This episode of Diabetic Foot Files focuses on Klebsiella pneumoniae as an emerging and dangerous pathogen in diabetic foot ulcers, highlighting its capsule, biofilm formation, and rising antimicrobial resistance.It covers clinical presentation, the importance of deep tissue cultures, diagnostic tips, and a three-pronged treatment approach: source control (debridement), mechanical offloading, and targeted antimicrobial therapy with infectious disease involvement for ESBL or carbapenem-resistant strains.The episode also reviews prevention strategies, the role of vascular assessment, and current research directions including anti-biofilm approaches and adjunctive therapies.

In this episode of Diabetic Foot Files Dr. G opens the mini-series "Royal Wounds" by asking whether King Henry VIII’s notorious, years-long lower-leg wounds were due to diabetes, venous disease, or a mixed cause. Using historical accounts of his obesity, post-jousting trauma, chronic swelling, foul drainage, and fluctuating pain, the episode argues that his wounds most closely match chronic venous or mixed-etiology ulcers worsened by metabolic dysfunction.The episode also outlines how modern clinicians would evaluate and treat such wounds—vascular studies, glucose control, compression, debridement, and multidisciplinary care—and emphasizes that correct diagnosis, not status or money, is what heals chronic wounds.

Dr. G interviews Dr. Andronica Handie, DPM, MS about combining his background in nuclear medicine and biopharmaceutical sciences with podiatric innovation to tackle onychomycosis in diabetic patients. They discuss TripleClear HF, an all‑natural topical antifungal using nanotechnology to penetrate nail plates, trial results showing marked reductions in nail thickness, and safety advantages over systemic antifungals. Takeaways: TripleClear HF can be used preventively or as primary therapy to reduce fungal burden, improve compliance through rapid visible effects, and may play a role in long‑term diabetic foot hygiene and limb preservation alongside blood sugar control and daily foot checks.

Dr. G breaks down Morganella morganii — a gram-negative, urease-producing opportunist that appears in late-stage diabetic foot ulcers when tissue is necrotic, hypoxic, and antibiotic-weakened.The episode covers its origin, why it thrives in alkaline, chronic wounds, typical clinical signs, diagnostic pitfalls in polymicrobial cultures, intrinsic resistances (eg, ampicillin), treatment priorities like deep cultures, targeted antibiotics, aggressive debridement, and vascular assessment.

Episode decoding Stenotrophomonas maltophilia — a water-associated, multi-drug resistant bacterium that thrives in hospital plumbing and chronic diabetic foot ulcers. Learn how it forms biofilm, resists many antibiotics, and presents as a chronic non-healing wound that often requires targeted therapy (trimethoprim-sulfamethoxazole), aggressive debridement, and ecosystem-based care.We cover reservoirs and transmission, diagnostic tips (deep tissue culture, susceptibility testing), prevention strategies (sterile irrigation, avoid unnecessary broad-spectrum antibiotics, moisture control, early culturing) and why this quiet organism is a marker of chronicity and limb-threatening risk.

Dr. G dives into the Proteus genus—Proteus mirabilis and Proteus vulgaris—explaining their history, swarming behavior, urease-driven alkalinization, virulence factors, and why diabetic foot ulcers provide the perfect environment for these pathogens.The episode covers clinical clues (strong ammonia odor), diagnostic differences, biofilm-driven resistance, treatment priorities (sharp debridement, systemic antibiotics, pH control, and topical agents), and case examples including osteomyelitis and crystal formation.

In this episode of Diabetic Foot Files we explore Serratia marcescens — a red-pigment producing, opportunistic gram-negative bacterium that can rapidly worsen diabetic foot ulcers. We cover its history, microbiology and virulence, clinical clues (including the telltale pink drainage on dressings), diagnostic tips, and culture-directed treatment strategies.The episode also reviews wound care approaches to disrupt biofilm, antibiotic options guided by sensitivities, prevention steps for clinics and patients, and real-world case examples to help clinicians protect limbs and improve outcomes.

Dr. D breaks down two standardized swab techniques—the Levine and the Essen rotary methods—and explains why proper wound cleansing and pressure-based sampling are critical to getting accurate cultures. Learn step-by-step instructions, common mistakes to avoid, and when to use each method for diabetic foot ulcers.This episode highlights evidence comparing each technique to deep tissue biopsy, real clinical case examples, and practical tips to reduce false negatives, detect anaerobes, and improve patient outcomes.

In this episode of Diabetic Foot Files we walk through below‑knee amputation (BKA): why it’s performed, how surgeons select the level, and the step‑by‑step surgical technique including flap design, vascular and nerve management, and bone handling.We discuss risks of delaying surgery, post‑op care and staged rehabilitation, pain and phantom limb strategies, and the key questions patients and families should ask when facing a BKA.Clinically accurate, compassionate, and practical—this episode helps patients and caregivers understand when BKA can be life‑saving and how to prepare for recovery and return to function.

This episode explores how healthcare reimbursement incentives make amputations far more profitable than months of limb salvage and wound care for patients with diabetic foot disease.It explains the reimbursement differences, who benefits financially, why wound care programs struggle to stay open, and practical questions patients should ask to protect their limbs.

This episode of Diabetic Foot Files explains when and how it’s safe to expose dressings, incisions, ulcers or amputation sites to water — covering showers, baths, pools, beaches and hot tubs.Learn why uncontrolled moisture causes maceration, slower healing and infections (Pseudomonas, MRSA, Vibrio), and get practical prevention tips: use professional waterproof protectors or sponge baths, keep dressings dry, wait until sutures are out and there’s no drainage for 48–72 hours, and always get explicit clearance from your provider before swimming or bathing.

This episode explores the human side of diabetic foot ulcers and how they affect dating, self‑image, and intimacy. Dr. G blends medical facts, psychology, practical tips (what to wear, safe positions, disclosure scripts), and patient stories to help listeners date confidently while healing.Topics include the science of wound odor and drainage, mobility and fashion hacks, timing and scripting disclosure, low‑mobility date ideas, safe intimacy practices, and rebuilding identity after amputation—aimed at empowering patients and partners.

In this episode of Diabetic Foot Files Dr. G explores how pets can contaminate diabetic wounds, the common zoonotic bacteria involved (Pasteurella, Capnocytophaga, Staphylococcus species, Pseudomonas, Bartonella, fungi), why dog licking is a medical emergency, and typical signs of infection to watch for.The episode also covers recommended antiseptics and antibiotics, practical home prevention strategies (pet-free dressing areas, hand hygiene, laundering, grooming), and clear red flags when to seek emergency care.

Dr. G examines acetic acid (medical vinegar) as a low-cost, evidence-based treatment for multi-drug-resistant Pseudomonas aeruginosa in diabetic foot ulcers. The episode explains the bacterium's virulence and biofilm behavior, how acetic acid works (pH lowering, membrane and biofilm disruption), recommended concentrations (0.25–1%), application methods, safety precautions, and clinical outcomes.Listeners receive concise, practical guidance including soak times, treatment duration, and cautions for exposed bone, plus case examples and why acetic acid is a valuable, accessible tool for limb salvage and resource-limited settings.

Dr. Gabrielle Hutchinson-Donaldson explains when elective foot surgery is appropriate for people with diabetes, the key green and red flags to consider, and what must be included in valid informed consent.Learn how to prevent and manage post-operative wounds—what to do if an incision opens, steps for offloading, testing, imaging, pathology, and when to seek a wound care or limb salvage specialist to avoid infection, osteomyelitis, or amputation.

In this episode of Diabetic Foot Files the host exposes why patients with diabetic wounds are often unfairly blamed and explains how system gaps, provider bias, and limited training cause poor outcomes.Learn what thorough wound investigation looks like, what patients can and cannot control, and how both clinicians and patients can advocate for better, evidence-based limb preservation.

Dr. G explains why people with diabetes are far more vulnerable to surgical site infections — covering neuropathy, poor blood flow, high blood sugars, immune dysfunction, and common pathogens that colonize incisions.The episode reviews high-risk foot procedures, signs of infection, and evidence-based prevention: preoperative optimization, vascular assessment, strict glucose control, meticulous surgical technique, incisional hygiene, strict offloading, and early intervention.Key takeaway: most diabetic surgical site infections are preventable with careful patient selection, close follow-up, and responsible wound care — because every incision in a diabetic deserves special attention to avoid serious complications.

In this episode Dr. G explains “holiday heel” — calcaneal (heel) fractures that spike during the holidays from ladder falls, slips and carrying heavy decorations. Learn the common mechanisms, key exam findings (plantar bruising, Mulder’s sign, inability to bear weight), and why diabetics are at higher risk due to neuropathy, poor bone quality, and slower healing.Dr. G covers emergency concerns such as compartment syndrome, diagnostic steps including x-ray and CT, immediate management (non‑weightbearing, splinting, ER evaluation), expected recovery, and diabetic-specific complications. The episode finishes with clear prevention tips: ladder safety, proper footwear, clearing hazards, checking blood sugar, and delegating risky tasks.

This episode offers a concise Thanksgiving survival plan for people with diabetes: which foods help or harm wound healing, how to manage blood sugar before and after the meal, and which holiday habits raise ulcer risk.Learn practical tips on protective footwear, offloading during long cooking or shopping days, burn and fall prevention, and when to inspect feet or seek urgent care.Simple, actionable advice on what to eat, what to avoid, blood glucose targets and monitoring times, and immediate steps to take if you notice redness, drainage, or swelling.

Dr. G uses the Mercury Retrograde analogy to explain why diabetic foot ulcers often recur, covering medical and mechanical causes like osteomyelitis, unresolved pressure, neuropathy, scar tissue, and poor footwear. He outlines common hotspot locations, signs of underlying bone infection, and why healed skin remains fragile.The episode emphasizes immediate reassessment for reopened wounds, essential tests (cultures, labs, X-ray/MRI), and proven prevention: timely offloading (TCC, boots, custom orthotics), footwear adjustments, surgical fixes when needed, daily foot checks, moisturizing, and close follow-up to stop the cycle and avoid amputation.