International Wound Journal最新文献

Open femoral vessel access is commonly performed in vascular surgery, but surgical site complications (SSCs) occur frequently. The aim of this study is to evaluate the incidence and identify potential risk factors by applying a new standardised definition and grading of various types of groin wound complications. This retrospective analysis includes 201 consecutive patients with 219 vertical groin incisions to expose the femoral vessels for different vascular interventions. A prophylactic drain was placed intraoperatively in almost all incisions (91%). Groin SSCs were defined and graded into four categories according to a modified Clavien-Dindo classification. Potential risk factors were evaluated using univariable analysis. For multivariable analysis, a multiple logistic regression was performed. Cutoff values were determined through ROC analysis. According to the proposed definition, regular postoperative course grade 0 (no SSC) occurred in 163 patients (74.4%), grade 1 (minor SSC) in 10 (4.6%), grade 2 (moderate SSC) in 14 (6.4%), and grade 3/4 (major or life-threatening SSC) in 32 (14.6%) incisions. The incidence of clinically relevant SSCs (grade 2–4) was 21%. Drainage volume was an independent parameter that predicted relevant SSCs with a threshold value of 70 mL/24 h on postoperative day 4 (sensitivity 100%; specificity 67%; AUC = 0.835; p = 0.0004). Groin wound complications following vascular procedures are common. Lymphatic leakage appears to be the most significant, potentially preventable condition associated with relevant SSCs. Prophylactic or early therapeutic interventions should focus on reducing lymphatic morbidity.

Near infrared (NIR) therapy is increasingly used to enhance postoperative wound healing, yet clinical trial results remain inconsistent. To evaluate the effectiveness of NIR therapy on postoperative wound healing and identify treatment parameters associated with optimal outcomes: This systematic review and meta-analysis registered at PROSPERO (CRD420251163415) assessed evidence on comparing NIR therapy (630–1100 nm) with standard care or placebo on healing of surgical-induced wounds. A multilevel random-effects meta-analysis of standardised mean differences (SMDs) was conducted. Moderator analyses examined the wavelength, fluence, session number, application technique and anatomical site. Risk of bias was assessed using Cochrane RoB 2.0 and certainty of evidence was rated with GRADE. Fifty-six trials (N = 4920) were included for systematic review and 35 trials contributed 69 outcomes to meta-analysis. NIR significantly improved wound healing (0.78, [0.46–1.09], p < 0.01) and reduced postoperative pain (0.71, [0.24–1.17], p < 0.01), but heterogeneity was high and effects varied across studies. Optimal outcomes were associated with short NIR wavelengths (700–850 nm), 4–10 sessions and non-contact application. Effects on swelling, scarring and inflammatory markers were inconsistent. Overall, certainty of evidence was very low. This first systematic review and meta-analysis indicates that NIR therapy demonstrates promise for enhancing postoperative healing and reducing pain, though effects vary by protocols.

Although topical oxygen therapy (TOT) is a promising treatment for chronic wounds, its clinical efficacy and safety remain to be rigorously established. We conducted a two-arm randomised controlled trial to evaluate the efficacy and safety of TOT for treating chronic wounds by a commercially available portable continuous diffusion of oxygen (CDO) system. Eighty-eight patients were allocated to the TOT (n = 44) or moist wound therapy (MWT) (n = 44) group for a 28-day intervention period, followed by standardised MWT for unhealed wounds until the 12-week endpoint. Eighty-eight patients were allocated to either the TOT group (n = 44) or the standard MWT group (n = 44) for 28 days (or until wound closure) and were followed for up to 12 weeks. Wound area, depth, pH, healing rate and healing time were assessed weekly for 28 days or until 12 weeks. Any adverse event was observed at the same time. At day 28, the TOT group demonstrated significantly greater reductions in wound area and depth compared with the MWT group (p < 0.05). The wound bed pH in the TOT group was lower than the MWT group at day 14 and 28. Although the healing rate was higher in the TOT group than in the MWT group at day 28 (45.5% vs. 11.4%, p < 0.001), the healing rate in both groups was similar at week 12 (95.5% vs. 90.9%, p = 0.536). The healing time of the TOT group was shorter than that of the MWT group at week 12 by 13.5 days (95% CI: 6.74–15.40; p = 0.004). No TOT-related adverse events were reported. These findings indicate that portable TOT can significantly accelerate wound healing, particularly by improving wound bed pH that could facilitate subsequent healing processes in patients with chronic wounds.

Burn injuries are a significant cause of morbidity and mortality globally; however, limited data are available from low- and middle-income countries such as Jordan. This study aimed to describe burn patient presentation, initial management and factors associated with in-hospital mortality. A retrospective descriptive study was conducted using records of 493 patients admitted to a national referral centre in Jordan between 2018 and 2022. The sample was predominantly male (61.5%) with a mean age of 19.6 years (SD = 21); children under 18 years comprised 58.4%. The mean total body surface area (TBSA) burned was 18%. Flame (50.1%) and scald (44.6%) injuries were most common. Inhalation injury occurred in 25.8% and 21.3% required mechanical ventilation. The hospital mortality rate was 15.6%, significantly associated with TBSA, age, inhalation injury and low serum total protein. Baux and revised Baux scores showed high predictive accuracy (AUC = 0.902 and 0.918). Logistic regression identified TBSA, age, inhalation injury and total protein level as independent predictors of mortality. Burn injuries in Jordan disproportionately affect children and are associated with substantial mortality. Early identification of high-risk patients using validated scores and prompt nutritional and respiratory interventions are essential. Multicentre studies and a national burn registry are recommended to guide future policy and care improvements.

EXPRESSION OF CONCERN: A. K. Mousa, A. A. Elshenawy, S. M. Maklad, S. M. M. Bebars, H. A. Burezq, S. E. Sayed, “Post-Burn Scar Malignancy: 5-Year Management Review and Experience,” International Wound Journal 19, no. 4 (2022): 895–909, https://doi.org/10.1111/iwj.13690.

This Expression of Concern is for the above article, published online on 14 August 2023 in Wiley Online Library (wileyonlinelibrary.com), and has been issued by agreement between the journal Editor-in-Chief, Professor Keith Harding; and John Wiley & Sons Ltd. An investigation by the publisher found that images in Figures 8B and 8C had been duplicated and rotated, albeit with different staining. In addition, the investigation found that information regarding the study's ethical approval and informed consent procedure were unclear. In addition, the study reported in the article is not registered in a clinical trial registry, as required by the journal's guidelines.

The authors responded to an inquiry by the publisher stating that the article received approval from the Aswan University ethical committee and that the study was not registered in a clinical trial registry because no trial management protocol was applied to the study. The authors did not provide original ethical approval documents as requested and did not provide an explanation for the duplicated images nor all original data for the study. The Expression of Concern has been agreed to because the concerns regarding a duplicated image and lack of clarity regarding the ethics and informed consent procedures remain unresolved. The authors were informed of this Expression of Concern.

Pressure injuries represent a significant public health challenge in the context of global population aging. As China faces rapid aging, the characteristics of its disease burden and the strategies for prevention and control remain unclear. This study analyses the trends in the disease burden of pressure injuries in China over the past 30 years, based on the Global Burden of Disease (GBD) 2021 data, and predicts the future trends over the next 20 years. The GBD 2021 data were used in combination with the Joinpoint regression model, age-period-cohort (APC) model and Bayesian age-period-cohort (BAPC) model to analyse the burden of pressure injuries in China from 1990 to 2021 and forecast trends from 2022 to 2040. Additionally, decomposition analysis was performed to quantify the contribution of population aging to the disease burden. In 2021, the number of people with pressure injuries in China was 102 938.9, the number of new cases was 397 312.3, the disability-adjustede life years (DALYs) totaled 27 383.5 and the number of deaths was 3131.5. The gender difference was characterised by ‘higher prevalence in middle-aged men, with a reversal in very old women’. Between 1990 and 2021, the burden of pressure injuries significantly increased, with population aging being the main driving factor (46.5%–65.0%). The cohort effect indicated a higher risk for those born before 1942 (RR = 1.04–1.86), and a decreasing risk for those born after 1960 (RR = 0.91). Future projections suggest a 25.8% decrease in total cases, but an increased burden in those aged 85 and older, with deaths rising by 127%. This study highlights the aging-driven burden of pressure injuries in China, along with gender differences and typical period and cohort effects. As the population ages, the burden of pressure injuries in older age groups will continue to rise. The findings provide evidence for the ‘Healthy China 2030’ initiative and call for the inclusion of pressure injury prevention and control in the core agenda of national aging governance.

Needling therapy may be a novel alternative therapeutic intervention for burn injuries and related complications. This scoping review aimed to comprehensively evaluate the evidence status of needling therapy for burns and their complications. Studies on needling therapy for burns and related complications were retrieved from inception to 1st June 2024. Nine databases (MEDLINE, Embase, CENTRAL, CNKI, CiNii, RISS, KISS, DBpia and OASIS) were searched without any language or study-type restrictions. The study design, details of the needling therapy, and results of needling for burn injuries (or related complications) were evaluated. Of the 1475 articles screened, 46 studies (comprising 16 experimental studies, 12 case studies, four observational studies, 13 randomised controlled trials, and one systematic review) were included in the final analysis. Most studies (71.7%) investigated the acute-phase burn wound healing process, while the remaining studies (28.3%) focused on the modulation of burn-related complications. Experimental studies demonstrated that needling therapy activates phases of the wound healing process including the inflammation, proliferation, and remodelling phases and modulates the cholinergic anti-inflammatory response in burn-related acute symptoms. Clinical studies exhibited a significant heterogeneity regarding treatment period, patient population, and needling type across different study designs. Experimental studies have primarily focused on the wound healing process itself, whereas clinical studies have investigated short-term outcomes related to burn complications, with great heterogeneity observed in the methods of needling employed. Further studies are required to strengthen research gaps between experimental and clinical research, with proper treatment and evaluation periods to demonstrate the effectiveness of needling therapy for burns and associated complications.

Trial Registration: INPLASY202450102

L. Yu, Y. Wang, D. Ma, et al., “In-Hospital Nursing Care Intervention Increasing the Effect of Vacuum Sealing Drainage on Wound Healing: A Meta-Analysis,” International Wound Journal 20, no. 8 (2023): 3371–3379, https://doi.org/10.1111/iwj.14169.

In the Results section, the sentence “Then, the rest of 92 studies were checked, and 47 studies were excluded for their irrelevancy to our study objective” was incorrect. It should have been: “Then, the rest of 92 studies were checked, and 69 studies were excluded for their irrelevancy to our study objective.”

We apologise for this error.

The aim in this human trial is to compare the efficacy and safety of polygalacturonic–caprylic acid (PG–CAP) ointment to MediHoney in chronic wounds at three international medical centres. In this prospective open-label study, patients with chronic full-thickness wounds were randomised to daily treatment with PG–CAP ointment or MediHoney. Assessments were obtained weekly for 6 weeks. The validated Pressure Ulcer Scale for Healing (PUSH) score was used to track healing. Efficacies were compared using the Wilcoxon rank-sum test for continuous variables and chi-square or Fisher's exact test for categorical variables. Twenty-six patients with chronic wounds were included. Baseline characteristics were comparable between the groups; however, the history of diabetes mellitus was higher in the PG–CAP group (p = 0.011). All 13 PG–CAP patients showed improvement (100%), compared to only 69% of the 13 MediHoney patients (p = 0.023). Half of the failures in the MediHoney arm were associated with death (15%). No failures, adverse events or deaths occurred in the PG–CAP arm. PG–CAP wound ointment is a novel combination of two plant-based compounds that pose minimal risk of promoting antimicrobial resistance, was highly effective for eradicating wound-pathogen biofilms in vitro and promoted chronic wound healing in vivo with minimal inflammatory reactions. Our findings support PG–CAP as safe, noninferior and possibly more effective than MediHoney in healing chronic contaminated wounds.