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The Limb Preservation Center is a unique clinical setting dedicated to preserving the function of the lower extremities, through a comprehensive preventative program, care of diabetic foot issues, and advanced complex wound healing modalities for the ambulatory and/or diabetic patient. Its primary mission is to make a dramatic impact on reducing the prevalence of lower extremity amputations in the North Texas community.

Preventative Diabetic Foot Examinations

Diabetes mellitus is diagnosed once every 17 seconds worldwide. Up to 70% of lower extremity amputations are associated with diabetes. Every 20 seconds, somewhere in the world, a lower extremity is amputated in a patient with diabetes. With as few as 14% of primary care physicians performing sensory or vascular exams on their diabetic patients, this center provides a preventative comprehensive approach to the patient with diabetes with the goal of preventing diabetic foot ulcers which globally has a 20% chance of leading to a lower extremity amputation.

Comprehensive diabetic foot examinations are provided to diabetic patients who are under the collaborative diabetes management care of a primary care physician. After a complete medical history taking, physical exam and a review of recent Hemoglobin A1c are done, a risk classification is established following the guidelines from the International Working Group on the Diabetic Foot (IWGDF).

Risk classification based on the comprehensive foot examination
Category Risk profile Check-up frequency
1No sensory neuropathyOnce a year
2Sensory neuropathyOnce every 6 months
3Sensory neuropathy, signs of peripheral arterial disease and/or foot deformitiesOnce every 3 months
4History of ulcer or amputationOnce every 1-3 months
Source: International Working Group on the Diabetic Foot (IWGDF)

Once a diabetic ulcer heals, there is a 48% chance of recurrence within 12 months. The Center specializes in the manufacturing of custom-made full-length diabetic functional orthotics in lieu of the extra-depth shoes with diabetic inserts to reduce this recurrence rate. These hybrid diabetic orthotics provide accommodative shear reduction found in traditional diabetic inserts plus correct functional biomechanical abnormalities found in custom orthotics, thus reducing risks for surgery and/or amputation.

As part of the comprehensive approach, the Limb Preservation Center has an outpatient registered dietitian available to help our patients manage their diabetes.

Diabetic Foot Issues

As the Center has a podiatrist on its medical staff, regular foot and ankle issues for the patient with diabetes are also part of our comprehensive approach. These can include, but are not limited to, foot pain, heel pain, ankle pain, foot and ankle injuries, ingrown toenails, neuromas.

The Center has a full imaging suite including lab, x-rays, CT scan, vascular lab, and diagnostic musculoskeletal sonography available on-site.

Advanced Wound Modalities

The Limb Preservation Center specializes in working with patients who have developed wounds that have not healed within several weeks – a complicated failure of the skin organ system. The goal is to promote wound healing and ultimately restore the quality of life with a functional limb. Physicians can refer patients with diabetic foot or wound complications for:

  • Comprehensive assessments and treatment plans
  • Highly specialized treatment modalities, such as total contact casting
  • Critical education and nutritional guidance provided by a registered dietitian to help control their glucose levels, increase protein intake, and manage nutrition.
  • On-site diagnostic imaging tools to accurately devise a therapy plan, including lab testing, x-rays, arterial studies, venous Doppler ultrasound testing, CT angiography
  • A multidisciplinary and experienced medical team that includes podiatric and vascular surgeons. The Center has a podiatric surgeon on its medical staff with direct access to vascular specialists and a vascular lab to quickly evaluate blood flow and vascular-related issues at the wound site.
  • Total contact casting is routinely performed and available. This specialized type of cast removes pressure from the wound on the bottom of the foot but allows the patient to walk. The Limb Preservation Center is one of very few centers in the Dallas/Fort Worth area to offer traditional total contact casting.
  • Custom biomechanically-corrective functional diabetic orthotics. The EvenKeel Advanced Custom Diabetic Orthotics are a very unique hybrid cross of custom functional orthotics used to correct biomechanical faults with custom inlays used in diabetic patients to reduce shear and prevent ulcerations. The Limb Preservation Center is the only program in the State of Texas and Southern United States which offer this type of hybrid custom diabetic orthotic. This orthotic device is used as an alternative to performing biomechanically-corrective diabetic foot surgery and is the only one of its kind.
  • Cell and Tissue-Based Products are available. A multitude of both bioengineered tissues and human cadaveric tissues are utilized to facilitate more rapid wound closure versus taking tissue from another part of the body.

Vascular Services

Diabetes is a cardiovascular disease and can lead to a 2-4 times increase in atherosclerosis (hardening of the arteries). Peripheral arterial disease (PAD) has a 64% relative 5-year mortality rate, the 3rd high rate behind pancreatic cancer and lung cancer.

Vascular surgeons evaluate patients and can determine if and what level of vascular interventions are needed. The Center has a complete complement of on-site imaging services including non-invasive vascular testing, CT angiography, therapies to improve circulation, and edema reduction. The vascular surgeons are highly trained and well versed in both endovascular interventions and open peripheral bypass graft surgery through The Heart Hospital Baylor Plano.

Meet the Physician »

Image ofPatient Story:  Charles Fisher

Patient Stories

Charles Fisher

Charles Fisher struggled with congestive heart failure and cellulitis, a serious skin infection, on his lower legs. At the Center for Advanced Cardiovascular Care (CACC), Charles found help for both of these conditions. 

Read more about Charles »

Physicians:

Call 469.814.3480 to refer to the
CACC in Plano or McKinney.

Call 1.855.220.0887 to refer to the
Comprehensive Wound & Vascular Center in Denton.