International Wound Journal最新文献

The aim of this study was to assess the performance and safety of daily treatment with a 0.2% hyaluronic acid-based hydrogel (Hyalo4 Skin Gel) in patients with chronic and acute wounds. The primary endpoint was the amelioration rate after 14 days of treatment, defined as the percentage of patients showing improvement in at least one of the following wound characteristics: wound tissue type, exudate amount, or type. Secondary endpoints included assessments of the treatment's effects on wound bed type, exudate amount and type, and patients' quality of life (EQ-5D QoL), as well as its safety and ease of application. Data were collected up to 56 days of treatment. A total of 170 patients were enrolled. Wound bed amelioration was observed in 46.0% of the patients after 14 days. The amelioration rate increased from 0.291 after 7 days to 0.561 after 56 days. The treatment promoted wound healing, increased granulation tissue formation, and normalized exudate levels. Additionally, QoL significantly improved, and the product was deemed easy to apply and safe, with no serious treatment-related adverse events reported. Being effective in enhancing the re-epithelialization of both acute and chronic wounds, Hyalo4 Skin Gel emerges as a promising strategy, improving clinical outcomes across a wide range of patients.

This integrative review aimed to describe the postoperative wound care practices and knowledge of nurses in acute care settings. Whittemore and Knafl's framework was used to identify and synthesise relevant studies. Full-text, primary articles published after 2000, focusing on postoperative wound care by nurses in hospital settings, were included. Quality appraisal was undertaken using the Mixed Methods Appraisal Tool (MMAT) for qualitative and quantitative studies and the Standards for QUality Improvement Reporting Excellence (SQUIRE) 2.0 for quality improvement (QI) studies. Five databases were searched (MEDLINE, Scopus, CINAHL, Embase and Web of Science) in August 2024. Of the 5329 studies, 36 articles were included. Inductive content analysis was used for data synthesis. Three categories were identified: Variation in using a holistic approach impacts optimal wound care practice, nurses' surgical wound care practices are shaped by individual factors, organisational support, and resource availability, and nurses' participation in surgical wound care is influenced by role clarity and multidisciplinary collaboration. In conclusion, this integrative review highlights that acute care nurses predominantly focused on technical dressing procedures with limited emphasis on comprehensive assessment, documentation, nutrition and patient education. Therefore, adopting a more holistic approach in surgical wound care could minimize practice variations among nurses.

This prospective, double-blind controlled trial was conducted to determine the effect of silicone gel in the reduction of postoperative scar after bilateral inguinal varicocelectomy. Thirty-four patients were enrolled in this study; the right-side inguinal scar was treated with silicone gel and petroleum jelly (Vaseline) applied on the left side as a placebo for 60 consecutive days. Scars were evaluated using the Vancouver Scar Scale, pruritus and pain. The result of this study showed that silicone gel was effective in the regression of postoperative scar after microscopic inguinal varicocelectomy in five key parameters, including vascularity, pigmentation, pliability, height and pruritus in comparison to placebo application (p < 0.05), while its effect on pain was insignificant (p > 0.05). The study showed that silicone gel had a considerable effect in the treatment and management of postoperative scar management. Varicocele is a condition that is considered the most common cause of male infertility. While microscopic inguinal varicocelectomy is considered a gold standard in the management of varicocele, its postoperative complications, such as scar formation remain a concern. Recent studies show that silicone gel can be an effective non-invasive treatment for scar regression. Accordingly, we designed this trial to evaluate the effect of silicone gel after microscopic inguinal surgery. A prospective double-blind controlled trial was conducted on 34 patients who had microscopic bilateral inguinal varicocelectomy (their age ranged from 19 to 41) at Namazi hospital. Two weeks after surgery, each patient received two identical tubes for application on the scars, the first tube containing silicone gel and the second one dispensed with petroleum jelly (Vaseline). The right side was treated with silicone gel, and the left side with Vaseline twice daily for 60 days. Then, patients were evaluated three times: firstly 2 weeks after surgical repair; second appointment after 2 months and third one after 6 months after surgery, using the Vancouver Scar Scale, pruritus and pain score. The collected data were analysed in SPSS 26, using the chi-square and Mann–Whitney U tests. The significance level was defined at p < 0.05. This study showed that silicone gel was highly effective in scar parameters, including pliability, height, vascularity pruritic and pigmentation. However, its effect on pain reduction was not significant (p > 0.05). The results of the study indicated that silicone gel effectively improved scar characteristics following microscopic inguinal varicocelectomy, while its efficacy against pain was not significant.

This study aimed to gain clinician consensus on which signs/symptoms reported to be indicative of biofilm in chronic wounds are likely to be so. An international, two-round eDelphi process including wound care clinicians ran from December 2023 to February 2024. Participants rated 26 items on a 9-point Likert scale. Consensus to include: ≥ 70% of respondents rate an item 7–9, ≤ 15% rate it 1–3. Consensus to exclude: ≥ 70% of respondents rate an item 1–3, ≤ 15% rate it 7–9. Eleven items (visual indicators [a shiny, slimy, persistent layer, easily removed, returns quickly without frequent intervention]; failure to respond to antimicrobials; infection > 30 days duration; poor quality granulation tissue; stalled wound despite optimal management; persistent/prolonged inflammation; wound > 6 weeks duration; soft tissue deterioration despite antimicrobials/debridement; signs of local infection; tunnelling/undermining; presence of slough) achieved consensus to include status. To our knowledge, consensus work on this topic has not previously been performed on such a wide scale. When examined alongside similar work, clinical opinion on the matter lacks coherence. We hope that these findings will help direct us toward greater cohesiveness. The work supports a need for research to quantify the predictive abilities of signs and symptoms reported to be indicative of biofilm in chronic wounds.

In England, diabetes-related foot ulcers and related amputations equate to approximately 1% of the National Health Service budget. Most of these costs are related to hospital admissions with diabetes-related foot ulcers, found to be 8.04 days longer when compared to those without ulcers. Although South Asian (SA) populations living in Western countries experience disproportionately high diabetes rates, they exhibit significantly lower prevalence of diabetes-related foot ulcers and lower-limb amputations compared to White European populations. This paradox remains underexplored, necessitating a scoping review to map existing evidence, elucidate disparities, and identify gaps. To explore the burden of diabetes-related foot ulcers among South Asians living in Western countries by examining their incidence, prevalence, and predisposing factors. Assessing clinical outcomes and lived experiences during the ulcerative phase and reviewing existing literature on recurrence and long-term post-healing complications. Following Joanna Briggs Institute methodology and reported in line preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews. A comprehensive search will be conducted across databases, and registered with open science framework. This will be the first scoping review to map diabetes-related foot ulcers burden among South Asians in Western settings. Clarifying incidence and outcome disparities, highlighting research gaps, and suggesting directions for future studies.

Chronic limb ischemia (CLI) is a significant health issue, particularly among patients with diabetes who are at elevated risk of diabetic foot ulcers (DFU) due to peripheral neuropathy and ischemia. In Singapore, approximately one in six adults is affected by diabetes, with a lifetime risk of developing DFU ranging from 15% to 25%. This paper examines the indications, surgical techniques and postoperative protocols for transverse tibial transport (TTT), an innovative limb salvage procedure implemented in a general hospital in Singapore and presents our early experience with this technique. All six patients in our study successfully achieved limb salvage with complete wound healing, with a median healing time of 4 months. Four patients required additional wound debridement and skin coverage to facilitate healing. Importantly, none of the patients experienced pin site infections during the procedure or throughout the postoperative healing phase. Our study demonstrates favourable outcomes and underscores the clinical utility of TTT in augmenting the multimodal treatment of recalcitrant DFUs.

Complex reconstructions are often required after head and neck tumour resections, particularly in irradiated fields and areas with exposed bone. Fish skin grafts (FSG) have recently emerged as a potential adjunct in difficult wound healing. This case report series evaluates the effectiveness of FSG in combination with octenidine-based antiseptics, which have already shown beneficial results in split-thickness skin transplantation in high-risk patients, focusing on the time period for granulation and wound closure. Five patients with seven defects of different aetiology in the head and neck region received FSG applications. Defect sizes ranged from 2 × 4 cm (occipital) to 7 × 6 cm (temporal). Granulation was determined, with irradiated and non-irradiated wounds analysed separately. In three consecutive cases, octenilin gel (octenidine-based hydrogel) was implemented in the treatment regimen. Three patients achieved complete granulation, while two reached 66%–80% granulation. Non-irradiated wounds demonstrated faster granulation (mean 16.5 days) compared to irradiated wounds (mean 48.8 days). Although there was no statistical significance, a trend toward delayed healing in irradiated tissue was observed. Patients treated with octenilin gel showed favourable healing outcomes, including shorter granulation times. Despite the poor prognosis for uncomplicated healing in this cohort, both treatment protocols—octenisept with Flaminal forte and octenisept with octenilin gel—achieved satisfactory outcomes when combined with FSG transplantation. This approach appears promising for reconstruction in challenging head and neck wounds and warrants further evaluation in prospective clinical studies.

This study retrospectively reviewed 46 patients undergoing transmetatarsal amputation (TMA) between January 2017 and January 2023 to evaluate complication rates within 6 months and assess the predictive value of the SINBAD classification for re-amputation risk. Patients were categorised based on re-amputation occurrence, and clinical and demographic data were collected. Each case was evaluated using the SINBAD scoring system, with logistic regression used to assess associations. Among the patients, 28 (60.9%) experienced no re-amputation, while 18 (39.1%) underwent re-amputation. Baseline demographics and laboratory findings did not significantly differ between groups. The mean SINBAD score was significantly higher in the re-amputation group (3.67 vs. 2.29; p < 0.001), with logistic regression identifying SINBAD score as an independent predictor (OR 6.76; 95% CI: 2.18–21.02; p < 0.001). A SINBAD score of ≥ 4 was associated with a re-amputation rate of 90.9%. In conclusion, the SINBAD classification proves to be a simple and effective tool for predicting re-amputation post-TMA, facilitating risk stratification and surgical planning for diabetic foot ulcer patients.

This study aimed to determine the level of knowledge of nurses caring for inpatients about medical device-related pressure injuries (MDRPI). This descriptive and cross-sectional study was conducted in a city hospital. A self-reporting survey was provided to a sample of 217 nurses. The research data were collected using the ‘Personal Information Form’ to assess the independent variables and the ‘MDRPI Knowledge Questionnaire’ to measure the dependent variable, which is the nurses' knowledge level regarding MDRPI. The mean total score of the MDRPI knowledge questionnaire of the participant nurses was found to be 12.82 ± 2.99 on a scale from 0 to 25. In the study, a statistically significant difference was found between the educational level and the clinic where the nurses worked and the mean scores of the questionnaire (p < 0.05). When examining the correct responses given by nurses to the survey items assessing their knowledge of MDRPIs, the highest correct response rate was 94.9% for the statement “The appropriate medical device with the right size should be chosen for the patient to avoid MDRPIs,” whilst the statement with the lowest correct response rate, at 6.5%, was “To avoid the occurrence of MDRPIs, the skin under and around the medical device should be checked at least once a day.” As a result, it was found that nurses' knowledge level about MDRPI was moderate.