Vascular Surgery & Endovascular Therapy

Dr. Jeffrey B. Matthews

Christopher L. Skelly, MD
Associate Professor of Surgery
Chief, Section of Vascular Surgery and Endovascular Therapy
Director, Vascular Surgery Fellowship Program
Director, Vascular Lab
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Trissa A. Babrowski, MD

Limb Salvage for Patients on the South Side

After taking a close look at amputation rates on the South Side of Chicago, Christopher L. Skelly, MD, Chief of Vascular Surgery and Endovascular Therapy at the University of Chicago Medicine, and Trissa A. Babrowski, MD, Assistant Professor of Surgery, collaborated with colleagues at the University of Chicago Booth School of Business to create the Limb Salvage Program.

“When we compare patients in our geographic region to patients anywhere else in the country, our amputation rate is about 20 times the national average, which is shocking and totally unacceptable.”

Trissa A. Babrowski, MD
Assistant Professor of Surgery

She and her team leaped into action, building a programmatic component to help identify the specific actions needed to make a positive impact on limb salvage.

Holistic care for a vulnerable population

On the South Side of Chicago, a disproportionate number of people have diabetes, as well as renal failure, compared to the national average. These prodromal illnesses are what lead to significant peripheral arterial disease—and amputations. Dr. Babrowski and the Limb Salvage Program team found it imperative to formalize a process for patients to receive holistic care and optimal treatment from a multidisciplinary team—an approach for which UChicago Medicine is renowned.

“It’s not just about what we as vascular surgeons are able to provide—the plan needs to be systematic and should support the overall care of the patient,” said Dr. Babrowski. “That involves podiatry, for toe amputations and foot wound management, and plastic surgery, because oftentimes these patients need complex wound closures or a flap for coverage. It’s also important to involve the endocrinologists, who are responsible for managing the patients’ diabetes long-term. It really needs to be a holistic effort,” she added. “Although we work in our own silos, the Limb Salvage Program is all about working together to salvage legs.”

Debilitating disease and limb loss

In the US alone, there are approximately one million diabetics who have wounds and some type of amputation—a toe, foot or leg. Diabetics’ blood contains a substantial amount of sugar, which is problematic because bacteria thrive in a sugar-rich environment. Infections settle in and procreate rapidly. Many of these patients suffer from diabetic infections—wounds that have become severely infected with bacteria.

In the US alone, there are approximately one million diabetics who have wounds and some type of amputation—a toe, foot or leg.

Losing a limb, or any part of the foot, is traumatic. It takes a toll on patients and their families not only emotionally, but economically as well. The ravages of diabetes may affect the patient’s ability to work or to care for another family member’s children, which in turn affects that family member’s ability to work. Dr. Babrowski and her Limb Salvage Program team recognize the striking healthcare disparities within this community and not only support patients medically, but show a sense of compassion which ultimately contributes to their healing and improves the quality of their lives.

Longevity in their legs and their lives

The COVID-19 outbreak caused a slowdown for many areas of the hospital; however, there was a sharp rise in amputation patients. Beginning in mid-March, Dr. Babrowski was operating every day, and this continued for more than six weeks straight. Many patients needed an urgent amputation, largely due to neglect, fear and lack of access. Strict social-distancing guidelines mandated virtual visits, which, according to Dr. Babrowski, presented some challenges.

“We struggled greatly with the concept of video visits, because our patients don’t have access to the technology to connect with us. While it’s nice to be able to maintain connection via telephone visits, I can’t see them, and I can’t look at their feet; a lot of the patients can’t look at their feet themselves,” she said.

Despite the challenges of connecting virtually with patients, it is vital to build effective plans of care and also establish a foundation of trust. Dr. Babrowski is committed to building partnerships that extend beyond the clinic. “I always tell patients that I’m not their doctor—I’m their partner. We’re in this together, working toward saving their legs,” said Dr. Babrowski. “Vascular disease is not curable. But we manage it in a way that helps patients gain longevity in their legs and their lives—that’s what this is really all about.”

Trissa A. Babrowski, MD

The Limb Whisperer fights for her patients

In the thick of the pandemic, a stoic Dr. Babrowski was stationed on the frontlines. The work did not stop and neither did the complexities of life. She lost her father and mother-in-law this year, yet even while grieving in isolation with the inability to mourn among family, she has continued to dauntlessly lead the Limb Salvage Program and uphold close partnerships with her patients.

“She is truly an unsung hero, fighting the good fight every day,” said Dr. Skelly. “She needs someone to hear it—not for her, not for us, but for our patients.” Dr. Babrowski—mother, wife, surgeon, physician, partner to patients and master of balance—says, “It’s really important to me to be a part of the community I serve. I think that really helps with the balance.”

As a South Sider herself, she has the ability to connect with neighborhood patients.  They value that familial sense of closeness, which makes them open and willing to build partnerships with Dr. Babrowski—often referred to by her patients and colleagues in the Limb Salvage Program as the “Limb Whisperer.” Her maternal tough-love approach gives her patients that extra boost they need to get over their last (or first) hurdle.

Making an impact in clinic and community

Limb salvage is critically important for our community and neighbors. It makes an incredible impact on patients’ and families’ lives. Dr. Babrowski is a true heroine within the Section of Vascular Surgery and Endovascular Therapy and her community. “I take the concept of service to heart,” said Dr. Babrowski. “I try to set the example for my family, residents and fellows, that when you’re doing something you are passionate about, the sacrifices you make in all aspects of your life are worth it.”

Trissa A. Babrowski, MD

faculty listing

Professor of Surgery
Ross Milner, MD, Professor of Surgery; Director, Center for Aortic Diseases

Associate Professor of Surgery
Christopher L. Skelly, MD, Associate Professor of Surgery; Chief, Section of Vascular Surgery and Endovascular Therapy; Medical Director, Noninvasive Vascular Imaging Laboratories

Assistant Professor of Surgery
Trissa A. Babrowski, MD, Assistant Professor of Surgery; Director, Limb Salvage Program
Chelsea Dorsey, MD, Assistant Professor of Surgery; Director, Vein Clinic
Luka Pocivavsek, MD, PhD, Assistant Professor of Surgery

Research Associate of Surgery
Nicole Pierce, PhD, RN, Research Associate of Surgery

faculty honors

Ross Milner, MD, was named Editor-in-Chief of Vascular and appointed an Editorial Board Member of Annals of Vascular Surgery.

Ross Milner, MD, and Trissa A. Babrowski, MD, hosted a group of surgeons from Australia for a workshop on EVAR and TAVR and live case observation.

select publications

Patel MV, Dalag L, Weiner A, Skelly C, Lorenz J. (2019). Inability of conventional imaging findings to predict response to laparoscopic release of the median arcuate ligament in patients with celiac artery compression. Journal of Vascular Surgery 69(2), 462–469. doi: 10.1016/j.jvs.2018.04.062.

Pocivavsek L, Milner R. (2020). Dynamic seal at the aortic neck-endograft interface studied using a novel method of cohesive zone modeling. Journal of Vascular Surgery 72(2), 703–713.e3. doi: 10.1016/j.jvs.2019.07.101.

Pocivavsek L, Ye SH, Pugar J, Tzeng E, Cerda E, Velankar S, Wagner WR. (2019). Active wrinkles to drive self-cleaning: A strategy for anti-thrombotic surfaces for vascular grafts. Biomaterials 192, 226–234. doi: 10.1016/j.biomaterials.2018.11.005.

Sharafuddin MJ, Reece TB, Papia G, Pozeg ZI, Peterson BG, Shafi B, Man J, Milner R. (2019). Proposed classification of endoleaks after endovascular treatment of Stanford type-B aortic dissections. Vascular 27(6), 585–594. doi: 10.1177/1708538119847394.

Venturini JM, Milner R, Shah AP. (2019). Percutaneous transapical access to facilitate complex thoracic endovascular aortic repair. Journal of Vascular Surgery Cases and Innovative Techniques 5(3), 205–209. doi: 10.1016/j.jvscit.2019.03.003.

residents & fellows

View the Vascular Surgery Residents and Fellows here.