Diabetic Foot Files

Why Your Wound VAC Hurts: The Hidden Pain Behind Healing

19 min · 2. juni 2026
episode Why Your Wound VAC Hurts: The Hidden Pain Behind Healing cover

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Dr. G explains why negative pressure wound therapy (wound VAC) can cause significant pain—covering foam adherence, nerve ingrowth, inflammation, and the four types of VAC-related pain. He highlights why pain may signal complications in diabetic wounds and why neuropathy does not always mean no pain. This episode offers practical solutions: premedication, topical anesthetics, saline soaking, silicone contact layers, continuous versus intermittent modes, regional blocks, and the role of communication and monitoring to reduce suffering while preserving limb salvage.

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episode Positive vs. Negative Surgical Margins- Every Millimeter Matters: Surgical Margins in Diabetic Limb Salvage cover

Positive vs. Negative Surgical Margins- Every Millimeter Matters: Surgical Margins in Diabetic Limb Salvage

In this episode of Diabetic Foot Files Dr. G explains why surgical margins in diabetic foot surgery — especially with osteomyelitis — directly affect recurrence, healing, and the risk of further amputation. She covers the difference between positive and negative margins, how pathology and imaging guide management, and how margin status influences antibiotics, reoperation, and prognosis. Practical steps to improve margin status are discussed, including thorough debridement to bleeding bone, preoperative imaging and vascular assessment, offloading, and close coordination with infectious disease. Key takeaway: achieving negative margins greatly increases healing odds, while residual infected bone significantly raises recurrence and higher-level amputation risk.

I går24 min