International Wound Journal最新文献

Retraction: Z. Xinyu, X. Sheng, “ Wound incidence and outcomes in atrial fibrillation: Comparing catheter ablation and anti-arrhythmic drug therapy,” Int Wound J 21, no. 4 (2023): e14612, https://doi.org/10.1111/iwj.14612.

The above article, published online on 21 December 2023, in Wiley Online Library (http://onlinelibrary.wiley.com/), has been retracted by agreement between the authors; the journal Editor-in-Chief, Professor Keith Harding; and John Wiley & Sons, Ltd. The authors submitted a request for retraction, reporting that the conclusions in the published article were partially inaccurate. Following an investigation by the publisher and Editor-in-Chief, they concluded that the peer review and publishing process were found to have been manipulated. The retraction has been agreed on because the findings reported in the article are not considered reliable. The authors did not respond to our notice of retraction.

Retraction: Y. Li, Z. Huang, K. Yu, and Y. Li, “ Effects of evidence-based nursing in preventing pressure ulcers in intensive care unit patients: A meta-analysis,” Int Wound J 21, no. 3 (2023): e14489, https://doi.org/10.1111/iwj.14489.

The above article, published online on 16 November 2023, in Wiley Online Library (http://onlinelibrary.wiley.com/), has been retracted by agreement between the journal Editor in Chief, Professor Keith Harding; and John Wiley & Sons, Ltd. It came to the publisher's attention from a third party that a number of articles shared concerning similarities in format and structure. Following an investigation by the publisher, the retraction of this article has been agreed on because the peer review and publishing process for this article were found to have been manipulated. The authors did not respond to our notice of retraction.

We read with keen interest the article titled “Antimicrobial resistance is not increasing in subsequent cases of ischaemic foot infections: a single-centre cohort from 2012 to 2021” by Salm et al., published in your esteemed journal.¹ This study addresses a significant aspect of infectious disease management by examining the link between antibiotic therapy and antimicrobial resistance (AMR) in recurring episodes of ischemic foot infections (IFI). However, several methodological considerations and limitations warrant further discussion to enhance the study's impact and validity:

Firstly, the study's statistical power is intrinsically tied to the sample size. The relatively small sample size used in this research may undermine the robustness of the findings, leading to an increased margin of error and reduced reliability of the conclusions.² Cohort studies require a sufficiently large sample to ensure the precision and generalizability of the results.

Secondly, retrospective cohort studies, such as this one, are prone to various biases. Incomplete recording of medical and laboratory data in patient files poses a significant risk. Moreover, the study did not adjust for critical confounding variables such as patient comorbidities and previous antimicrobial use, which could significantly impact the outcomes. A more rigorous adjustment for these factors is essential to accurately assess the relationship between antibiotic therapy and AMR.

Another notable limitation is the short follow-up period for monitoring antimicrobial resistance, which was confined to the duration of hospital stays. This approach fails to capture the long-term dynamics of AMR development and the recurrence of IFI post-discharge. Including follow-up data after patients are discharged would provide a more comprehensive understanding of AMR trends over time.

The findings of this study are crucial given the current global trends in AMR. However, the methodological limitations outlined above restrict the broader applicability of the results. Addressing these limitations in future research is essential to develop more effective strategies for managing IFI and combating AMR.

In conclusion, despite these limitations, the study by Salm et al. offers valuable insights into AMR patterns in IFI cases. Addressing the highlighted methodological issues would significantly bolster the robustness and applicability of the findings for future research and clinical practice. We urge the authors and the journal to consider these concerns and integrate feasible solutions in subsequent studies.

The authors declare no conflicts of interest.

The standard treatment for patients with confirmed Venous Leg Ulcers (VLUs) is compression therapy to improve the function of the calf muscle pump. There is a significant cohort of patients who are unable to tolerate optimal compression therapy or indeed any level of compression therapy. In addition, there is a cohort of patients who can tolerate compression whose ulcers show little or no evidence of healing. There is a need for ways to further improve calf muscle pump function and to improve venous ulcer healing in these patients. Published data were reviewed on the use of Muscle Pump Activation (MPA) using common peroneal nerve neuromuscular electrical stimulation (NMES) to improve calf muscle pump function. There is physiological evidence that MPA can improve calf muscle pump function and venous return in both control subjects and in patients with venous disease. The use of MPA has also been shown to improve venous flow volume and venous flow velocity on ultrasound scanning in patients with venous disease. MPA has been shown to improve microcirculation in the skin using Laser Doppler and laser Doppler Speckle Contrast Imaging, in both normal subjects as well as in patients with venous disease and VLU. A recent randomized controlled trial of MPA plus compression therapy compared with compression therapy alone, found significantly faster rates of healing with the use of MPA in addition to compression therapy. There are indications for the use of MPA as an adjunctive treatment to enhance calf muscle pump function in patients with VLU:

Wound development and healing involve intricate genetic and molecular processes, posing significant clinical management challenges. The objective of this study was to assess commonly used fat extracts' efficacy and safety (autologous fat, stromal vascular fraction and adipose-derived stem cells) in wound healing, particularly for refractory wounds, with the goal of providing evidence in clinical use. After a systematic review, 21 randomised controlled trials were included in our study. Based on the classification of human fat products, our meta-analysis revealed that the use of human fat products could speed healing rate, shorten healing time and achieve more complete healing, with statistically significant differences in outcome indicators when compared to conventional treatments. The analysis of histological findings across various studies indicated that fat extracts can promote epithelialization, collagen deposition and vascularization, thereby facilitating tissue regeneration and reducing inflammatory reactions. There were potential benefits to reducing patient pain levels after using adipose extracts. Furthermore, we analysed and summarised adverse events indicating the safe and effective clinical use of human fat products in wound treatment. Our research findings supported the efficiency of human fat products and demonstrated a high degree of safety in the clinical practice of wound management.

We read with great interest the article ‘Risk Factors for Amputation in Diabetic Foot Ulcers: A Retrospective Analysis’ by Zhang et al., published in your esteemed journal.¹ This study has investigated several risk factors for diabetic foot ulcer (DFU) amputation. However, we believe some methodological weaknesses and limitations warrant further investigation.

Firstly, a more thorough classification of the wounds should be conducted based on their anatomical locations, such as under and inner metatarsal heads and malleoli. Detailed differentiation between major and minor amputations, especially concerning wound locations, would enhance the categorization of patients.

Secondly, the study mentions that microvascular disease (e.g., retinopathy and neuropathy) is a systemic phenomenon, where diagnosis in one capillary bed suggests systemic microvascular dysfunction. Microvascular disease, peripheral artery disease (PAD) and diabetes mellitus are known to be associated with lower limb outcomes and nontraumatic amputations. However, the relationship between vascular involvement and amputations remains inadequately explored in the current research. Future studies should address this gap to understand better the vascular factors contributing to amputations.²

The Wagner classification system, commonly used for grading diabetic foot ulcers, was employed in this study. Nonetheless, other classification tools, such as the PEDIS classification—which includes factors like perfusion, extent, depth, infection and sensation—offers a more comprehensive assessment.³ The severity of each PEDIS subcategory is linked to various adverse outcomes of diabetic foot ulcers, and incorporating this system could provide deeper insights into patient prognosis.

Additionally, the study's omission of several comorbidities, such as kidney disease, congestive heart failure and mental illness, is a significant oversight. These comorbidities significantly influence the outcomes of diabetic foot complications and should be accounted for in future research.

While the study correctly identifies the neutrophil-to-lymphocyte ratio (NLR) as a marker for systemic inflammation, it would have been beneficial also to investigate other inflammatory markers, such as the platelet-to-lymphocyte ratio (PLR) and the monocyte-to-lymphocyte ratio (MLR).⁴ Including these markers could provide a more comprehensive view of the inflammatory processes involved.

In conclusion, although the study provides valuable insights into risk factors for amputation, addressing the limitations mentioned above would substantially strengthen the article and guide future studies. We hope the authors and the journal will consider these points and propose feasible solutions to the highlighted issues.

The authors declare no conflicts of interest.

Postpartum sepsis following caesarean sections among women in Uganda remains a risk. However, erratic supplies of standard dressing material make the risk a reality. Alternative wound dressing materials, therefore, remain a viable option. This study examined the outcome of a honey and olive oil-based dressing material on caesarean section wound healing. Using the Uganda Industrial Research Institute (UIRI), the study team created I-Dress, a wound dressing made of honey and olive oil. A case-series study was conducted on 25 women who received I-Dress following caesarean births at three health facilities in south-west Uganda. Vital signs (temperature, blood pressure, and heart rate) were measured, along with wound induration, dehiscence, and discharge. The primary outcome was the length of time it took for the wound to heal. The average age of the women who received I-Dress was 27.5 (±4.8) years. Following the application of I-Dress, all of the women (100%) had no wound induration or dehiscence, with only two (13%) experiencing wound discharge. The vast majority of the women (88%) had never had a Caesarean section before. The mean time required for wound healing was 2.2 (±0.7) days. The findings indicate that honey and olive oil-based dressings improve Caesarean section wound healing in terms of wound induration, dehiscence, and time to healing. These dressing materials can therefore supplement the standard dressing materials, especially in resource-constrained settings.

The evidence on products for the prevention of radiodermatitis is limited. The primary objective was to analyse the effectiveness of the spray skin protectant ‘non-burning barrier film’ in the prevention of radiodermatitis with moist desquamation in patients with the anal canal and rectal cancer followed in nursing consultations compared to a standardised moisturiser based on Calendula officinalis and Aloe barbadensis. Single-blind randomised clinical trial. The study was performed in a hospital in Rio de Janeiro, Brazil, with 63 patients undergoing anal canal and rectal cancer treatment, randomised into one of the following two groups: an experimental group, which used a spray skin protectant and a control group, which used a moisturiser. Data were collected using an initial and subsequent evaluation form and were assessed using descriptive and inferential analyses. Participants who used the spray skin protectant had a lower chance of presenting radiodermatitis with moist desquamation and a longer time without this outcome when compared to the control group. The overall incidence of radiodermatitis was 100%, with 36.5% being severe. Furthermore, 17.5% of participants discontinued radiotherapy due to radiodermatitis. There were no differences between the groups regarding the severity of radiodermatitis and the number of patients who discontinued radiotherapy. The skin protectant was effective in preventing radiodermatitis with moist desquamation amongst patients with anal canal and rectal cancer.

The disturbance of the inflammatory microenvironment is a frequent pathological trait of diabetic wounds, contributing to the emergence of numerous chronic illnesses. This is crucial in both the development and recovery of wounds caused by diabetes. This study aims to perform a bibliometric analysis of research on the inflammatory microenvironment within the domain of diabetic wounds (DW) over the past 10 years. The objective is to map out the current global research landscape, pinpoint the most significant areas of study and offer guidance for future research avenues. Our research involved querying the Web of Science Core Collection (WoSCC) database for all pertinent studies on the inflammatory microenvironment in diabetic wounds (DW). We utilized bibliometric tools such as CiteSpace, VOSviewer and R (version 4.3.1) to identify and highlight the most impactful studies in the field. The study encompassed a review of 1454 articles published from 2014 to 2023, highlighting China and the United States as pivotal nations in the research of the inflammatory microenvironment in diabetic wounds (DW). Within this sphere, the University of Michigan and Harvard University in the United States, along with Shanghai Jiaotong University in China, emerged as the most prolific institutions. WANG Y from China was identified as the most productive author, while KUNKEL SL from the United States received the most citations. The research primarily focuses on topics such as wound healing, repair processes, angiogenesis, oxidative stress and macrophage activity. Additionally, “macrophage” and “delivery” were pinpointed as the leading subjects with promising research potential in this area. Research on the inflammatory microenvironment of diabetic wounds is rapidly advancing through active international collaboration. The study of new mechanisms related to the inflammatory microenvironment and the development of novel materials for repair based on this microenvironment represent emerging fields of future research, particularly in terms of translational applications. This may offer guidance and novel perspectives for further research in the area of the diabetic wound inflammatory microenvironment.

Chan K, Loh CYY. Early postoperative infection in patient with IgM deficiency. Int Wound J. 2024;21(7):e70003. doi:10.1111/iwj.70003

Charles Yuen Yung Loh is the senior author of the Letter and should be added as co-corresponding author. Any queries or questions from readers can be directed to him. The email address is [email protected].