Diabetic Foot Files

This episode explains gossypiboma (retained surgical sponge), how the body mounts a foreign‑body granuloma response, and why these sponges can mimic infection or tumors and lead to chronic inflammation.

It highlights the added danger for people with diabetes (impaired immunity, poor circulation, neuropathy), shares a real diagnostic case, and reviews prevention steps like sponge counts, radiopaque markers, barcode systems, and surgical timeouts. The key message: persistent non‑healing wounds often need a detective approach to look beneath the surface.

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 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.

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.

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.