Dr. G explains why leaving the fifth digit after other forefoot amputations creates biomechanical imbalance, increased lateral pressure, and recurrent ulcers. He reviews the muscle and tendon changes that drive varus/supination bias and lateral overload.

The episode covers when a full transmetatarsal amputation (TMA) is preferable, the importance of adjunct procedures like Achilles tendon lengthening, and post-op management including orthotics, AFOs, rocker soles, and rehabilitation to restore balanced gait and prevent reulceration.

This episode explains why limb salvage is a philosophy, not just a procedure, and gives the essential questions patients and clinicians must ask before consenting to a lower-extremity or digital amputation.

Topics include global amputation rates and mortality, distinguishing infection from ischemia, the importance of vascular assessment and revascularization, diagnosing and treating osteomyelitis, proper offloading and advanced wound-care strategies, and assessing metabolic healing capacity.

The host also covers when amputation is lifesaving, alternatives to amputation, informed consent, and practical steps to ensure a thorough, multidisciplinary approach to preserving limbs when possible.

This episode explains why precise wound sizing—length, width, depth, surface area, volume, undermining and tunneling—is the most important metric in wound care. Dr. G covers practical measurement techniques, common mistakes, and devices to improve consistency.

Key takeaways: always document depth, use disposable rulers and sterile probes, measure baseline and weekly (pre/post debridement), and escalate care if size doesn’t reduce sufficiently within weeks. Size changes, not vibes, predict healing and limb risk.

In this episode Dr. G explains auto-amputation — when severely ischemic tissue becomes irreversibly necrotic, the immune system walls it off (demarcation), and the dead segment desiccates and may spontaneously detach. You’ll learn the step-by-step mechanisms from loss of blood flow and ATP depletion to fibro-inflammatory border formation and bone resorption.

We also cover why demarcation is not healing, how infection can convert dry gangrene to dangerous wet gangrene, and when urgent vascular care is needed to prevent limb loss or life-threatening complications.

This episode explores why wheelchair-bound diabetic patients are at high risk for foot ulcers despite not walking. It explains how static pressure, neuropathy, contractures, and poor positioning concentrate force on the heels, lateral toes, and dorsal toes, leading to deep, hard-to-heal wounds.

Dr. G covers common ulcer sites, pressure-mapping thinking, prevention strategies (heel offloading, padded foot plates, AFOs, daily inspection), the role of caregivers, and practical tips for limb salvage and early detection.

Dr. G breaks down essential wound-care terminology and explains why precise medical language matters for diagnosis, treatment, and communication with colleagues. The episode covers types of cell death, infection descriptors, gas in tissues, depth and space terms, vascular terminology, biofilms, debridement techniques, and common board-style questions.

Listeners learn practical phrasing to replace vague descriptions (e.g., "purulent exudate" instead of "pus", "chronic limb-threatening ischemia" instead of "bad circulation") and how accurate documentation can improve care and limb salvage.

This episode explains why a "black toe" is usually a sign of systemic vascular failure and breaks down the three main causes—chronic digital ischemia, acute arterial embolism, and blue-toe (cholesterol) syndrome—covering how each presents, key distinguishing features, essential diagnostic tests, and immediate management steps.

Takeaway actions include calling vascular early, avoiding premature amputation, initiating urgent anticoagulation for embolism when indicated, providing supportive care for cholesterol emboli, and preventing future events through diabetes control, smoking cessation, lipid management, and careful vascular intervention.

Dr. G explains how pregnancy alters diabetic foot care and why you must treat maternal and fetal risks together. This episode covers stricter glucose targets in pregnancy, safest imaging (ultrasound, MRI without contrast), preferred local anesthesia (lidocaine without epinephrine), recommended antibiotics (e.g., clindamycin), and cautions on CT, gadolinium, and long-term silver or iodine dressings.

Key practical points include careful vascular and wound exams, prompt evaluation of puncture wounds and foreign bodies, multidisciplinary decision-making with obstetrics, and tailoring wound care and procedures to minimize fetal risk while managing maternal infection and ischemia.

This episode uses George Orwell's Animal Farm as an allegory to examine how healthcare systems can prioritize profit, rules, and convenience over equitable wound care. Dr. G explains how delays, denial of vascular studies, and systemic bias lead to unnecessary amputations and worse outcomes for underserved patients.

He outlines practical wound-care commandments—vascular evaluation, offloading, infection control, prevention, and persistence—and urges clinicians and patients to choose limb salvage over quick amputation. The episode emphasizes endurance, patient advocacy, and treating every limb as if it belonged to someone you love.

Dr. Gabby (Dr. G) the Skin Gardener  reframes wound care as "skin gardening," explaining how skin regenerates layer by layer and why diabetic foot ulcers reflect a breakdown of the body’s ecosystem. She covers history, skin anatomy and cell roles, how diabetes disrupts healing (neuropathy, ischemia, infection), and why the basement membrane, fibroblasts, and perfusion are essential.

Practical takeaways include the core needs for growth: oxygen and perfusion, offloading and mechanical protection, moisture balance, debridement, and replacing missing signals. She also previews future tools—stem cells, bioengineered skin, and personalized therapies—to cultivate better healing outcomes.