Toe and flow: Essential components and structure of the amputation prevention team

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At the end of an anatomic peninsula, the foot in diabetes is prone to acute and chronic complications involving neuropathy, vasculopathy, and infection. Effective management requires an interdisciplinary effort focusing on this triad. In this article, we describe the key factors leading to foot complications and the critical skill sets required to assemble a team to care for them. Although specific attention is given to a conjoined model involving podiatry and vascular surgery, the “toe and flow” model, we further outline three separate models of care—basic, intermediate, and center of excellence—that can be implemented in the developed and developing world.

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Competition of interest: None.

This article is being co-published in the Journal of Vascular Surgery® and the Journal of the American Podiatric Medical Association.

The editors and reviewers of this article have no relevant financial relationships to disclose per the JVS policy that requires reviewers to decline review of any manuscript for which they may have a competition of interest.