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303 episodes

Salvage Saturdays; Sound Waves That Heal: Shockwave Therapy for Diabetic Foot Ulcers
05/23/2026 | 23 mins.
On this episode of Salvage Saturdays, Dr. G explores extracorporeal shockwave therapy — the use of focused sound waves to stimulate healing in diabetic foot ulcers. We review its history from lithotripsy to orthopedics, how mechanical energy triggers angiogenesis, collagen remodeling, stem cell activation, and reduces chronic inflammation.

The episode explains treatment types, energy settings, typical protocols, contraindications, and the patient experience, and emphasizes that shockwave therapy is an adjunct to standard wound care (debridement, offloading, infection control, vascular optimization).

Research is promising but varied; combined regenerative approaches and larger trials are likely next steps. A case study demonstrates meaningful wound improvement with focused low-energy shockwave therapy as part of comprehensive limb salvage care.
Forgotten Infection Friday: Mucormycosis in a Diabetic Patient
05/22/2026 | 21 mins.
Case study of a 58-year-old man with uncontrolled type 2 diabetes (A1C 12.4) who developed a rapidly progressive left foot ulcer after stepping on a nail. Despite antibiotics, the wound became black, necrotic, and septic; labs showed DKA and elevated inflammatory markers.

MRI and tissue biopsy revealed deep angioinvasive fungal infection with broad, ribbon-like non-septate hyphae consistent with mucormycosis. Management required urgent surgical debridement, antifungal therapy (liposomal amphotericin B), metabolic stabilization, and often limb-sparing or amputation procedures; early recognition is critical due to rapid vascular invasion and high mortality.
When a Skin Flap Fails: Spot the Early Signs Before It’s Too Late
05/20/2026 | 22 mins.
This episode explains how and why skin flaps die, focusing on the early warning signs, differences between arterial insufficiency and venous congestion, and the underlying microvascular physiology.

It covers common causes of flap failure—tension, hematoma, infection, diabetes-related microangiopathy, and poor offloading—how to assess a threatened flap (color, capillary refill, temperature, Doppler), and the step-by-step rescue measures clinicians use to improve perfusion.

Listen for practical timelines for salvage, prevention strategies before surgery (vascular testing, optimization, smoking cessation, nutrition), and the importance of rapid action and frequent monitoring to maximize flap survival and protect the limb.
S.A.V.E T.H.E. F.A.S.C.I.A: Rapid Recognition Protocol for Necrotizing Fasciitis
05/17/2026 | 40 mins.
In this episode we introduce "Save the Fascia," a clear, stepwise mnemonic to help clinicians recognize necrotizing fasciitis early and act urgently. It outlines warning signs, diagnostic steps, and the rapid escalation needed for a time-sensitive surgical emergency.

The episode emphasizes tracking progression, immediate wound management, broad-spectrum antibiotics, and early surgical consultation to improve limb salvage and survival.
Medically Stable? The Dangerous Misuse in Diabetic Foot Discharges
05/16/2026 | 23 mins.
Dr. G examines how the phrase "medically stable for discharge" is often misapplied to diabetic foot patients, sometimes with dangerous consequences. He explains why diabetic foot infections can be deceptively quiet, reviews warning signs like gas in tissue and abscesses, and outlines when discharge is and isn’t appropriate.

The episode stresses the need for specialist input, proper imaging, source control, clear outpatient plans, and patient advocacy to prevent missed limb‑threatening emergencies and improve outcomes.

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About Diabetic Foot Files

Big news! 👟✨ We’ve teamed up with DARCO to bring you 25% off the POGO shoe! Want to stay active, reduce pressure, and help prevent ulcers before they begin? Visit darcodirect.com/product/pogo/ and use our exclusive code FootFiles25 at checkout to save 25% off your pair. 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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