Nystatin Uncovered: Why It Heals Some Foot Fungi and Fails Others
06/24/2026 | 20 mins.
This episode of Diabetic Foot Files dives into nystatin: its history, how it kills Candida, and why it often works for moist, macerated toe-web infections but fails against dermatophyte-caused athlete's foot.
Dr. G explains the importance of delivery method (powder vs. cream/ointment), diabetic risk factors like moisture and hyperglycemia, and practical prevention tips for patients.
The episode also covers real-world issues such as supply shortages and cost, plus effective OTC alternatives and when to seek professional evaluation.
Zaynich: A New Weapon Against MDR Gram-Negatives
06/23/2026 | 17 mins.
In this episode of Diabetic Foot Files, Dr. G explores Zaynich (cefepime + ZD-bactam), a newly FDA-approved IV antibiotic designed to overcome multi-drug resistant gram-negative infections. He explains the drug's dual-target mechanism, its potential role in limb salvage for severe diabetic foot infections, common side effects, dosing, current FDA indications, and when to involve infectious disease specialists.
Listeners will learn why this combination may be a game-changer for difficult-to-treat infections, the importance of antibiotic stewardship, and practical considerations for use in wound care and limb salvage scenarios.
This episode explains sarcopenia—the progressive loss of skeletal muscle—and how diabetes accelerates it, increasing risk of poor mobility, delayed wound healing, and higher mortality in patients with diabetic foot ulcers.
Dr. G reviews the causes (insulin resistance, inflammation, ubiquitin–proteasome activity), clinical signs and tests, and practical treatments including resistance training, protein/leucine supplementation, vitamin D, and tighter glycemic control to preserve muscle and improve outcomes.
To Masquelet or Not to Masquelet? Masquelet Magic: How an Induced Membrane Saves Limbs
06/20/2026 | 23 mins.
This episode explains the Masquelet (induced membrane) technique — a two-stage reconstructive approach where infected bone is removed, an antibiotic-loaded PMMA spacer is placed to control infection and induce a vascular membrane, and weeks later the spacer is removed and the membrane-filled cavity is packed with bone graft to regenerate bone.
We cover the science of the induced membrane, antibiotic selection, how diabetes and poor blood flow affect membrane quality, and the technique's role and limitations in diabetic limb salvage.
Forgotten Infection Friday: Ecthyma Gangrenosum — The Rapidly Deadly Black Lesion
06/19/2026 | 27 mins.
This episode explains ecthyma gangrenosum: a rapidly evolving, black necrotic skin lesion most classically caused by Pseudomonas aeruginosa invading blood vessels. It covers the pathophysiology, stages of progression, risk factors (immunocompromise, neutropenia, diabetes), and how it differs from ordinary diabetic foot ulcers.
Key takeaways: urgent tissue biopsy and cultures for diagnosis, prompt broad-spectrum IV antibiotics and surgical debridement for source control, and early recognition to prevent sepsis, limb loss, and death.
June is Wound Healing Awareness Month (WHAM)! Join us in raising awareness, advancing education, and improving outcomes for patients with wounds—because every wound deserves the chance to heal. Celebrate Wound Healing Awareness Month (WHAM) this June with the American Board of Wound Management (ABWM) and take the next step in your wound care career with 25% off your first certification application- https://abwmcertified.org/promo/
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Welcome to the Diabetic Foot Files Podcast and the LIMBWatch series — where diabetic foot surveillance, wound intelligence, prevention science, and limb preservation come together. I’m Dr. G / Dr. WoundPicasso aka Dr. Gabrielle Hutcheson Donaldson, podiatrist and wound care specialist, and I’m here to educate, empower, and guide you through the evolving world of diabetic foot care.
From wound healing and pressure injuries to surveillance systems and amputation prevention, we break down the science, challenge the myths, and share strategies that help save limbs and improve lives. Whether you’re a patient, caregiver, clinician, or healthcare professional, this is your destination for diabetic foot education, prevention, and preservation.
So let’s dive in — because when you take care of your feet, they take care of you.LIMBWatch: Surveillance Before Salvage.
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