Background: Wearable smart glasses offer new opportunities to enhance limb preservation surgery by enabling hands-free photo/video capture, real-time communication, and improved surgical education. While earlier devices such as Google Glass demonstrated feasibility, they were hindered by limited battery life and cumbersome ergonomics. The new Ray-Ban Meta smart glasses may address these limitations by providing high-definition recording in a lightweight, ergonomic frame. Recent consumer-grade smart glasses may address these limitations by providing high-definition recording in lightweight, ergonomic frames. Methods: From November 2023 to April 2025, 2 limb preservation surgeons used Ray-Ban Meta consumer-grade smart glasses during foot and ankle procedures. Five domains were evaluated: overall use and feasibility, image and video utility, workflow and communication impact, team and trainee feedback, and technical performance. Patients were enrolled based on procedural scheduling and availability for device setup, with written consent obtained preoperatively. Results: The smart glasses were easily integrated into operative workflows, enabling hands-free documentation without disrupting sterility. Trainees found first-person footage more engaging than conventional video formats. Real-time streaming supported remote consultation, and occasional live transmission facilitated tele-mentoring. Although battery capacity decreased with frequent use, no major technical failures occurred over the study period. Conclusion: This is the first comprehensive report on using Ray-Ban Meta consumer-grade smart glasses in limb preservation surgery. Early findings support their use as a low-profile, hands-free solution for intraoperative documentation, education, and communication. Further optimization—especially regarding battery endurance and data integration—will enhance the role of wearable devices in surgical care.

Background: Diabetic foot ulcers recur frequently after healing. The first three months carry the highest risk. Remission is a vulnerable phase that demands precise self-care and timely feedback. Evidence supports thermometry and protective footwear with gradual return to activity, yet adherence at home is inconsistent. Objective: To describe the design and planned evaluation of a conversational agent (chatbot) that guides patients through the remission phase following diabetic limb reconstruction. Methods: This protocol describes a conversational agent (chatbot) that turns remission guidance into daily actions, grounded in clinical expertise and established care guidelines. Walking is dosed like a drug, with careful titration based on tissue response. The agent integrates automatic data capture (smartphone step counts, skin temperature, shoe step streams, smartwatch step streams, Bluetooth thermometry when available, and app session timestamps) with manual patient entries (shoe wear time, skin redness persistence, and symptom checks). It doses walking activity, guides footwear break-in, prompts photo-confirmed concerns, following clinician-informed rules and escalation pathways. We define data quality checks for missingness and physiologic plausibility, and the agent reinforces reducing weight-bearing activity when risk signals appear. We outline device drift. The study is designed as a single-arm feasibility pilot (n = 30) to assess engagement, safety, and implementation fidelity. Results: No clinical outcome results are reported because this is a protocol study and enrollment has not yet begun. This study presents the prespecified sensing-to-decision workflow, escalation logic, and pilot endpoints, along with internal technical verification procedures (e.g., message delivery reliability, data completeness checks, and rule-engine consistency testing). Conclusions: A remission chatbot is a plausible method to extend specialist support into the home, reflecting integration of clinical expertise with digital health tools. This protocol defines how feasibility, safety, and usability will be evaluated. Clinical efficacy should be confirmed in future studies.

Chronic limb‐threatening ischemia (CLTI) compounded by diabetic foot ulceration remains a leading precursor to major lower‐extremity amputation. Transverse tibial transport (TTT) can improve perfusion but requires corticotomy and bulky external fixation. We report what is, to our knowledge, the first application of fully automated tibial periosteal distraction (PD) for limb preservation. A 65‐year‐old man with recurrent forefoot gangrene underwent tibial PD using a miniaturised, programmable motor to gradually elevate the periosteum. Through a 1 cm incision, a low‐profile subperiosteal plate was implanted and linked to the motor, which advanced 0.031 mm hourly (0.75 mm/day) up to 10 mm. Distraction was completed uneventfully over 13 days, and the device was removed at the bedside on Day 21. Skin temperature increased by 2°C, and digital systolic (toe) pressure rose from 22 to 50 mmHg. The wound progressed to healing without complication. Automated PD may offer a minimally invasive, biologically driven alternative for high‐risk CLTI patients, eliminating the need for patient‐adjusted screws and standardising adherence. Prospective studies are required to validate its safety, durability, optimal distraction parameters and cost‐effectiveness.