Wound Intelligence Wednesday:Gustilo Classification & Contamination: Don’t Close a Dirty Wound

In this episode of Diabetic Foot Files, Dr. G explores why seemingly small or clean-looking wounds—especially in diabetic patients—can hide severe underlying damage from retained plant matter and contamination. Learn how organic debris promotes infection, why imaging may miss wooden or thorn fragments, and the importance of exploration, serial debridement, and appropriate antibiotics. The episode reviews the Gustilo wound classification, practical management steps for different contamination levels, and imaging tips to avoid missing retained foreign bodies or necrotizing infections. Key takeaways: never primarily close contaminated wounds, antibiotics don’t replace debridement, and maintain high suspicion for gas-forming and rapidly progressive infections.