International Wound Journal最新文献

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.

The management of diabetic foot ulcers in patients with peripheral artery disease remains challenging. Human placenta-derived cells (PDA-002), a mesenchymal stromal cell-like population obtained from full-term placental tissue, possess angiogenic and tissue regenerative properties. Participants were stratified based on peripheral artery disease status. A total of 159 individuals were randomly assigned to receive intramuscular PDA-002 at one of three doses (3 × 10⁶, 10 × 10⁶ and 30 × 10⁶ cells) or a placebo. This Phase 2 multi-center, randomised, double-blind, placebo-controlled trial evaluated adults with chronic diabetic foot ulcers with and without peripheral artery disease. The primary efficacy endpoint was the proportion of participants achieving complete wound closure of the index ulcer within 3 months, with sustained closure maintained for an additional 4 weeks. PDA-002 was well-tolerated, with no treatment-related serious adverse events. Intramuscular PDA-002 treatment achieved the highest efficacy at the 3 × 10⁶ cell dose within the peripheral artery disease subgroup (38.5% vs. 22.6% for placebo), meeting a stringent 4-week durability endpoint that surpassed the U.S. Food and Drug Administration's recommended 2-week sustainability criterion. PDA-002 shows promise as a breakthrough treatment for diabetic foot ulcers and peripheral artery disease, demonstrating efficacy with two intramuscular doses and no re-treatment.

Trial Registration: ClinicalTrials.gov identifier: NCT # 02264288

Hypertrophic scars (HTSs) result from excessive collagen accumulation and impaired wound remodelling, leading to considerable aesthetic and functional concerns. Despite the availability of various treatment strategies, their clinical success remains limited, emphasising the need for alternative approaches. Human amniotic fluid (hAF), naturally enriched with cytokines and growth factors, has emerged as a promising biological material for tissue regeneration. This study investigated the therapeutic potential of two forms of hAF—pooled-frozen and pooled-frozen gamma-irradiated—in a rat model of hypertrophic scarring. Fifteen adult male Sprague–Dawley rats were randomly assigned to receive subcutaneous injections of either saline, pooled-frozen hAF, or pooled-frozen gamma-irradiated hAF at the wound margins on days 1, 3 and 5 following the induction of hypertrophic scars via talc powder application. After 21 days, wound healing was evaluated through histological and immunohistochemical analyses. Both treatment groups demonstrated significantly improved wound healing compared to the control group. Granulation tissue formation was enhanced in the treated groups, particularly in animals receiving gamma-irradiated fluid, which also showed superior collagen remodelling characterised by aligned and mature collagen bundles. Both treatment groups demonstrated an increase in M2 macrophage density, as evidenced by elevated Arg⁺/CD68⁺ cell ratios; however, this effect was more pronounced in the gamma-irradiated group, indicating a stronger shift towards a regenerative immune profile. Enhanced reepithelialisation, increased hair follicle density and reduced scar thickness were also observed. These findings suggest that gamma-irradiated hAF provides a more effective and minimally invasive therapeutic option for modulating scar formation and improving wound healing outcomes, supporting its potential translation into clinical applications for the management of hypertrophic scars.

Surgical site infections (SSI) and surgical site complications (SSC) significantly impact surgery outcomes, increasing hospital stays and mortality rates, and negatively affecting patients' quality of life. Closed-incision negative pressure therapy (ciNPT) emerged as a prophylactic strategy to reduce these complications. However, its applicability across different surgical procedures remains unclear. A scoping review was conducted to synthesise the available evidence on the use of ciNPT in different surgical contexts. A multidisciplinary panel of experts from different surgical specialties was assembled to identify patient risk factors for SSCs specific to each modality. Surgical procedures were categorised based on anticipated SSC rates and the impact of SSI. A decision diagram was finally developed, providing tailored recommendations for ciNPT use according to individual surgical circumstances. The findings of the review indicate that ciNPT effectively reduces SSI and SSC in most surgical procedures. Key patient-related factors influencing outcomes, such as age, obesity, and malnutrition, were outlined. Additionally, a specialty-based list of surgical procedures was compiled, specifying whether ciNPT is recommended, not recommended, or conditionally recommended based on specific criteria. This study underscores the benefits of ciNPT and provides a comprehensive guide to its application across several surgical specialties, aiming to optimise patient management and inform clinical practise.

F. I. de la Rosa-Negrón, M. Á. Castaño-López, and F. Navarro-Roldán, “Predictive Value of Clinical and Demographic Variables in Martorell Ulcers: An Analysis Based on Case Reports” International Wound Journal 22, no. 8 (2025): e70721, https://doi.org/10.1111/iwj.70721.

The epidemiological data at the end of the first paragraph of the Introduction is supported by reference no. 21 (Liroz-Imaz A., García-Montero A., Gombau-Baldrich Y., and Guinot-Bachero J., “Martorell Hypertensive Ischemic Ulcer: A Pain Perspective Approach,” Gerokomos 33, 3 (2022): 146–151).

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