International Wound Journal最新文献

We aimed to investigate the learning needs of general practitioners and their preferences as regards the most appropriate teaching session for continuing medical education in wound management. A survey targeting general practitioners at the public health centres in the City of Helsinki. Twenty-seven general practitioners participated in the study. The majority (74.1%) had received education in medical school, 40.7% from wound care nurses, and 40.7% from colleagues. Participants felt the most competent in wound diagnosis (59.3%) and etiological tests (55.6%) and requested training in these topics (74.1% and 74.1%). A peer-led lecture (88.9%) was the most preferred technique, followed by lectures by wound care nurses (55.6%), an educational video (44.4%), a specialist-led lecture (37.0%), an interactive wound product session (29.6%), and digital self-study (29.6%). Wound diagnostics and etiological tests are recognised as crucial topics for continuing medical education. Peer-led lectures were preferred over other techniques; however, we observed varying preferences regarding the most optimal technique. Based on our results, we propose a half-day training including lectures, interactive and hands-on activities, and reflection, led by a peer and a wound care nurse with supporting video materials. Future studies could assess its impact on learning outcomes and wound care quality.

Patients with combat wounds and injuries, presented as extensive infected and purulent defects with antibiotic-resistant microflora, were treated in a surgical inpatient setting. Closure of extensive soft tissue defects of the limbs is possible using methods of plastic and reconstructive surgery and requires preoperative infection control. The lack of effect from preoperative treatment for purulent limb defects with antibiotic-resistant microflora leads to limb amputation. This clinical study proposes a method of treatment by hyperbaric oxygenation with an ozone-containing steam–water mixture as an anti-bacterial agent. Eighteen male patients, aged between 20 and 60 years, were categorised into three groups based on the time elapsed since the injury. All patients were treated using the proposed method. The high effectiveness of the proposed method was demonstrated in all groups and resulted in saving limbs from amputation, establishing suitable conditions for closing the soft tissue defects of the limbs and achieving significant progress in the recovery.

Chronic limb-threatening ischemia (CLTI) compounded by diabetic foot ulceration remains a leading precursor to major lower-extremity amputation. Transverse tibial transport (TTT) can improve perfusion but requires corticotomy and bulky external fixation. We report what is, to our knowledge, the first application of fully automated tibial periosteal distraction (PD) for limb preservation. A 65-year-old man with recurrent forefoot gangrene underwent tibial PD using a miniaturised, programmable motor to gradually elevate the periosteum. Through a 1 cm incision, a low-profile subperiosteal plate was implanted and linked to the motor, which advanced 0.031 mm hourly (0.75 mm/day) up to 10 mm. Distraction was completed uneventfully over 13 days, and the device was removed at the bedside on Day 21. Skin temperature increased by 2°C, and digital systolic (toe) pressure rose from 22 to 50 mmHg. The wound progressed to healing without complication. Automated PD may offer a minimally invasive, biologically driven alternative for high-risk CLTI patients, eliminating the need for patient-adjusted screws and standardising adherence. Prospective studies are required to validate its safety, durability, optimal distraction parameters and cost-effectiveness.

Investigate the epidemiological characteristics of outpatients initially diagnosed with skin ulcers who were ultimately confirmed to have cutaneous malignant tumours, and provide a diagnostic and therapeutic basis for the occurrence of secondary diseases in chronic wounds. We conducted a retrospective study analysing clinical data from patients initially diagnosed with skin ulcers at our hospital between July 2021 and February 2025, and analysed the epidemiological characteristics of malignant transformation in these ulcer cases. Among 128 patients initially diagnosed with skin ulcers, 16 cases (12.5%) were confirmed with cutaneous malignancies. The malignant group had a significantly higher mean age (69.44 ± 11.30 years) compared to the non-malignant group (58.39 ± 17.88 years; t = 5.752, p = 0.01). The distribution of lesion sites differed significantly between the malignant and non-malignant groups (χ² = 30.498, p < 0.01). In the malignant group, the head and neck (41.2%) and trunk & extremities (41.2%) were the predominant sites. The most common malignancy was squamous cell carcinoma (SCC). The trunk & extremities was the most frequent site (62.5%). The second was basal cell carcinoma, which mainly occurs in the head and neck (80.0%). The mean duration of ulceration was 4.5 years. The primary treatment modality was surgical excision (11 cases, 68.8%). Approximately one-seventh of skin ulcer cases were confirmed as cutaneous malignancies. This finding underscores the significance of skin ulcers as potential malignant lesions, highlighting the need for clinicians to maintain a high index of suspicion and promptly perform histopathological examinations to improve early detection rates of skin cancers.

Patient participation improves patient outcomes, but factors that predict participation in pressure injury prevention (PIP) are relatively unknown. This study aimed to identify patient-related factors predictive of patient participation in pressure injury prevention (PPPIP) in hospitalised medical and surgical patients and to assess the psychometric properties of the PPPIP scale. This observational substudy recruited consenting adults at risk of pressure who participated in a parent trial. The seven-item PPPIP scale was administered within 48 h of recruitment, with higher scores reflecting more participation. Multiple regression was used to identify patient-related factors predictive of patient participation. The scale's psychometric properties were assessed using confirmatory factor analysis and Cronbach's alpha. In total, usable data were obtained from 856 patients. Mean PPPIP scale scores were relatively high, with 571 (66.7%) scores reflecting agreement or strong agreement. The Cronbach's alpha was 0.81, and most confirmatory factor analysis criteria for construct validity were met. Only the use of mobility aids was statistically significant in the model, but it predicted a small amount of variability in PPPIP score (adjusted R² = 0.017; p < 0.001). Targeting patients with limited mobility may be a useful strategy when trying to engage patients in PIP if resources are limited.

A new surgical technique for ray amputation of the diabetic foot is described. The procedure provides soft tissue reconstruction using a local flap in combination with negative pressure wound therapy to close these wounds safely and effectively. This article reports on 12 patients treated with this technique in a Tertiary Hospital/General Hospital in Singapore and compares their outcomes to those of 12 comparative cases from neighbouring institutions under the same health group who received conventional dressings. The new technique led to a higher number of healed wounds (12 vs. 4) and a shorter median time to healing (46.5 vs. 196.5 days). No major amputation or further minor amputation of the target limb occurred in the group treated with the new technique, whereas one major amputation and two further minor amputations took place in the comparison group. Our results suggest that the new technique is promising in this diabetic population with concurrent comorbidities.

A lack of murine models that mimic impaired wound healing in people with type 2 diabetes has hindered research. The commonly used leptin-receptor knockout model (db/db) fails to accurately reflect the pathophysiology of human disease. This study aimed: (i) to investigate whether our novel murine model of diabetes, whilst less hyperglycaemic and obese than db/dbs, effectively demonstrated impaired wound healing, and (ii) to identify the most robust methods for quantifying wound closure. C57BL/6J mice were high-fat diet fed for a total of 11 weeks and injected with three doses of streptozotocin (65 mg/kg body weight) at week 5 with chow-fed mice as controls. All mice received four excisional wounds and were euthanised at day-4 or day-10 post-wounding (n = 8/group/timepoint). Wound healing was evaluated by digital planimetry, histology, Micro-CT, and tensiometry. Histological analysis was the most sensitive method for identifying impaired wound healing. Our high-fat diet/low-dose streptozotocin model had significantly higher non-fasting blood glucose (25.7 ± 5.4 mmol/L vs. 8.7 ± 0.8 mmol/L) and lower wound quality scores (day-4 post-wounding: 2.6 ± 1.9 vs. 4.4 ± 0.8) than healthy controls (both p < 0.05). At day-10 post-wounding, a linear trend in wound healing was observed between healthy controls, our novel model and the db/db model, indicating that our diabetic murine model may be clinically relevant for studying diabetes-related wound healing.

Venous leg ulcers (VLU) account for the majority of chronic wounds, with an estimated rise in prevalence due to demographic change. Care often does not comply with evidence, and patients remain passive and uninformed. To support general practice VLU care, the 'UlcusCrurisCare' (UCC) project developed a multimodal intervention comprising provider training, software-supported case management and standardised patient education. Experts from the medical community (physicians, nurses, association of medical assistants), health insurance and patient representatives provided their assessment of barriers in VLU care, requirements for intervention components and their expected effects. Semi-structured interviews and questionnaires were used at two measuring points. Qualitative data analysis was based on the Theoretical Domains Framework. Quantitative data were analysed descriptively. Ten experts named a lack of knowledge and application regarding compression therapy, reluctance to assume role as primary care provider, and inadequate remuneration as barriers for evidence-based VLU care. To effectively address these barriers, interventions are required to foster the use of compression therapy and patient education. A multimodal approach such as pursued in UCC is expected to effectively address deficits in VLU care at general practitioner level by promoting provider knowledge about evidence-based treatment and supporting patient adherence.

The study aimed to translate the PUKAT 2.0 tool from English to Italian. This was an adaptation and validation study; the validity of the Italian version was determined through content validity, item validity and construct validity. The reliability of the instrument was assessed by conducting a test-retest analysis on a sample of 62 nurses. The I-CVI indices were above the threshold of 0.78 for 91% of the questions, and according to the S-CVI index, 96% of the evaluators agreed that the questionnaire was highly relevant. The overall values for item difficulty were good, with two items being too difficult and none being too easy. The item discriminant index was overall good and reasonable, low for four items. The overall ICC was poor to moderate with a value of 0.48 (95% CI 0.26-0.65). The instrument has proven to be a good starting point although not yet completely reliable, as it clearly requires more basic preparation on the part of the staff, further modifications regarding the reliability and clarity of the questions and more training of the nursing staff if it is to be used in the Italian context.

Complex chronic wounds are an increasing health concern, affecting individuals both physically and psychologically. To measure the quality of life of this population properly translated and validated questionnaires in their native language are needed. The aim of this work is to provide a validated instrument for measuring the quality of life in the Catalan speaking population with complex wounds. A cultural adaptation of the Wound-QoL-17 questionnaire into Catalan was carried out by independent official translators and the back translation was approved by the original author. Validity, reliability, responsiveness, and feasibility were assessed. Face and content validity were determined by a group of experts: the 17 items of the Wound-QoL-17 Catalan version were appropriate for their purpose. Reliability was demonstrated by an interclass correlation coefficient of 0.884 for the scores obtained by two different observers and of 0.928 for the same observer on two time points. Chronbach's alpha coefficient was 0.926. Responsiveness was proved by a Pearson's correlation coefficient of 0.661. Feasibility was shown by the time, 3.46 min, taken to complete the questionnaire.