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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.

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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- World Leaders in LIMB Salvage

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Copyright: © Copyright 2025 All rights reserved.

Latest Episodes:

Forgotten Infection Friday- Melioidosis: The Soil-Borne Killer That Mimics Diabetic Foot Ulcers Jul 31, 2026

Show notes

Melioidosis is an infection caused by the soil and water bacterium Burkholderia pseudomallei that can enter through cuts, wounds, or inhalation. It often mimics common conditions—pneumonia, tuberculosis, routine wound infections, or chronic diabetic foot infections—making diagnosis challenging.

People with diabetes are at higher risk, and proper diagnosis requires culture and targeted therapy (IV intensive antibiotics such as ceftazidime or meropenem followed by prolonged oral eradication therapy). Prevention focuses on reducing soil and water exposure, protective footwear, wound care, and detailed environmental history for at-risk patients.

The Knee We Fight to Save: the history, biomechanics and science to Below-the-Knee Amputation Jul 30, 2026

Show notes

The below-the-knee amputation (BKA) is a common major limb loss in people with diabetes, resulting from a long pathway of neuropathy, vascular disease, biomechanical breakdown, ulcers, and infection. Modern amputation philosophy focuses on preserving the knee to maximize function, but BKA remains a marker of advanced systemic disease with significant morbidity and mortality.

Preserving the knee improves mobility, energy efficiency, and prosthetic outcomes; yet prevention is crucial. Early screening, offloading, wound care, vascular assessment, and multidisciplinary limb-salvage teams—especially podiatrists working with vascular and infectious disease specialists—are key to stopping the progression that leads to amputation.

LIMB Watch Series: Dr. Lady DeJesus DPM, FACFAS, DABPM, CWSP- Saving Soles: Minimally Invasive Breakthroughs in Diabetic Limb Salvage Jul 27, 2026

Show notes

LIMBWatch Series | Dr. Paula DeJesus DPM, FACFAS, : The Future of Limb Salvage Through Minimally Invasive Surgery
In this episode of the LIMBWatch Series on Diabetic Foot Files sits with Dr. Lady Paula DeJesus DPM, FACFAS, DABPM, CWSP— a triple board‑certified podiatric surgeon and Section Chief at Yale New Haven Health Greenwich Hospital
Dr. Dejesus shares her remarkable journey into podiatric medicine and discusses the clinical decision-making behind complex diabetic foot infections, osteomyelitis, peripheral arterial disease, and limb preservation. She explains how minimally invasive surgical techniques are transforming diabetic limb salvage, including innovative approaches to treating calcaneal osteomyelitis while avoiding major amputations such as minimally invasive techniques like Avedis suction curettage.
The conversation also explores the importance of multidisciplinary care, early vascular assessment, biomechanics, patient compliance, advanced imaging, regenerative medicine, and the compassionate communication needed to help patients understand amputation risk without losing hope.
Whether you’re a podiatrist, wound care clinician, vascular specialist, student, or simply passionate about preventing amputations, this episode is filled with practical clinical pearls and inspiring insights from one of today’s leaders in limb salvage.
In this episode you’ll learn:
When to escalate from conservative care to surgery
The role of vascular assessment in limb preservation
Why biomechanics is often the missing piece in wound healing
Modern approaches to diabetic foot osteomyelitis
How minimally invasive surgery is changing limb salvage
The value of multidisciplinary teams in reducing amputations
Strategies for improving patient compliance and communication
Clinical lessons every young limb salvage specialist should know
In this episode of Limb Watch, — shares real-world limb preservation strategies, including skin substitutes, and the importance of revascularization for diabetic foot infections.
Diabetic Foot Files is dedicated to advancing diabetic foot care, wound healing, and amputation prevention through conversations with world-renowned experts in limb salvage.

Who Owns the Toe? The hidden battle over responsibility, accountability, and limb salvage Jul 26, 2026

Show notes

Dr. G examines how diabetic toes and ulcers are rarely just wounds but visible warnings of neuropathy, poor circulation, infection, and gaps in care. She asks who is responsible for protecting the foot — the patient, primary care, podiatry, vascular, infectious disease, surgery, or nursing — and how fragmented referrals and delayed access can lead to a cascade ending in amputation.

The episode also explains hospital handling of amputated tissue, patients’ rights to their removed parts, and the future of limb preservation through surveillance technologies and coordinated responsibility to prevent avoidable loss.

Edge Trenching: Turning a Wound’s Cliff into a Healing Ramp Jul 25, 2026

Show notes

This episode introduces edge trenching, a novel debridement technique developed by Dr. Igor Melnichuk that targets dysfunctional wound edges (epibolies, hyperkeratosis, rolled or fibrotic margins) to create a biologically active transition zone and promote epithelial migration.

It explains the procedure, proposed mechanisms, clinical use—especially in diabetic plantar ulcers—how trenches are created and repeated, and emphasizes that edge trenching must be part of comprehensive care addressing perfusion, infection control, offloading, and underlying causes.

Vascular Insights with Dr. Giulia Baldazzi MD, vascular surgery fellow and PhD candidate from Italy 🇮🇹: Healing begins with circulation Jul 24, 2026

Show notes

Dr. Giulia Baldazzi, a vascular surgeon, fellow and phd candidate researcher, shares her journey from UCSF to Italy and explores advances in perfusion assessment, revascularization, and limb preservation for diabetic foot care.

She discusses diagnostic innovations (PAT, MaxCORE, NIRS), the importance of early vascular referral and multidisciplinary teams, and practical strategies to prevent amputations and improve healing.

Forgotten Infection Friday- The Great Pretender: Actinomycosis Masquerading as Diabetic Foot Infection Jul 24, 2026

Show notes

Actinomycosis is a rare, slow-growing filamentous gram-positive bacterial infection that can mimic cancer, tuberculosis, or chronic diabetic foot infections by producing woody fibrosis, interconnected sinus tracts, and characteristic yellow "sulfur" granules.

Diagnosis requires deep tissue biopsy and careful anaerobic culture or histology; treatment is prolonged high‑dose penicillin (or alternatives if allergic) often combined with surgical drainage and debridement.

Liquid Biopsies: The Future of Diabetic Foot Care Jul 23, 2026

Show notes

In this episode of Diabetics with Files, Dr. G explains liquid biopsies — blood tests that detect cell-free DNA and other molecular signals — and how they work.

We explore how this technology could help detect infection early, identify harmful inflammation, predict a wound’s healing potential, and personalize treatment for diabetic foot ulcers.

The episode also covers current limitations — cost, access, standardization, and need for clinical validation — and explains that liquid biopsies would complement, not replace, clinical exams and imaging.

Ultimately, liquid biopsies could shift wound care from reactive to predictive and improve limb salvage in the future.

Exudative tax- When Wounds Become Protein Vampires: The Hidden Drain Jul 22, 2026

Show notes

This episode explains how chronic wounds—especially heavily exudative and diabetic ulcers—act like metabolic drains, leaking proteins, growth factors, immune cells, electrolytes, and calories and impairing the body’ s ability to heal.

Listen for signs of protein loss (low albumin, persistent drainage, weight/muscle loss, delayed healing) and practical strategies to fight back: infection control, offloading, appropriate compression, nutrition optimization, and closing the wound to stop the ongoing resource loss.

LIMBWatch Series: Dr. David Alper, DPM-Beyond the Operating Room: The Legislative Fight to Save Limbs Jul 20, 2026

Show notes

LIMBWatch | Dr. David B. Alper – The Policy Behind Preventing Amputations

Why are so many lower extremity amputations still happening when the majority could be prevented?

In this powerful episode of LIMBWatch, Dr. Gabrielle Hutcheson sits down with nationally recognized limb preservation advocate Dr. David B. Alper, DPM, to explore the critical intersection of healthcare policy, reimbursement, advocacy, and limb salvage. Drawing on decades of clinical experience and legislative leadership, Dr. Alper explains why preventing amputations requires more than excellent medicine—it requires changing the healthcare system itself.

Together, they discuss the barriers clinicians face in obtaining early diagnostic testing, advanced wound care therapies, diabetic footwear, vascular imaging, and emerging technologies that could dramatically reduce limb loss. Dr. Alper also shares ongoing legislative efforts to improve access to care, simplify insurance requirements, expand diabetic foot protection programs, and strengthen multidisciplinary collaboration.

The conversation highlights the importance of early detection of peripheral artery disease (PAD) and chronic limb-threatening ischemia (CLTI), the role of advocacy organizations, and why clinicians, patients, and policymakers must work together to shift healthcare from reacting to amputations toward preventing them.

In this episode, you'll learn:

Why an estimated 85% of diabetic-related amputations may be preventable
The policy barriers limiting early PAD and CLTI diagnosis
How insurance reimbursement influences limb salvage decisions
Why diabetic footwear, vascular imaging, and preventative screening remain underutilized
The importance of multidisciplinary limb preservation teams
How clinicians and patients can become advocates for legislative change
Practical clinical pearls for identifying high-risk patients before limb loss occurs

Whether you're a podiatrist, vascular specialist, wound care clinician, primary care provider, healthcare administrator, policymaker, or patient advocate, this episode offers valuable insight into how policy decisions directly impact patient outcomes—and what can be done to change the future of limb preservation.

Because saving limbs starts long before the operating room—it starts with education, early intervention, and advocacy.

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