Welcome to the ALPS Toe & Flow hub — a curated selection of educational resources in interdisciplinary limb preservation. Explore the most recent updates at the intersection of podiatry, wound care, and vascular surgery. In short, find everything you need to know about Toe & Flow to get you ready to go!
The Toe & Flow model, first introduced in 2010, highlights the foundational collaboration between podiatrists and vascular surgeons in the effort to prevent diabetic foot complications and reduce limb loss. Today, this model has evolved into a global, interdisciplinary standard for diabetic foot care—encompassing wound care specialists, infectious disease experts, endocrinologists, rehabilitation professionals, and more.
A number of authors showcased have presented their expertise and innovative findings at DFCon in Anaheim, California: the premier Interdisciplinary Global Diabetic Foot Conference.
New resources and publications
This page is continuously updated with new resources and publications about Toe & Flow. We invite researchers, clinicians, and interdisciplinary teams to explore and share knowledge in our collective effort to eliminate preventable amputations. If you would like to reach out, please contact: info@alpslimb.org
Toe & Flow in 2025:
Find publications, case studies and guidelines related to the Toe & Flow Model, diabetic foot, and benefits of multidisciplinary teams below.
Editorial: In the know with toe and flow
Ahmed Kayssi, Samantha Minc, David G. Armstrong, 2025
Institutional toe & flow programs: How and why the teams work
Ahmed A. Naiem, Ryan T. Callahan, Alexander M. Reyzelman, Michael S. Conte, 2025
On the go with Toe & Flow: Private Clinic Design and Flow
Ben Li, Miguel Montero-Baker, Brian D. Lepow, 2025
Diabetic foot in primary and tertiary (DEFINITE) care: An efficacious, synergistic and cost-effective multidisciplinary team model for diabetic foot care in Singapore
Wen Zhe Leo, Lixia Ge, Sadhana Chandrasekar, Elaine Tan, … Zhiwen Joseph Lo, 2025
A scoping review of limb preservation interventions with primary care providers caring for US Indigenous patients with diabetes and peripheral artery disease
Juell Homco, Thane Gehring, W. Landon Jackson, Wato Nsa, … Kelly Kempe, 2025
Percutaneous approach to deep vein arterialization for the “no-option” chronic limb-threatening ischemia patient
Jayne R. Rice, Brett C. Chatman, Elizabeth A. Genovese, 2025
Fundamentals of wound care for amputation prevention
Beatriz Moschiar Almeida, Robyn Evans, Ahmed Kayssi, 2025
The role of flaps in preventing lower extremity amputations
John M. Felder, Emmanuel Nageeb, Ingrid Rocha, Ryan Qasawa, Syena Moltaji, Yuma Fuse, 2025
Charcot neuroarthropathy: Surgical and conservative treatment approaches
Michael Hurst, Laura Shin, 2025
Diabetic foot infections: Questions for an infectious disease consultant
Varidhi Nauriyal, Karin Byers, 2025
Diabetes-Related Extremity Amputation Depression and Distress (DREADD): A Multimethod Study
Levi M. Brooks, Bradley M. Brooks, Allison S. Arp, Cyaandi R. Dove, … David G. Armstrong, 2025
The role of physical therapy in managing peripheral artery disease and diabetes
Stephanie L. Woelfel, Deborah M. Wendland, 2025
Best practice offloading treatments for diabetic foot ulcer healing, remission, and better plans for the healing-remission transition
Peter A. Lazzarini, Jaap J. van Netten
Diabetic Foot Ulcers: How Four Steps Can Save Two legs, Worldwide
David G. Armstrong, 2025
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