennis, DO, MBA University of Illinois Chicago, IL David L. Gillespie, MD Southcoast Healthcare Systems Fall River and New Bedford, MA Mark S. Granick, MD, FACS Rutgers New Jersey Medical School Newark, NJ Elliott Gruskin, PhD DePuy Synthes Biomaterials West Chester, PA Lawrence B. Harkless, DPM Western University of the Health Sciences College of Podiatric Medicine Pomona, CA J.P. Hong, MD, PhD, MBA Asan Medical Center Seoul, South Korea David J. Margolis, MD, PhD University of Pennsylvania Philadelphia, PA Thomas Roukis,DPM,PhD, FACFAS Gundersen Health System La Crosse, WI Bonnie Hurwitz, PhD University of Arizona Tucson, AZ Joseph L. Mills Sr., MD University of Arizona Vascular Surgery Tucson, AZ Pamela Scarborough, DPT, CDE, CWS American Medical Technologies Irvine, CA William J. Jeffcoate, MB, MRCP Nottingham University Hospitals Trust Nottingham, UK J.A. Mustapha, MD Metro Health Hospital Wyoming, MI N.C. Schaper, MD Maastricht University Hospital Maastricht, The Netherlands Robert S. Kirsner, MD, PhD University of Miami Miller School of Medicine Miami, FL Aravinda Nanjundappa, MD West Virginia University Charleston, WV Kathleen D. Schaum, MS Kathleen D. Schaum & Associates, Inc. Lake Worth, FL Sean D. O’Donnell, MD Memorial Regional Hospital Hollywood, FL Niten Singh, MD University of Washington Seattle, WA John R. Laird, MD UC Davis Vascular Center Sacramento, CA Bradley Lamm, DPM, FACFAS Sinai Hospital Baltimore, MD Lawrence A. Lavery, DPM, MPH University of Texas Southwestern Medical Center Dallas, TX Benjamin A. Lipsky, MD University of Oxford; University of Geneva (Visiting); University of Washington (Emeritus) Oxford, UK Frank B. Pomposelli Jr., MD St. Elizabeth’s Medical Center Tuft's University School of Medicine Brighton, MA Seshadri Raju, MD The Rane Center Jackson, MS Gerry Rayman, MD, MRCP The Diabetes and Endocrine Centre Ipswich Hospital Ipswich, UK Grant H. Skrepnek, PhD The University of Oklahoma Health Sciences Center Oklahoma City, OK Lynne Tudhope, MD Montana and Wilgers Hospitals Pretoria, South Africa Dane K. Wukich, MD University of Pittsburgh Medical Center Pittsburgh, PA DR. WILLIAM JEFFCOATE TO RECEIVE 2014 MEDSTAR GEORGETOWN DISTINGUISHED ACHIEVEMENT AWARD Dr. William Jeffcoate, the MedStar Georgetown 2014 Distinguished Achievement Award recipient, received his medical training at Cambridge University. He started out in endocrinology and over the last two decades has narrowed the scope of his work to the field of diabetes and diabetic foot disease, centering on the principle of the ever-increasing need for evidence to reinforce routine clinical practice. “Throughout the duration of his career, Dr. Jeffcoate has repeatedly provided valuable insight into the field of diabetic foot disease,” said DLS Conference Co-Chairman Dr. Christopher Attinger. “He and his research team are relentless in their evidence-based pursuit to further understand this complex realm of medicine.” In 2002, Dr. Jeffcoate partnered with Dr. Fran Game to establish the Nottingham Foot Ulcer Trials Unit, which has since gone on to publish over 100 articles. By 2005, members of the group, alongside Professor Peter Cavanagh, proposed the widely-accepted hypothesis on the causes of the acute Charcot foot. His current research focuses on the microbiome of foot ulcers and the use of hyperspectral imaging to predict ulcer healing. DLS Conference Co-Chairman Dr. John Steinberg added, “We, in the medical community, are anxiously awaiting the results of Dr. Jeffcoate’s ground-breaking research. The insights gained will undoubtedly prove to be revolutionary in the treatment of diabetic ulcers.” Dr. Jeffcoate also functions as Clinical Lead of the newly-launched Foot Care Audit of England and Wales, seeking to not only establish an ongoing nationwide database of all newly presenting diabetic foot ulcers, but to also identify a link between outcome and the adoption of recommended guidelines of care. Previous honorees for the award include: George Andros, MD, 2013; Andrew J.M. Boulton, MD, DSc, 2012; William J. Ennis, DO, MBA, 2011; Gary W. Gibbons, MD, 2010; Peter Sheehan, MD, 2009; Lawrence B. Harkless, DPM, 2008; and David G. Armstrong, DPM, MD, PhD, 2007. CMEs/Evaluations Please complete CME certificates of attendance/evaluations online at www.DLSconference.com through November 3, 2014. Attendance Verification To meet the requirements of the credentialing bodies, we are using a scanning system to verify attendance throughout the conference. All participants seeking continuing education credit are required to scan the bar code on their name badge in the morning and afternoon of each day. Scanners will be set up outside of the Education Ballroom. If you lose your badge, please go to the registration desk where a new badge can be prepared for you. View Poster Abstracts MEZZANINE LEVEL -2 POSTER ABSTRACT REVIEW WITH AUTHORS Friday 6:00 - 7:00 PM Photography Please be advised that photographs may be taken at the meeting for use a) on the conference website and on conference social media pages b) in the press, including marketing materials and publications distributed to the public. By entering the meeting, you consent to such photographing and use of your image and likeness for the purposes mentioned above. DLS Presentation Access Online streaming video of the DLS Educational Program will be available for viewing at www.portaleducation.com. Following the conference, every attendee will be provided a username and password via email from Portal Education to continue to access the course presentations. You must follow the steps in the email in order to access the presentations. If you do not receive your username and password, please check your SPAM folder. Passwords can be retrieved by clicking the “Lost Your Password” link and entering your email address. Queries regarding this should be sent to [email protected]. Note: Presentations will be made available as quickly as possible. Some presentations may be omitted due to no author permissions. Worldwide Broadcast DLS 2014 is broadcast live globally in partnership with Portal Education. Visit www.portaleducation.com Thursday S PECIAL EVENTS October 9 8:30 – 10:30 AM MedStar Georgetown University Hospital Center for Wound Healing Tour Bus departs at 8:30 AM from Penn Ave. level of JW Marriott and returns at 10:30 AM PENNSYLVANIA AVENUE -1 Tour is not a CME event. 12:15 - 12:30 PM MEDSTAR GEORGETOWN DISTINGUISHED ACHIEVEMENT AWARD IN DIABETIC LIMB SALVAGE HONOREE - WILLIAM J. JEFFCOATE, MB, MRCP Presented by Dr. Richard Goldberg, President, MedStar Georgetown University Hospital 12:30 - 1:15 PM LUNCH SYMPOSIUM Clinical Experience with Biologics for Atypical and Inflammatory Wounds Attinger, Kim, Steinberg This non-CME accredited activity is supported by Integra LifeSciences. 6:00 - 7:30 PM RECEPTION WITH EXHIBITORS CAPITOL BALLROOM & FOYER, GRAND FOYER -3 Thursday October 9 8:30 – 10:30 MedStar Georgetown University Hospital Center for Wound Healing Tour Bus departs at 8:30 AM from JW Marriott and returns at 10:30 AM. Tour is not a CME event. 7:30 – 8:00 Breakfast DLS: Defining the Scope of the Problem Moderators: Christopher E. Attinger, MD; John S. Steinberg, DPM 8:00 – 8:05 Introduction Christopher E. Attinger, MD; John S. Steinberg, DPM; Cameron M. Akbari, MD, MBA 8:05 – 8:25 Simple Science: Diabetic Ulcers and Sensory Neuropathy Andrew J.M. Boulton, MD, DSc 8:25 – 8:45 Simple Science: Diabetic Ulcers and Critical Limb Ischemia Cameron M. Akbari, MD, MBA 8:45 – 9:05 Simple Science: Diabetic Ulcers and Biomechanics Lawrence A. Lavery, DPM, MPH 9:05 – 9:25 The Team Concept: Essential Components to Success Frances Game, MD 9:25 – 9:45 Limb Salvage Lessons Learned from ‘Eurodiale’: European Study Group on Diabetes and the Lower Extremity N.C. Schaper, MD 9:45 – 10:00 Panel Discussion 10:00 – 10:15 Break Managing the Cost of Diabetic Limb Salvage Moderators: Christopher E. Attinger, MD; John S. Steinberg, DPM 10:15 – 10:35 Lawrence B. Kirstein Memorial HBO Lectureship: Role of HBO Therapy for the Diabetic Foot: Yes or No? David J. Margolis, MD, PhD 10:35 – 11:00 NICE and NHS: What Can the British Teach Us about Fiscal Management in Diabetic Limb Salvage? William J. Jeffcoate, MB, MRCP 11:00 – 11:20 Not All Diabetic Foot Care Is Created Equal: Learning from the Regional Disparity in Care Gerry Rayman, MD, MRCP 11:20 – 11:40 Cost Containment in a Comprehensive Hospital Based Wound Program William J. Ennis, DO, MBA 11:40 – 12:00 Recidivism: Fancy Word for a Really Big Problem. Can It Be Avoided? Michael Edmonds, MD 12:00 – 12:15 Panel Discussion 12:15 – 12:30 MEDSTAR GEORGETOWN DISTINGUISHED ACHIEVEMENT AWARD IN DIABETIC LIMB SALVAGE Honoree – William J. Jeffcoate, MB, MRCP Presented by Dr. Richard Goldberg, President, MedStar Georgetown University Hospital 12:15 – 1:30 Lunch 12:30 – 1:15 LUNCH SYMPOSIUM Clinical Experience with Biologics for Atypical and Inflammatory Wounds Attinger; Kim; Steinberg This non-CME accredited activity is supported by Integra LifeSciences. First Impressions: Making a Proper Initial Assessment Moderators: Christopher E. Attinger, MD; John S. Steinberg, DPM 1:30 – 1:50 The Patient Interview: Can We Actually Apply the Socratic Method to Educate the Patient? Gerry Rayman, MD, MRCP 1:50 – 2:05 Physical Examination of the Diabetic Foot Ulcer: What Not to Leave Out Michael Edmonds, MD 2:05 – 2:20 Biofilm and Implants: Why the Connection? Elliott Gruskin, PhD 2:20 – 2:35 Assessing the Ulcer: Etiology Determines Treatment Javier Aragón-Sánchez, MD, PhD 2:35 – 2:55 So Much Attention to Cultures...: Evidence for What, When, and How? Benjamin A. Lipsky, MD 2:55 – 3:15 Lower Extremity Imaging Options from Bones to Vessels: What Do We Really Need? Emil I. Cohen, MD 3:15 – 3:35 Wound Bed Preparation: What Works Best and When? Robert S. Kirsner, MD, PhD 3:35 – 3:45 Panel Discussion 3:45 – 4:05 Break The Battle of Infection Moderators: Christopher E. Attinger, MD; Benjamin A. Lipsky, MD 4:05 – 4:25 Implant Related Biofilm: Can We Define It, Treat It, and Prevent It? Bonnie Hurwitz, PhD 4:25 – 4:45 Evidence-Based Antibiotic Therapy Recommendations in DLS Benjamin A. Lipsky, MD 4:45 – 5:05 The Architecture of Reimbursement for Limb Salvage in the US: What Does the Future Hold? Stephen R.T. Evans, MD 5:05 – 5:25 Osteomyelitis in the Diabetic Limb: Surgical Management Javier Aragón-Sánchez, MD, PhD 5:25 – 5:40 Osteomyelitis in the Diabetic Limb: Medical Management Frances Game, MD 5:40 – 6:00 Infection Imposters!: Charcot, PVD, Lymphedema Venous Stasis Michael Edmonds, MD 6:00 – 7:30 Opening Reception with Exhibitors A T E A M A P P R O A C H Diabetic Limb Salvage M E D S TA R G E O R G E T O W N U N I V E R S I T Y H O S P I TA L Friday S PECIAL EVENTS October 10 7:00 - 8:30 AM HANDS-ON WORKSHOP Are You Healing Enough of Your DFU Patients? Come Learn How to Heal More… Jeffrey D. Lehrman, DPM, FACFAS LOCATION: SALON I This non-CME accredited activity is supported by BSN Medical, Inc. 7:00 - 8:00 AM BREAKFAST SYMPOSIUM Meet the Masters Abbruzzese; Andros; Gibbons; Harkless LOCATION: SALONS II-IV 12:15 - 1:15 PM LUNCH SYMPOSIUM What Is the Solution for NPWT with Instillation: Saline vs. Prontosan Attinger; Kim; Lavery; Lipsky 6:00 - 7:00 PM POSTER ABSTRACT REVIEW WITH AUTHORS LOCATION: MEZZANINE LEVEL -2 6:00 PM - 7:30 PM EVENING SYMPOSIUM Platelet Derived Growth Factors - Faster Healing for Lower Extremity Diabetic Neuropathic Ulcers Paul Sullivan, DPM LOCATION: SALON I This non-CME accredited activity is supported by Smith & Nephew Biotherapeutics. Friday October 10 7:00 – 8:00 BREAKFAST SYMPOSIUM: Meet the Masters Abbruzzese; Andros; Gibbons; Harkless Location: Salons II-IV 7:00 – 8:30 HANDS-ON WORKSHOP Are You Healing Enough of Your DFU Patients? Come Learn How to Heal More… Jeffrey D. Lehrman, DPM, FACFAS Location: Salon I This non-CME accredited activity is supported by BSN Medical, Inc. 7:00 – 8:00 Breakfast It’s All about Blood Flow? Moderators: George Andros, MD; Gary W. Gibbons, MD 8:00 – 8:20 PVD and Diabetes: The Implications of Trifurcation Disease Frank B. Pomposelli Jr., MD 8:20 – 8:40 LIVE CASE Session I Surgeon: Cameron M. Akbari, MD, MBA Moderators: Campbell, Laird, Mills, Pomposelli 8:40 – 9:00 The Benefits and Shortcomings of the Endovascular Approach John R. Laird, MD 9:00 – 9:10 LIVE CASE Recap Session I Surgeon: Cameron M. Akbari, MD, MBA Moderators: Campbell, Laird, Mills, Pomposelli 9:10 – 9:30 Is There Still a Role for Bypass Surgery? Where and When David R. Campbell, MD 9:30 – 10:15 Break / Exhibits 10:15 – 10:35 LIVE CASE Session II Surgeons: Christopher E. Attinger, MD; Karen F. Kim Evans, MD Moderators: Colen, Gibbons, Steinberg, Wukich 10:35 – 10:55 Vascular Imaging: So Many Choices, How Do I Choose? Angiogram, CT Angiogram, MRA, Ultrasound, or SPY Joseph L. Mills Sr., MD 10:55 – 11:00 LIVE CASE Recap Session II Surgeons: Christopher E. Attinger, MD; Karen F. Kim Evans, MD Moderators: Colen, Gibbons, Steinberg, Wukich 11:00 – 11:20 Lymphedema: In Search of a Protocol for Effective Diagnosis and Treatment Lynne Tudhope, MD 11:20 – 11:40 LIVE CASE Session III Surgeons: Christopher E. Attinger, MD; Karen F. Kim Evans, MD Moderators: Colen, Gibbons, Steinberg, Wukich 11:40 – 12:00 What You Need to Know about Venous Disease When Managing Patient with Diabetes Lynne Tudhope, MD 12:00– 12:10 LIVE CASE Recap Session III Surgeons: Christopher E. Attinger, MD; Karen F. Kim Evans, MD Moderators: Colen, Gibbons, Steinberg, Wukich 12:10 – 1:30 Lunch / Exhibits 12:15 – 1:15 LUNCH SYMPOSIUM What Is the Solution for NPWT with Instillation: Saline vs. Prontosan Attinger; Kim; Lavery; Lipsky Assessing What We Do Not Know Moderator: Christopher E. Attinger, MD 1:30 – 1:50 Questions to Ask and Research to Do: What Do We NOT Know about Diabetic Foot Ulcers? Lawrence A. Lavery, DPM, MPH 1:50 – 2:10 LIVE CASE Session IV Surgeon: Cameron M. Akbari, MD, MBA Moderators: Campbell, Gibbons, Mills, Pomposelli 2:10 – 2:30 LIVE CASE Session V Surgeons: Paul J. Kim, DPM, MS; John S. Steinberg, DPM Moderators: Attinger, Harkless, Wukich 2:30 – 2:50 Putting Published Literature to the Test: How to Evaluate Wound Literature Critically to Assess What Is Claimed William J. Jeffcoate, MB, MRCP 2:50 – 3:00 LIVE CASE Recap Session V Surgeons: Paul J. Kim, DPM, MS; John S. Steinberg, DPM Moderators: Attinger, Harkless, Wukich 3:00 – 3:30 Break / Exhibits 3:30 – 3:40 LIVE CASE Recap Session IV Surgeon: Cameron M. Akbari, MD, MBA Moderators: Campbell, Gibbons, Mills, Pomposelli A Chance to Cut Is a Chance to Cure? Moderators: Christopher E. Attinger, MD; Dane K. Wukich, MD 3:40 – 4:00 LIVE CASE Session VI Surgeons: Paul J. Kim, DPM, MS; John S. Steinberg, DPM Moderators: Attinger, Lavery, Wukich 4:00 – 4:20 Forefoot: Biomechanical Approach to Prophylactic Surgery and Partial Amputations Lawrence A. Lavery, DPM, MPH 4:20 – 4:30 LIVE CASE Recap Session VI Surgeons: Paul J. Kim, DPM, MS; John S. Steinberg, DPM Moderators: Attinger, Lavery, Wukich 4:30 – 4:50 Midfoot and Rearfoot: Biomechanical Approach to Prophylactic Surgery and Amputations Richard Derner, DPM 4:50 – 5:10 Charcot Surgery: Evidence-Based Approach to a Complex Deformity Dane K. Wukich, MD 5:10 – 5:30 Algorithm for Diabetic Foot Reconstruction vs. Major Amputation J.P. Hong, MD, PhD, MBA 5:30 – 5:50 Why Major Amputations, When Properly Done on the Right Patient, Is Not a Failure but a New Life Dane K. Wukich, MD 5:50 – 6:00 Panel Discussion 6:00 – 7:00 Poster Abstract Review with Authors 6:00 – 7:30 EVENING SYMPOSIUM: Platelet Derived Growth Factors - Faster Healing for Lower Extremity Diabetic Neuropathic Ulcers Paul Sullivan, DPM This non-CME accredited activity is supported by Smith & Nephew Biotherapeutics. Saturday October 11 6:30 – 8:00 Breakfast 8:00 - 12:45 THREE CONCURRENT SPECIALTY TRACKS WITH THE LATEST UPDATES ON THE NEXT 3 PAGES. SEE PAGE 4 OF SATURDAY SPREADS FOR SYMPOSIA AND CADAVER WORKSHOPS TRACK I TRACK I: VASCULAR/CARDIO TRACK – LEAVES LOCATION: GRAND BALLROOM, SALON I Diabetic Foot Ulceration and Venous Disease: No Healing Despite Normal Arterial Flow Moderator: Cameron M. Akbari, MD, MBA 8:00 – 8:15 The Pathophysiology of Venous Reflux, Venous Obstruction, and Ulceration Seshadri Raju, MD 8:15 – 8:30 Techniques for Endovascular Treatment of Chronic Venous Occlusion David L. Gillespie, MD 8:30 – 8:45 Catheter-Based Ablation of the Saphenous Vein Sean D. O’Donnell, MD 8:45 – 9:00 Complications in Endovenous Ablation: Avoidance, Recognition, and Treatment TBA 9:00 – 9:15 Panel Discussion 9:15 – 9:45 Break / Exhibits Arterial Disease I: Open Bypass Moderator: Cameron M. Akbari, MD, MBA 9:45 – 10:00 Autogenous Vein Bypass: Technical Tips for Success Frank B. Pomposelli Jr., MD 10:00 – 10:15 Prosthetic Bypasses: Do They Really Work? 10:15 – 10:30 Paramalleolar and Inframalleolar Bypass David R. Campbell, MD 10:30 – 10:45 Panel Discussion 10:45 – 11:00 Break / Exhibits Cameron M. Akbari, MD, MBA Arterial Disease II: Endovascular Moderator: Edward Y. Woo, MD 11:00 – 11:15 Traversing the Lesion: Update on Wires and CTO Devices Aravinda Nanjundappa, MD 11:15 – 11:30 Subintimal Angioplasty: Technique and Re-Entry John R. Laird, MD 11:30 – 11:45 Aortoiliac Occlusions: Endovascular Options and Techniques Niten Singh, MD 11:45 – 12:00 When and How to Use Stent Grafts in the SFA 12:00 – 12:15 Endovascular Approaches to Long Tibial Occlusions Aravinda Nanjundappa, MD 12:15 – 12:30 Atherectomy: When, Which, Why, and How J.A. Mustapha, MD 12:30 – 12:45 Pedal Access: Techniques and Tips Nelson L. Bernardo, MD Robert S. Dieter, MD Saturday October 11 TRACK II TRACK II: ADMINISTRATIVE TRACK Moderators: William J. Ennis, DO, MBA; Gary W. Gibbons, MD; Niten Singh, MD LOCATION: GRAND BALLROOM, SALON II The Business of Running a Wound Center 8:00 – 8:05 Introduction Gary W. Gibbons, MD 8:05 – 8:20 The Cost of Leaving Podiatry Out of Diabetic Foot Care: The Case for Comprehensive Coverage Grant H. Skrepnek, PhD 8:20 – 8:35 The Good, the Bad, and the Ugly of the New Reality in Medicine: Consumerism and Public Ratings Are Here to Stay M. Jeffrey Novorr, MHA 8:35 – 8:50 What Does a Wound Center Bring to the Hospital’s Margin? Brinder Singh, MHA 8:50 – 9:05 Choosing Between Private vs. Hospital-Based Wound Centers: The Advantages and Disadvantages of Both William J. Ennis, DO, MBA 9:05 – 9:20 Panel Discussion 9:20 – 10:00 Break / Exhibits 10:00 – 10:15 Telemedicine in Wound Care: The Next Horizon or Regulatory Nightmare Mark S. Granick, MD, FACS 10:15 – 10:30 Common Coding Errors in Wound Care: How to Bill Visits and Procedures Correctly Kathleen D. Schaum, MS 10:30 – 10:45 Clinical Practice Guidelines: Opportunities and Challenges D. Scott Covington, MD, FACS, CHWS 10:45 – 11:05 Current Innovations That May Make Limb Salvage Obsolete if Insurance Will Pay for Them David G. Armstrong, DPM, MD, PhD 11:05 – 11:25 Using Advanced Technology to Maximize Efficiency in the Hospital Environment J.P. Hong, MD, PhD, MBA 11:25 – 11:45 Auditing: Nightmare or Chance to Excel Helen Turner, RN, CPHQ 11:45 – 12:00 Panel Discussion A T E A M A P P R O A C H Diabetic Limb Salvage M E D S TA R G E O R G E T O W N U N I V E R S I T Y H O S P I TA L Saturday October 11 TRACK III TRACK III: WOUND CARE AND BIOMECHANICAL SURGERY Moderator: John S. Steinberg, DPM LOCATION: GRAND BALLROOM, SALONS III-IV 8:00 – 8:05 Introduction John S. Steinberg, DPM 8:05 – 8:20 Stop Blaming the Achilles for Everything: Maybe You Should Be Messing with Some OTHER Tendons… Paul J. Kim, DPM, MS 8:20 – 8:35 New Wound Care Technologies That Are Worth Your Time and Your Money Kara S. Couch, MS, CRNP, CWS 8:35 – 8:50 Nutritional Therapy for Wound Healing: Real or Imagined? Adrian Barbul, MD, FACS 8:50 – 9:05 Just Put the Cast Back On and Heal the Wound Lawrence A. Lavery, DPM, MPH 9:05 – 9:20 Panel Discussion 9:20 – 10:00 Break / Exhibits 10:00 – 10:15 Cellular and Tissue-Based Products for Wounds: A Method or a Madness? John S. Steinberg, DPM 10:15 – 10:30 Saving the Unsavable: Case Reports Bradley Lamm, DPM, FACFAS 10:30 – 10:45 Engaging the Team to Include Physical Therapy Modalities for Wound Healing Pamela Scarborough, DPT, CDE, CWS 10:45 – 11:00 Amputation and Reamputation: Let the Data Speak Thomas Roukis, DPM, PhD, FACFAS 11:00 – 11:15 I Wish I Had Never Done This Case: Diabetic Foot Reconstruction Richard Derner, DPM 11:15 – 11:30 You Only See What You Look for and You Only Recognize What You Know Lawrence B. Harkless, DPM 11:30 – 11:45 Internal Fixation vs. External Fixation for Charcot Reconstruction Paul S. Cooper, MD 11:45 – 12:00 You Have It All Wrong…Caring for the Patient AND the Wound from the RN Perspective Katherine J.S. Hubley, RN, CWCN 12:00 – 12:15 Panel Discussion SATURDAY Gloves-On Cadaver Workshops RUSSELL, HART, CANNON MEETING ROOM LEVEL -2 Workshop III: Wound Care, Compression, and Casting COMMERCE RAYBURN Workshop II: Skin Grafts, Tendon Transfers, and Tendon Lengthening TREASURY JUSTICE Workshop I: Local and Regional Flaps for Foot and Ankle Wound Closure STATE DIRKSEN Workshop IV: Vascular Workshop LONGWORTH Saturday October 11 12:00 – 1:30 Lunch / Exhibits 12:15 – 12:30 Poster Session Awards LOCATION: SALONS III-IV 1:30 - 3:30 GLOVES-ON CADAVER WORKSHOPS Gloves-On Cadaver Workshops are non-CME accredited activities. LOCATION: MEETING ROOM LEVEL -2 WORKSHOP I Local and Regional Flaps for Foot and Ankle Wound Closure Christopher E. Attinger, MD; Lawrence B. Colen, MD; Karen F. Kim Evans, MD Location: Treasury -2 WORKSHOP II Skin Grafts, Tendon Transfers, and Tendon Lengthening Paul J. Kim, DPM, MS; John S. Steinberg, DPM; Katherine Raspovic, DPM Location: Commerce -2 WORKSHOP III Wound Care, Compression, and Casting Kara S. Couch, MS, CRNP, CWS; Katherine J.S. Hubley, RN, CWCN; Dorothy Goodman, BSN, RN, CWOCN; Kerry Moose, NP Location: Russell/Hart/Cannon -2 WORKSHOP IV Vascular Workshop: Chronic Total Occlusion, Atherectomy, and Pedal Access Cameron M. Akbari, MD, MBA Location: State -2 FACULTY DISCLOSURES As a sponsor accredited by the ACCME, it is the policy of MedStar Georgetown University Hospital to require that everyone who is in the position to control the content of an educational activity disclose all financial relationships with any commercial interest prior to the educational activity. The ACCME considers relationship of the person(s) involved in the CME activity to include financial relationship(s) of a spouse or partner. Faculty and planners who refuse to disclose their financial relationships will be disqualified from participating in the CME activity. For an individual with no relevant financial relationship(s), the participant must be informed that no conflicts of interest or financial relationship(s) exist. Name Name of Commercial Interests Nature of Financial Relationship Mark R. Abbruzzese, MD No relevant financial relationships with any commercial interests to disclose Cameron M. Akbari, MD, MBA No relevant financial relationships with any commercial interests to disclose George Andros, MD No relevant financial relationships with any commercial interests to disclose Javier Aragón-Sánchez, MD, PhD No relevant financial relationships with any commercial interests to disclose David G. Armstrong, DPM, MD, PhD No relevant financial relationships with any commercial interests to disclose Christopher E. Attinger, MD No relevant financial relationships with any commercial interests to disclose Adrian Barbul, MD, FACS No relevant financial relationships with any commercial interests to disclose Nelson L. Bernardo, MD Cook Medical Terumo Medical Medtronic, Inc. Training Site Consultancy Training Site, Speakers Bureau Andrew J.M. Boulton, MD, DSc No relevant financial relationships with any commercial interests to disclose David R. Campbell, MD No relevant financial relationships with any commercial interests to disclose Emil I. Cohen, MD No relevant financial relationships with any commercial interests to disclose Lawrence B. Colen, MD No relevant financial relationships with any commercial interests to disclose Paul S. Cooper, MD Integra, Small Bone Innovations Smith and Nephew Consultant Royalties Kara S. Couch, MS, CRNP, CWS Mölnlycke, Organogenesis Derma Sciences Speakers Bureau Honorarium D. Scott Covington, MD, FACS, CHWS Healogics Medical Advisory Board Richard Derner, DPM No relevant financial relationships with any commercial interests to disclose Robert S. Dieter, MD No relevant financial relationships with any commercial interests to disclose Michael Edmonds, MD Urgo, Olympus, Crawford, Bard Advisory Committee William J. Ennis, DO, MBA Accelecare Wound Centers Consultant Stephen R.T. Evans, MD No relevant financial relationships with any commercial interests to disclose Frances Game, MD No relevant financial relationships with any commercial interests to disclose Gary W. Gibbons, MD No relevant financial relationships with any commercial interests to disclose David L. Gillespie, MD Volcano Cook Medical Consultant, Speakers Bureau Speakers Bureau Dorothy Goodman, BSN, RN, CWOCN No relevant financial relationships with any commercial interests to disclose Mark S. Granick, MD, FACS No relevant financial relationships with any commercial interests to disclose Elliott Gruskin, PhD DePuy Synthes, Companies of Johnson & Johnson Employee Lawrence B. Harkless, DPM Valeant Pharmaceuticals North America, LLC Consultant L&M Healthcare Communications, Organogenesis Speakers Bureau J. P. Hong, MD, PhD, MBA No relevant financial relationships with any commercial interests to disclose Katherine J.S. Hubley, RN, CWCN No relevant financial relationships with any commercial interests to disclose Bonnie Hurwitz, PhD No relevant financial relationships with any commercial interests to disclose Name Name of Commercial Interests Nature of Financial Relationship William J. Jeffcoate, MB, MRCP No relevant financial relationships with any commercial interests to disclose Paul J. Kim, DPM, MS KCI, Integra LifeSciences Karen F. Kim Evans, MD No relevant financial relationships with any commercial interests to disclose Robert S. Kirsner, MD, PhD Mölnlycke, Cardinal Health, 3M, Kerecis Keretec Smith and Nephew, Macrocure Advisory Board Consultant Research Grant John R. Laird, MD Abbott Vascular, Boston Scientific, Covidien, Shockwave, AngioSlide Bard Peripheral Vascular Medtronic WL Gore VIVA Physicians Syntervention Advisory Board Consultant Consultant/Advisory Board Research Support Board Member Stock, Board Member Research and Consulting Bradley Lamm, DPM, FACFAS No relevant financial relationships with any commercial interests to disclose Lawrence A. Lavery, DPM, MPH No relevant financial relationships with any commercial interests to disclose Benjamin A. Lipsky, MD Cubist, Forest Merck Innocoll Debiopharm, Dipexium David J. Margolis, MD, PhD No relevant financial relationships with any commercial interests to disclose Joseph L. Mills Sr., MD No relevant financial relationships with any commercial interests to disclose Kerry Moose, NP No disclosures submitted at press time J.A. Mustapha, MD Cardiovascular Services, Inc., Covidien, Spectranetics, Bard Peripheral Vascular Bayer, Boston Scientific Advisory Board Speakers Bureau Consultant, Research Funding Consultant Consultant, Research Consultant Aravinda Nanjundappa, MD No relevant financial relationships with any commercial interests to disclose M. Jeffrey Novorr, MHA No relevant financial relationships with any commercial interests to disclose Sean D. O'Donnell, MD No relevant financial relationships with any commercial interests to disclose Frank B. Pomposelli Jr., MD No relevant financial relationships with any commercial interests to disclose Seshadri Raju, MD Veniti, Inc. Katherine Raspovic, DPM No disclosures submitted at press time Gerry Rayman. MD, MRCP No relevant financial relationships with any commercial interests to disclose Stock Thomas Roukis, DPM, PhD, FACFAS No relevant financial relationships with any commercial interests to disclose Pamela Scarborough, DPT, CDE, CWS No relevant financial relationships with any commercial interests to disclose N. C. Schaper, MD No relevant financial relationships with any commercial interests to disclose Kathleen D. Schaum, MS Smith & Nephew Biotherapeutics Niten Singh, MD No relevant financial relationships with any commercial interests to disclose Employee Brinder Singh, MHA No relevant financial relationships with any commercial interests to disclose Grant H. Skrepnek, PhD No disclosures submitted at press time John S. Steinberg, DPM KCI Lynne Tudhope, MD No disclosures submitted at press time Helen Turner, RN, CPHQ No relevant financial relationships with any commercial interests to disclose Consultant Edward Y. Woo, MD No relevant financial relationships with any commercial interests to disclose Dane K. Wukich, MD Stryker Orthopaedics Arthrex Consultant Royalties Faculty Disclosures including those not submitted at press time are available at the Faculty Desk. ACCREDITATION FOR EVERY MEMBER OF THE TEAM ◆ Diabetes & Wound Healing Specialists ◆ Vascular Surgeons ◆ Orthopaedic Surgeons ◆ Podiatric Surgeons ◆ Plastic Surgeons ◆ Endocrinologists ◆ FPs ◆ Infectious Disease Specialists ◆ Cardiovascular & Endovascular Specialists ◆ NPs ◆ PTs ◆ RNs ◆ CDEs ◆ Peripheral Nerve Specialists… the entire team that works on the diabetic foot and on limb salvage MedStar Georgetown University Hospital is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. MedStar Georgetown University Hospital designates this educational activity for a maximum of 21.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity. International Conference Management is approved by the Council on Podiatric Medical Education as a sponsor of continuing medical education in podiatric medicine. International Conference Management has approved this conference for a maximum of 21.5 continuing medical education contact hours of CPME credit. MedStar Georgetown University Hospital Department of Nursing Education is an approved provider of continuing nursing education by the Maryland Nurses Association, an accredited provider by the American Nurses Credentialing Center's Commission on accreditation. Nurses will be awarded a maximum of 21.5 contact hours for successfully completing the program. Disclosure of Financial Relationships with Any Commercial Interest: As sponsors accredited by the ACCME and CPME, it is the policy of MedStar Georgetown University Hospital and International Conference Management to require that everyone who is in the position to control the content of an educational activity disclose all relevant financial relationships with any commercial interest prior to the educational activity. The ACCME and CPME consider relationships of the person involved in the CME activity to include financial relationships of a spouse or partner. Faculty and planners who refuse to disclose relevant financial relationships will be disqualified from participating in the CME activity. For an individual with no relevant financial relationship(s), the participant must be informed that no conflicts of interest or financial relationship(s) exist. Conference Objectives: This course will enhance the background, knowledge and skills of attendees in the science of diabetic limb salvage. At the conclusion of this CME activity, participants should be able to: discuss the public health crisis of diabetic limb loss • discuss the pain of sensory loss and non-compliance • discuss the options in vascular interventional technology and techniques, both surgical and endovascular • discuss the complexities of biomechanics, limb salvage, the problem wound, wound based infection, preserving limb length • cite the financial and social impact of diabetic limb salvage and amputation • integrate into their practices the knowledge obtained through the didactic lectures, workshops and live surgical cases. Target Audience: This program has been planned, designed, and is intended for Diabetes & Wound Healing Specialists • Vascular Surgeons • Orthopaedic Surgeons • Podiatric Surgeons • Plastic Surgeons • Endocrinologists • FPs • Infectious Disease Specialists • Cardiovascular & Endovascular Specialists • NPs • PTs • RNs • CDEs • Peripheral Nerve Specialists • the entire team who work on the diabetic foot and limb salvage Course Description: The MedStar Georgetown University Hospital's A Team Approach to Diabetic Limb Salvage conference is intended to better equip each member of the health care team with the education and resources needed to heal wounds and prevent amputations. It features a prominent multidisciplinary faculty that promotes the importance of every member of the team. The course is designed for health care practitioners of all specialties and promotes an evidence-based approach. The meeting format will include didactic lectures, hands-on workshops, specialty symposia, and live surgical case demonstrations for the purpose of providing a live interactive learning experience. Acknowledgment: This continuing medical education activity is supported by unrestricted educational grants from contributing organizations. A complete list is published in the program notebook. Advisory: Certificates of Attendance for CMEs and Contact hours are available for you to print online after this conference. Attendees can update or edit their Attendance Checklist or CME Certificates through November 3, 2014. After that time, no further changes can be made on the forms. Certificates can be printed for a period of two years. Sponsor: ACCME & ANCC Accredited by: CPME Accredited,Managed and Produced by: Administrative Headquarters: 2701 Johnston Street; Suite 201; Lafayette, LA 70503 Tel: 337.235.6606 ❖ Fax: 337.235.7300 ❖ [email protected] HOW TO PRINT YOUR OWN CME CERTIFICATE CME certificates for DLS will be available only online. You can complete yours for up to 3 weeks after the conference. 1. Log in to the DLS CME site www.DLSconference.com/cme Immediately after the conference, you will receive an email with a link to the CME site (www.DLSconference.com/cme) and your ID Number. Click on the link or paste it into your browser. Log in with your ID number. Note: You can update or edit your Attendance Checklist through November 3, 2014. After that time, no further changes can be made in the form. 2. Check off the box of the session you attended 3. Fill out the survey and click "Submit" at the bottom of the page 4. You will automatically be taken back to the main page 5. Repeat this process for each session you attended 6. Once all session surveys are completed, click “Print Certificate” Note: You can print your certificate as many times as you like for a period of two years. Be sure to keep the link and login ID number in order to do so. C OMMERCIAL F UNDING Funding for the conference has been provided by educational grants from the following companies: ABBOTT VASCULAR ACELITY (KCI, LIFECELL, SYSTAGENIX) B. BRAUN MEDICAL, INC. BOSTON SCIENTIFIC CORPORATION COVIDIEN ETHICON FASHEK FOUNDATION E XHIBITORS /S UPPORTERS Additional underwriting has been provided by the following exhibitors/supporters: ACELITY (KCI, LIFECELL, SYSTAGENIX) ACELL ALLIQUA BIOMEDICAL, INC. AMERICAN EXPRESS B. BRAUN MEDICAL, INC. BARD PERIPHERAL VASCULAR BAYER HEALTHCARE, LLC BIANCO BROTHERS INSTRUMENTS BOSTON SCIENTIFIC CORPORATION BSN MEDICAL, INC. CAPTUREPROOF CARDIOVASCULAR SYSTEMS, INC. CELLERATION COOK MEDICAL CORDIS CORPORATION, A JOHNSON & JOHNSON COMPANY COVIDIEN DARCO INTERNATIONAL DERMA SCIENCES, INC. GORE & ASSOCIATES HEALOGICS E XHIBITORS /S UPPORTERS HITACHI ALOKA MEDICAL HOLLISTER IMS MEDICAL EQUIPMENT INTEGRA LIFESCIENCES LIFENET HEALTH MEDICAL SOLUTIONS SUPPLIER MERCK & CO., INC. MIMEDX MISONIX, INC. MÖLNLYCKE HEALTH CARE MONARCH LABS NASCOTT, INC. – A HANGER CLINIC COMPANY NEUROGENX, INC. NOVADAQ OPTIMA-MOLLITER Italy ORGANOGENESIS ORPYX MEDICAL TECHNOLOGIES, INC. continued ORTHOMERICA PRODUCTS, INC. OSIRIS THERAPEUTICS, INC. PAMLAB SMITH & NEPHEW SMITH & NEPHEW BIOTHERAPEUTICS SPECTRANETICS SPIRACUR, INC. STEADMED SUREFIT SYSTAGENIX (AN ACELITY COMPANY) TEI MEDICAL, INC. TEKSCAN U. S. ARMY WIMBLEDON HEALTH PARTNERS WRIGHT MEDICAL TECHNOLOGY Z-MEDICA IN-KIND MARKETING JOURNAL OF WOUND TECHNOLOGY BOOK DONATIONS WOLTERS KLUWER HEALTH See Addendum Insert Win an iPad Air ® Enter to Win a new iPad Air – 32 GB ® • Pick up Entry Card at the Registration Desk • Visit DLS Supporters in the Exhibitor Ballroom • Have a minimum of 12 exhibitors initial your Entry Card • Drop Entry Card in the Drawing Box at the Registration Desk Prize Drawing will be held Saturday @ 9:45 AM Contest open to registered DLS delegates only. Entry requires visit to minimum of 12 exhibit booths. No purchase necessary. You need not be present to win. SPEAKER TOPIC Image by Christopher E. Attinger, MD Leadership in Action EDUCATIONAL GRANTS Abbott Vascular ■ Acelity (KCI, LifeCell, Systagenix) B. Braun Medical, Inc. ■ Boston Scientific Corporation Covidien ■ Ethicon ■ Fashek Foundation E XHIBITORS ACell Alliqua Biomedical, Inc. American Express Bard Peripheral Vascular Bayer HealthCare, LLC Bianco Brothers Instruments Boston Scientific Corporation CaptureProof Cardiovascular Systems, Inc. Celleration Cordis Corporation, a Johnson & Johnson Company Covidien Darco International Gore & Associates Hollister IMS Medical Equipment Journal of Wound Technology LifeNet Health Medical Solutions Supplier Merck & Co., Inc. MiMedx Misonix, Inc. Monarch Labs Nascott, Inc.–A Hanger Clinic Company NEUROGENX, Inc. Novadaq OPTIMA-MOLLITER Italy Orpyx Medical Technologies, Inc. Orthomerica Products, Inc. Osiris Therapeutics, Inc. Spectranetics Spiracur, Inc. SteadMed SureFit TEI Medical, Inc. Tekscan U. S. Army Wimbledon Health Partners Wolters Kluwer Health Wright Medical Technology Z-Medica Conference Co-Chairmen: Christopher E. Attinger, MD John S. Steinberg, DPM Cameron M. Akbari, MD, MBA Nelson Lim Bernardo, MD ■ ■ A T E A M A P P R O A C H Diabetic Limb Salvage MEDSTAR GEORGETOWN UNIVERSITY HOSPITAL Leadership in Action Image by Christopher E. Attinger, MD Thank You ALPHA ACELITY (KCI, LIFECELL, SYSTAGENIX) INTEGRA LIFESCIENCES PLATINUM SMITH & NEPHEW SILVER BSN MEDICAL, INC. HITACHI ALOKA MEDICAL GOLD SMITH & NEPHEW BIOTHERAPEUTICS BRONZE ABBOTT VASCULAR B. BRAUN MEDICAL COOK MEDICAL COVIDIEN DERMA SCIENCES HEALOGICS MÖLNLYCKE HEALTH CARE ORGANOGENESIS PAMLAB Conference Co-Chairmen: Christopher E. Attinger, MD John S. Steinberg, DPM Cameron M. Akbari, MD, MBA Nelson Lim Bernardo, MD ■ A T E A M A P P R O A C H Diabetic Limb Salvage MEDSTAR GEORGETOWN UNIVERSITY HOSPITAL ■
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