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Diabetic Foot Files — Health & Fitness
Diabetic Foot Files

THE DIABETIC FOOT FILES HAS A NEW HOME!

The brand-new Diabetic Foot Files website is LIVE!

Welcome to the digital home of everything diabetic foot, wound care, limb salvage, and beyond. From the latest podcast episodes and expert conversations to LIMBWatch, educational content, and resources for the limb-salvage community — it’s all coming together in one place.

www.diabeticfootfiles.com

Whether you’re a clinician, researcher, student, patient, advocate, or simply passionate about saving limbs — there’s a place for you here.

Listen.
Learn.
Think beyond the wound.
Save the limb. Change the life.

Welcome to the next chapter of Diabetic Foot Files.

👟✨ 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- World Leaders in LIMB Salvage

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Latest Episodes:

System Sundays: NO GUTS, NO GLORY: Microbiome, Diabetes, and Wound Healing May 24, 2026

Show notes

This episode explains how the gut microbiome — an internal ecosystem of bacteria, fungi, and viruses — regulates inflammation, immunity, metabolism, and wound healing, and how diabetes disrupts that balance.

High blood sugar, altered gut conditions, and repeated antibiotics can cause dysbiosis and leaky gut, driving chronic systemic inflammation, immune dysfunction, biofilm formation, impaired angiogenesis and collagen synthesis, and stalled diabetic wound healing.

Practical approaches discussed include glycemic control, nutrition (fiber and fermented foods), targeted probiotics/prebiotics, exercise, sleep and stress management, antibiotic stewardship, and multidisciplinary care to support both the gut and the wound for better limb salvage outcomes.

Salvage Saturdays; Sound Waves That Heal: Shockwave Therapy for Diabetic Foot Ulcers May 23, 2026

Show notes

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 May 22, 2026

Show notes

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 May 20, 2026

Show notes

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 May 17, 2026

Show notes

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 May 16, 2026

Show notes

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.

Breath Is Healing: Preventing Post-Op Complications with Incentive Spirometry May 14, 2026

Show notes

Dr. G explains why the simple incentive spirometer is more than a bedside toy: it forces deep breaths, prevents atelectasis, improves oxygenation, and reduces post-operative pulmonary complications.

The episode outlines the typical post-op timeline (0–24 hrs, 24–72 hrs, 3–5 days), how poor lung expansion harms wound healing—especially in diabetic foot patients—and how spirometry links breathing to overall recovery.

Wound Intelligence Wednesday:Gustilo Classification & Contamination: Don’t Close a Dirty Wound May 13, 2026

Show notes

In this episode of Diabetic Foot Files, Dr. G explores why seemingly small or clean-looking wounds—especially in diabetic patients—can hide severe underlying damage from retained plant matter and contamination. Learn how organic debris promotes infection, why imaging may miss wooden or thorn fragments, and the importance of exploration, serial debridement, and appropriate antibiotics.

The episode reviews the Gustilo wound classification, practical management steps for different contamination levels, and imaging tips to avoid missing retained foreign bodies or necrotizing infections. Key takeaways: never primarily close contaminated wounds, antibiotics don’t replace debridement, and maintain high suspicion for gas-forming and rapidly progressive infections.

Limb Watch Ep. 2 — Dr. Matthew G. Garoufalis, DPM, FASPS, DABPM, CWS, FFPM RCPS (Glasg) FRSM- Topical Oxygen- Game Changer in Limb Salvage May 12, 2026

Show notes

In this episode of Diabetic Flip Files’ Limb Watch, host Dr. G interviews Dr. Matthew Garoufalis , a leader in podiatric medicine, wound care and limb salvage, about the evolution of wound care into limb salvage and the science behind topical (intermittent) oxygen therapy. He is the Chief Medical Officer at Advanced Oxygen Therapy Inc.

They discuss how oxygen affects infection control, angiogenesis, collagen synthesis and cellular metabolism; clinical evidence supporting topical oxygen for diabetic foot and other wounds; practical use as an adjunctive therapy; and how optimization of oxygen can preserve tissue and reduce amputations.

Limb Watch Launch: Diabetic Limb Salvage with Dr. Haywan Chiu DPM, FACFAS May 10, 2026

Show notes

In this episode Dr. G launches the Limb Watch movement and interviews Dr. Haywan Chiu, DPM, FACFAS. Board- certified in foot surgery and reconstructive rearfoot/ankle surgery. As a leading expert in diabetic limb salvage, Dr. Chiu is dedicated to preventing lower extremity amputations through innovative surgical techniques and advanced wound care management.

They discuss the philosophy of limb preservation, clinical signs that predict limb loss, and when to operate or involve vascular surgery.

Dr. Chiu shares advanced techniques (flaps, tendon balancing, reconstructive options), the importance of source control, pitfalls of delayed referral, practical outpatient decisions, and prevention strategies to preserve mobility and quality of life.

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