David G. Armstrong

David G. Armstrong
Born February 18, 1969
Santa Maria, California, U.S.A.
Occupation Physician, Researcher
Notable works

University 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]

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 director of the Southern Arizona Limb Salvage Alliance (SALSA)[5] at the University of Arizona and has produced more than 410 peer reviewed manuscripts and more than 60 book chapters.

Biography

Early years

Armstrong was raised with his younger brother, Darrin B. Armstrong, a schoolteacher, in Santa Maria, California. His father, Leo N. Armstrong, was a noted podiatrist in California and figures large in many of Armstrong’s anecdotes, lectures, and writings.[6] 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.{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{CSPM}. 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{Diabetic Foot}. 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.

The San Antonio years

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{University of Texas Health Science Center 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 Associations Clinical Care of the Diabetic Foot (ISBN 1-58040-223-2){Clinical Care of the Diabetic Foot}. 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.

Tucson: first tour

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, which is still in existence under the direction of Katherine Neiderer, 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 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).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.[7]

Rosalind Franklin University, Scholl College and the "CLEAR years"

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),[8] 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.[9][10] Armstrong also became the first tenured podiatrist in the history of Rosalind Franklin University and the Scholl College.[11]

The University of Arizona

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] 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[14] with their colleague (and Armstrong's former fellow), Lee C. Rogers. 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). {}.

Recognition of the disease and of the investigator

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.[15][16] In 2010, he was the youngest ever recipient of the Roger Pecoraro Award 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. He frequently offers that these awards are more "recognitions of the importance of the problem" and of "the acknowledgement of the profession 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 at University of Western Australia and the Complutense University of Madrid.

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.[17][18] He lives in Tucson with his wife Tania and three daughters Alexandria, Natalie and Nina.

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.
  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. PMID 16984580.
  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 2494620Freely accessible. PMID 18663232.
  5. ↑ "Arizona Public Media | Video Shorts | Limb Salvage". Ondemand.azpm.org. 2009-02-11. Retrieved 2010-07-26.
  6. ↑ "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
  7. ↑ http://www.apma.org/s_apma/docmember.asp?TrackID=KAUUY8UGZDWVYS5UA79MXDQRQ82YUXB4&SID=1&DID=15574&CID=405&VID=122&RTID=0&CIDQS=&Taxonomy=False&specialSearch=false
  8. ↑ http://www.apma.org/s_apma/docmember.asp?TrackID=KAUUY8UGZDWVYS5UA79MXDQRQ82YUXB4&SID=1&DID=18959&CID=644&VID=122&RTID=0&CIDQS=&Taxonomy=False&specialSearch=false
  9. ↑ 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.
  10. ↑ http://www.apma.org/s_apma/docmember.asp?TrackID=KAUUY8UGZDWVYS5UA79MXDQRQ82YUXB4&trackid=&sid=1&did=17686&cid=480&vid=122&rtid=0&cidqs=&taxonomy=false&specialsearch=false
  11. ↑ http://diabeticfootonline.com/CLEAR/News/Entries/2007/9/25_DR._DAVID_G._ARMSTRONG_RECEIVES_GEORGETOWNDISTINGUISHED_ACHIEVEMENT_AWARD_IN_DIABETIC_LIMB_SALVAGE_2.htmll
  12. ↑ Taking a team approach to diabetic limb salvage (http://www.lowerextremityreview.com/article/taking-a-team-approach-to-diabetic-limb-salvage)
  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: 514–8. doi:10.1002/dmrr.2299. PMID 22431496.
  14. ↑ 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 3087505Freely accessible. PMID 21559249.
  15. ↑ "Dr. David G. Armstrong Receives Georgetown Distinguished Achievement Award in Diabetic Limb Salvage" (Press release). Center for Lower Extremity Ambulatory Research. 30 September 2007. Retrieved 12 July 2009.
  16. ↑ "PM Hall of Fame Luncheon Shatters Records". PM News. Podiatry Management Online. 3309. 28 July 2008. Retrieved 12 July 2009.
  17. ↑ &Na; (June 2006). "Notable & Quotable". Advances in Skin & Wound Care. 19 (5): 240. doi:10.1097/00129334-200606000-00005.
  18. ↑ "Chicago Honorees". American Diabetes Association. Archived from the original on June 2, 2007. Retrieved 12 July 2009.

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