This episode explains why podiatrists are often the first clinicians to detect peripheral arterial disease in diabetic patients, describing common signs—shiny skin, hair loss, delayed capillary refill, painful ulcers and nondetectable pulses—and the pathophysiology behind early ischemia.

It outlines the importance of prompt vascular referral, diagnostic tests (ABI, toe pressures, duplex), and early interventions to improve limb salvage and reduce major amputations, advocating annual vascular evaluation for people with diabetes.

Dr. G explains how lidocaine works, why its chemistry matters, and how too much—especially on open, inflamed, or diabetic wounds—can cause serious central nervous system and cardiac toxicity.

The episode covers safe dosing calculations, differences between wound types, safer alternatives for anesthesia, and first-aid steps if toxicity occurs, emphasizing caution and medical supervision.

Dr. G breaks down the Unna boot: its origin, ingredients (zinc oxide, glycerin, gelatin), and how its semi‑rigid, inelastic compression helps venous stasis ulcers. He compares Unna boots to modern multi‑layer systems, explains the pressure mechanics and therapeutic targets, and highlights practical application tips.

Key cautions are emphasized: always assess vascular status/ABI before compressing, avoid use with critical arterial disease, heavy drainage, active infection, non‑ambulatory patients, or purely neuropathic plantar ulcers. Compression must be individualized and combined with correct diagnosis and overall wound care.