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.

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