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Corrigendum to "Cognitive gaps and educational needs in foot self-care among patients with diabetic foot from a health literacy perspective: A qualitative study" [J Tissue Viabil 34 (2025) 100960]. “糖尿病足患者足部自我护理认知差异与教育需求的定性研究”[J].中国医学杂志,2015(4):391 - 391。
IF 2.4 3区 医学 Q2 DERMATOLOGY Pub Date : 2026-02-01 Epub Date: 2025-11-17 DOI: 10.1016/j.jtv.2025.100972
Xiaodan Lin, Xianghao Chen, Yuantian Li, Shumin He, Haidan Xie, Xiaozhou Zhou
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引用次数: 0
Prognostic factors of pressure injury: a scoping review 压力损伤的预后因素:范围综述
IF 2.4 3区 医学 Q2 DERMATOLOGY Pub Date : 2026-02-01 DOI: 10.1016/j.jtv.2026.100984
Yuki Fukui , Toshiaki Takahashi , Mao Kunimitsu , Miyako Muta , Sotaro Shimada , Gojiro Nakagami

Aim

This scoping review aimed to comprehensively map prognostic factors of pressure injuries and to synthesize reported evidence on their predictive performance to identify research gaps.

Materials and methods

Studies published between January 2001 and April 2025 were identified from databases using the PRISMA-ScR methodology. Eligible articles investigated the prognostic factors for pressure injuries.

Results

A total of 54 studies were included. Outcome definitions varied and included complete healing, time to heal, changes in wound area or depth, and assessment tool scores. Predictive performance was evaluated in 18 studies; however, one reported an area under the curve of ≥0.9. Prognostic factors were categorized according to their acquisition methods: Category A, clinical chart data or questionnaires (age, mobility, and pressure injury depth and size were reported most frequently); Category B, medical imaging (thermographic temperature differences and ultrasonographic findings were reported most frequently); and Category C, biomarkers (biofilm was most frequently reported). One study showed that combining factors obtained through different methods—none individually associated with outcomes—yielded a statistically significant prognostic value. Nineteen studies distinguished between superficial and deep-pressure injuries.

Conclusions

This review provides a comprehensive overview of the prognostic factors and predictive performance for pressure injuries, highlighting key research gaps. Prognosis was broadly defined, underscoring the need for standardization, although prognostic factors could still be mapped by acquisition method. Predictive performance was generally limited, highlighting the need for improvement. Stratifying prognostic factors by wound characteristics, such as depth, and integrating those from multiple acquisition methods may help address these gaps.
目的:本综述旨在全面绘制压力损伤预后因素,并综合有关其预测性能的报告证据,以确定研究空白。材料和方法使用PRISMA-ScR方法从数据库中确定2001年1月至2025年4月发表的研究。符合条件的文章调查了压伤的预后因素。结果共纳入54项研究。结果定义各不相同,包括完全愈合、愈合时间、伤口面积或深度的变化以及评估工具得分。在18项研究中评估了预测性能;然而,有一个报告曲线下面积≥0.9。预后因素根据其获取方法进行分类:A类,临床图表数据或问卷调查(最常报告的是年龄、活动能力和压伤深度和大小);B类,医学影像学(热成像温差和超声检查结果报告最多);C类,生物标记物(生物膜最常被报道)。一项研究表明,通过不同方法获得的综合因素-没有单独与结果相关-产生了统计学上显著的预后价值。19项研究区分了浅表和深压伤。本文综述了压力性损伤的预后因素和预测性能,突出了关键的研究空白。预后的定义很宽泛,强调了标准化的必要性,尽管预后因素仍然可以通过采集方法绘制。预测性能普遍有限,突出了改进的必要性。根据伤口特征(如深度)对预后因素进行分层,并整合来自多种采集方法的预后因素,可能有助于解决这些差距。
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引用次数: 0
Diagnostic accuracy of artificial intelligence to identify diabetic foot ulcers: A systematic review and meta-analysis 人工智能诊断糖尿病足溃疡的准确性:一项系统综述和荟萃分析。
IF 2.4 3区 医学 Q2 DERMATOLOGY Pub Date : 2026-02-01 DOI: 10.1016/j.jtv.2025.100975
Zhigang Chen , Xinliang Liu , Simeng Li , Zhenheng Wu , Haifen Tan , Fuqian Yu , Dongmei Wang , Changhua Zhu , Pengfei Lin

Background

The accuracy of artificial intelligence (AI) in diagnosing diabetic foot ulcers (DFUs) in dermatology remains uncertain.

Objective

To summarize the diagnostic accuracy of AI for DFUs and to provide specific theoretical basis for clinical diagnosis.

Methods

From the inception of the database up to November 3, 2024, we performed an extensive search across several databases, including PubMed, Web of Science (WoS), Embase, Scopus, the Cochrane Library, Wanfang, and the China National Knowledge Infrastructure (CNKI). To assess the overall efficacy of AI in diagnostic testing, we utilized combined metrics of sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and the area under the curve (AUC). Finally, we assessed the presence of publication bias using the Deeks' funnel plot asymmetry test.

Results

In this meta-analysis, a total of 16 references were identified. The summary diagnostic performance is as follows: sensitivity, 0.89 (95 % CI, 0.85–0.92); specificity, 0.93 (95 % CI, 0.90–0.95); PLR, 6.31 (95 % CI, 5.67–7.02); NLR, 0.14 (95 % CI, 0.12–0.15); DOR, 58.22 (95 % CI, 50.18–67.55); and AUC, 0.97 (95 % CI, 0.95–0.98). Subgroup analysis showed the best performance observed in studies with 300 to 1000 samples. Furthermore, the Fagan plot indicates an increase in post-test probability from 10 % pre-test to 59 % post-test.

Conclusion

In summary, our results suggest that AI has high accuracy in diagnosing DFUs.
背景:人工智能(AI)在皮肤科诊断糖尿病足溃疡(DFUs)中的准确性尚不确定。目的:总结人工智能对DFUs的诊断准确性,为临床诊断提供具体的理论依据。方法:从数据库建立到2024年11月3日,我们在PubMed、Web of Science (WoS)、Embase、Scopus、Cochrane Library、万方和中国知网(CNKI)等多个数据库进行了广泛的检索。为了评估人工智能在诊断测试中的总体疗效,我们使用了敏感性、特异性、阳性似然比(PLR)、阴性似然比(NLR)、诊断优势比(DOR)和曲线下面积(AUC)的综合指标。最后,我们使用Deeks漏斗图不对称检验来评估发表偏倚的存在。结果:本meta分析共发现16篇文献。总结诊断性能如下:敏感性为0.89 (95% CI, 0.85-0.92);特异性,0.93 (95% CI, 0.90-0.95);Plr, 6.31 (95% ci, 5.67-7.02);Nlr为0.14 (95% ci, 0.12-0.15);Dor, 58.22 (95% ci, 50.18-67.55);AUC为0.97 (95% CI, 0.95 ~ 0.98)。亚组分析显示,在300至1000个样本的研究中观察到最佳性能。此外,费根图表明测试后概率从测试前的10%增加到测试后的59%。结论:综上所述,我们的结果表明人工智能在诊断dfu方面具有较高的准确性。
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引用次数: 0
Corrigendum to Investigating UK packing practices for cavities resulting from the incision and drainage of perianal abscesses, a case for deimplementation? [Journal of Tissue Viability 2025 Nov;34(4):100965, doi: 10.1016/j.jtv.2025.100965]. 调查英国因肛门周围脓肿的切口和引流引起的空腔的填充物做法的勘误表,一个取消实施的案例?[j] Journal of Tissue Viability;[j].吉林大学学报(自然科学版),34(4):100965,doi: 10.1016/j.jtv.2025.100965]。
IF 2.4 3区 医学 Q2 DERMATOLOGY Pub Date : 2026-02-01 Epub Date: 2025-12-13 DOI: 10.1016/j.jtv.2025.100980
J Dumville, K Newton, J Mullings, P Wilson
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引用次数: 0
Lessons from earth, reimagined for space: Why pressure ulcer science must follow us beyond the atmosphere. 来自地球的教训,为太空重新设想:为什么压疮科学必须跟随我们超越大气层。
IF 2.4 3区 医学 Q2 DERMATOLOGY Pub Date : 2026-02-01 Epub Date: 2025-12-10 DOI: 10.1016/j.jtv.2025.100978
Pinar Avsar, Kerem Osman Cubuk, Tom O'Connor, Hannah Wilson, Declan Patton, Zena Moore
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引用次数: 0
Research progress of exosomes derived from platelet-rich plasma in angiogenesis of chronic diabetic wounds 富血小板血浆外泌体在慢性糖尿病创面血管生成中的研究进展。
IF 2.4 3区 医学 Q2 DERMATOLOGY Pub Date : 2026-01-09 DOI: 10.1016/j.jtv.2026.100985
Linlin Feng , Yuan Xue , Jingwen Kuang , Huiyi Tang , Pengcheng Xu
With the ageing of the population, the incidence rate of diabetes is also increasing an-nually. Difficulties in healing chronic wounds are common complications of diabetes and are highly detrimental to people's quality of life. There are many reasons why wounds are diffi-cult to heal. Among these factors, one of the most important is the obstruction of angiogene-sis. As important players in wound healing, platelets not only promote tissue regeneration and repair but also participate in the regeneration of blood vessels, playing an important role in improving wound healing in chronic diabetes. Research has revealed that the use of exosomes derived from platelet-rich plasma can significantly improve chronic wound healing in patients with diabetes. Therefore, exosomes derived from platelet-rich plasma have emerged as new targets for the treatment of chronic diabetic wounds. However, the standardized isolation, characterization, mechanism of action, and application of exosomes derived from platelet-rich plasma in the study of angiogenesis in chronic diabetic wounds have not been systematically described. This article reviews the latest advancements in understanding the mechanism by which exosomes derived from platelet-rich plasma promote angiogenesis in chronic diabetic wounds. It also reviews the therapeutic effects of PRP-Exos (hydrogel) and other novel applications. Consequently, this study systematically examines the research status and gaps in the understanding of how exosomes derived from platelet-rich plasma promote angiogenesis in chronic diabetic wounds, aiming to provide a theoretical basis for the further development and application of these exosomes in clinical treatment.
随着人口的老龄化,糖尿病的发病率也在逐年上升。慢性伤口愈合困难是糖尿病的常见并发症,严重影响患者的生活质量。伤口难以愈合的原因有很多。在这些因素中,最重要的因素之一是血管生成障碍。血小板作为创面愈合的重要参与者,不仅促进组织的再生和修复,还参与血管的再生,在促进慢性糖尿病创面愈合中起着重要作用。研究表明,使用来自富血小板血浆的外泌体可以显著改善糖尿病患者的慢性伤口愈合。因此,来自富血小板血浆的外泌体已成为治疗慢性糖尿病伤口的新靶点。然而,从富血小板血浆中提取的外泌体的标准化分离、表征、作用机制以及在慢性糖尿病伤口血管生成研究中的应用尚未有系统的描述。本文综述了富血小板血浆外泌体促进慢性糖尿病创面血管生成机制的最新进展。本文还综述了PRP-Exos(水凝胶)的治疗效果和其他新应用。因此,本研究系统梳理富血小板血浆外泌体促进慢性糖尿病创面血管生成的研究现状和空白,旨在为这些外泌体在临床治疗中的进一步开发和应用提供理论依据。
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引用次数: 0
Quantifying seated buttock tissue response to commercial wheelchair cushions through MRI and pressure mapping analyses 通过MRI和压力测绘分析量化坐着的臀部组织对商用轮椅坐垫的反应。
IF 2.4 3区 医学 Q2 DERMATOLOGY Pub Date : 2026-01-02 DOI: 10.1016/j.jtv.2026.100983
Sharon Eve Sonenblum , Mary Shea-Stifel , Kelly Waugh , Trevor Dyson-Hudson

Objective

To describe how different wheelchair cushion designs impact interface pressure and buttock tissue deformation during sitting.

Materials & methods

43 chronic full-time wheelchair users at high risk for pressure injuries were studied in an unloaded/suspended condition and on the Acta-Embrace, HR45, Jay J2 Deep Contour, Java, Matrx Vi, and/or the Roho HP cushions in randomized order. FONAR Upright MRI scans were used to measure seated soft tissue anatomy, and interface pressure mapping was used to measure peak pressure index (PPI) and pressure gradient.

Results

Median unloaded bulk tissue thickness beneath the ischium was 36.0 mm, decreasing by 53% when loaded. Tissue thickness under the ischium varied significantly between the Java (an off-loading design) and other pressure redistributing cushions (HR45, J2 Deep Contour, Matrx Vi) during upright sitting.
Greater bulk tissue thickness correlated with increased proximal thigh thickness and reduced deformation under the ischium. Average PPI and pressure gradient were 116.2 ± 44.8 mmHg and 26.1 ± 17.8 mmHg, respectively. Matrx Vi exhibited significantly higher PPIs and gradients despite comparable deformation. Both PPI and gradient showed weak inverse correlations with tissue thickness (r = −0.276, p = 0.002; r = −0.321, p < 0.001). Both were associated with greater immersion on most cushions.

Conclusion

The wheelchair cushions investigated showed comparable tissue deformation and PPI, though individuals with greater tissue thickness experienced less deformation. While participants experienced similar maximal tissue deformation across cushions, pressure gradients provided a more reliable representation of internal tissue response than PPI. Different cushion designs influenced load distribution uniquely despite similar overall tissue response, with notable differences between off-loading and pressure redistribution approaches. Regular skin checks remain essential for all wheelchair users.
目的:描述不同轮椅坐垫设计对坐位时界面压力和臀部组织变形的影响。材料与方法:对43名有压力损伤高风险的慢性全职轮椅使用者进行了研究,他们在卸载/悬浮状态下,随机顺序使用Acta-Embrace、HR45、Jay J2 Deep Contour、Java、matrix Vi和/或Roho HP坐垫。FONAR直立MRI扫描用于测量坐位软组织解剖结构,界面压力映射用于测量峰值压力指数(PPI)和压力梯度。结果:坐骨下非负重体组织中位厚度为36.0 mm,负重后减少53%。直立坐姿时,坐骨下组织厚度在Java(卸载设计)和其他压力再分配垫(HR45, J2 Deep Contour, matrix Vi)之间有显著差异。较大的体组织厚度与大腿近端厚度增加和坐骨下变形减少相关。平均PPI和压力梯度分别为116.2±44.8 mmHg和26.1±17.8 mmHg。尽管有类似的变形,但矩阵Vi表现出明显更高的ppi和梯度。PPI和梯度与组织厚度呈弱负相关(r = -0.276, p = 0.002; r = -0.321, p)。结论:轮椅坐垫的组织变形与PPI相当,但组织厚度越大,变形越小。虽然参与者在缓冲垫上经历了相似的最大组织变形,但压力梯度提供了比PPI更可靠的内部组织反应表示。尽管整体组织反应相似,但不同的缓冲设计对负荷分布的影响不同,卸载和压力重新分配方法之间存在显著差异。对所有轮椅使用者来说,定期的皮肤检查仍然是必不可少的。
{"title":"Quantifying seated buttock tissue response to commercial wheelchair cushions through MRI and pressure mapping analyses","authors":"Sharon Eve Sonenblum ,&nbsp;Mary Shea-Stifel ,&nbsp;Kelly Waugh ,&nbsp;Trevor Dyson-Hudson","doi":"10.1016/j.jtv.2026.100983","DOIUrl":"10.1016/j.jtv.2026.100983","url":null,"abstract":"<div><h3>Objective</h3><div>To describe how different wheelchair cushion designs impact interface pressure and buttock tissue deformation during sitting.</div></div><div><h3>Materials &amp; methods</h3><div>43 chronic full-time wheelchair users at high risk for pressure injuries were studied in an unloaded/suspended condition and on the Acta-Embrace, HR45, Jay J2 Deep Contour, Java, Matrx Vi, and/or the Roho HP cushions in randomized order. FONAR Upright MRI scans were used to measure seated soft tissue anatomy, and interface pressure mapping was used to measure peak pressure index (PPI) and pressure gradient.</div></div><div><h3>Results</h3><div>Median unloaded bulk tissue thickness beneath the ischium was 36.0 mm, decreasing by 53% when loaded. Tissue thickness under the ischium varied significantly between the Java (an off-loading design) and other pressure redistributing cushions (HR45, J2 Deep Contour, Matrx Vi) during upright sitting.</div><div>Greater bulk tissue thickness correlated with increased proximal thigh thickness and reduced deformation under the ischium. Average PPI and pressure gradient were 116.2 ± 44.8 mmHg and 26.1 ± 17.8 mmHg, respectively. Matrx Vi exhibited significantly higher PPIs and gradients despite comparable deformation. Both PPI and gradient showed weak inverse correlations with tissue thickness (r = −0.276, p = 0.002; r = −0.321, p &lt; 0.001). Both were associated with greater immersion on most cushions.</div></div><div><h3>Conclusion</h3><div>The wheelchair cushions investigated showed comparable tissue deformation and PPI, though individuals with greater tissue thickness experienced less deformation. While participants experienced similar maximal tissue deformation across cushions, pressure gradients provided a more reliable representation of internal tissue response than PPI. Different cushion designs influenced load distribution uniquely despite similar overall tissue response, with notable differences between off-loading and pressure redistribution approaches. Regular skin checks remain essential for all wheelchair users.</div></div>","PeriodicalId":17392,"journal":{"name":"Journal of tissue viability","volume":"35 1","pages":"Article 100983"},"PeriodicalIF":2.4,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145966538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Relationship between microbiota and healing status in diabetes-related foot ulcers treated with Trigona honey Trigona蜂蜜治疗糖尿病相关足溃疡中微生物群与愈合状况的关系
IF 2.4 3区 医学 Q2 DERMATOLOGY Pub Date : 2025-12-16 DOI: 10.1016/j.jtv.2025.100981
Sukarni Sukarni , Mao Kunimitsu , Kazuhiro Ogai , Delima Fajar Liana , Mahyarudin Mahyarudin , Muhammad Aminuddin , Kanae Mukai , Haryanto Haryanto , Suriadi Jais , Makoto Oe

Aims

Diabetes-related foot ulcers (DFUs) are a major complication of diabetes, and treatment with honey, which has antimicrobial properties, has been utilized in patients. However, the effects have been shown to vary, with the causes of these differences remaining unclear. Recently, microbiota has been reported to be associated with wound healing. Therefore, we hypothesized that differences in microbiota might explain the variations observed in response to honey. The present study aimed to investigate the relationship between the microbiota and the healing status in DFUs treated with Trigona honey.

Methods

A cohort study involving 12 DFUs categorized into healing and deteriorating groups was conducted. Wound and peri-wound microbiota observed at baseline and at 1 week later (after starting honey application) were investigated and then compared in the healing status.

Results

Enterococcus was higher in the deteriorating group at baseline in the wound (p = 0.02), while Corynebacterium was higher in the healing group at 1 week later in the peri-wound skin (p = 0.02). Changes in the relative abundance of Prevotella and Brevundimonas in the peri-wound skin significantly differed based on the healing status.

Conclusion

The findings suggest that the honey's effects might differ based on the composition of the wound microbiota, and they highlight the bacterial interactions with the changes in the wound and peri-wound skin environment induced by the honey. These results also imply that honey therapy on its own may not be enough for treating DFUs. This study is limited by the small sample size and short follow-up period; further research will need to explore combined treatment strategies and long-term microbiota dynamics to improve DFU management.
目的:糖尿病相关性足溃疡(DFUs)是糖尿病的主要并发症,蜂蜜具有抗菌特性,已被用于患者的治疗。然而,其影响各不相同,造成这些差异的原因尚不清楚。最近,微生物群被报道与伤口愈合有关。因此,我们假设微生物群的差异可以解释对蜂蜜的反应所观察到的变化。本研究旨在探讨微生物群与Trigona蜂蜜治疗DFUs愈合状况的关系。方法:将12例dfu分为愈合组和恶化组进行队列研究。在基线和1周后(开始应用蜂蜜后)观察伤口和伤口周围的微生物群,然后比较愈合状况。结果:恶化组创面基线时肠球菌含量较高(p = 0.02),愈合组创面1周后杆状杆菌含量较高(p = 0.02)。伤口周围皮肤中普雷沃氏菌和布氏单胞菌相对丰度的变化因愈合情况的不同而有显著差异。结论:研究结果表明,蜂蜜的作用可能因伤口微生物群的组成而异,并强调了蜂蜜引起的伤口和伤口周围皮肤环境变化与细菌的相互作用。这些结果也暗示蜂蜜疗法本身可能不足以治疗DFUs。本研究样本量小,随访时间短;进一步的研究将需要探索联合治疗策略和长期微生物群动态来改善DFU的管理。
{"title":"Relationship between microbiota and healing status in diabetes-related foot ulcers treated with Trigona honey","authors":"Sukarni Sukarni ,&nbsp;Mao Kunimitsu ,&nbsp;Kazuhiro Ogai ,&nbsp;Delima Fajar Liana ,&nbsp;Mahyarudin Mahyarudin ,&nbsp;Muhammad Aminuddin ,&nbsp;Kanae Mukai ,&nbsp;Haryanto Haryanto ,&nbsp;Suriadi Jais ,&nbsp;Makoto Oe","doi":"10.1016/j.jtv.2025.100981","DOIUrl":"10.1016/j.jtv.2025.100981","url":null,"abstract":"<div><h3>Aims</h3><div>Diabetes-related foot ulcers (DFUs) are a major complication of diabetes, and treatment with honey, which has antimicrobial properties, has been utilized in patients. However, the effects have been shown to vary, with the causes of these differences remaining unclear. Recently, microbiota has been reported to be associated with wound healing. Therefore, we hypothesized that differences in microbiota might explain the variations observed in response to honey. The present study aimed to investigate the relationship between the microbiota and the healing status in DFUs treated with Trigona honey.</div></div><div><h3>Methods</h3><div>A cohort study involving 12 DFUs categorized into healing and deteriorating groups was conducted. Wound and peri-wound microbiota observed at baseline and at 1 week later (after starting honey application) were investigated and then compared in the healing status.</div></div><div><h3>Results</h3><div><em>Enterococcus</em> was higher in the deteriorating group at baseline in the wound (<em>p</em> = 0.02), while <em>Corynebacterium</em> was higher in the healing group at 1 week later in the peri-wound skin (<em>p</em> = 0.02). Changes in the relative abundance of <em>Prevotella</em> and <em>Brevundimonas</em> in the peri-wound skin significantly differed based on the healing status.</div></div><div><h3>Conclusion</h3><div>The findings suggest that the honey's effects might differ based on the composition of the wound microbiota, and they highlight the bacterial interactions with the changes in the wound and peri-wound skin environment induced by the honey. These results also imply that honey therapy on its own may not be enough for treating DFUs. This study is limited by the small sample size and short follow-up period; further research will need to explore combined treatment strategies and long-term microbiota dynamics to improve DFU management.</div></div>","PeriodicalId":17392,"journal":{"name":"Journal of tissue viability","volume":"35 1","pages":"Article 100981"},"PeriodicalIF":2.4,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145827262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The mechanism by which negative pressure wound therapy promotes wound healing 负压伤口治疗促进伤口愈合的机制。
IF 2.4 3区 医学 Q2 DERMATOLOGY Pub Date : 2025-12-16 DOI: 10.1016/j.jtv.2025.100982
Ying Zeng , Jianjian Tu , Jichao Qin
Negative pressure wound therapy (NPWT) has demonstrated substantial advantages in a variety of clinical settings, including the management of acute and chronic wounds, open injuries with exposed bone, nerves, or tendons, and implant-associated infections in orthopedics. Although numerous studies have reported the beneficial effects of NPWT in controlling wound infections and infections related to orthopedic implants, the underlying molecular and cellular mechanisms remain incompletely understood and require further investigation. Given its widespread clinical use, a comprehensive understanding of the biological effects of NPWT is essential to ensuring its rational and optimized application in clinical practice. This review summarizes the potential mechanisms through which NPWT facilitates wound healing and provides insights to inform both clinical use and future research.
负压伤口治疗(NPWT)在各种临床环境中已经证明了巨大的优势,包括治疗急性和慢性伤口,骨、神经或肌腱暴露的开放性损伤,以及骨科中植入物相关感染。尽管大量研究报道了NPWT在控制伤口感染和骨科植入物相关感染方面的有益作用,但其潜在的分子和细胞机制仍不完全清楚,需要进一步研究。鉴于其广泛的临床应用,全面了解NPWT的生物学效应对于确保其在临床实践中的合理和优化应用至关重要。这篇综述总结了NPWT促进伤口愈合的潜在机制,并为临床应用和未来的研究提供了见解。
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引用次数: 0
Be there or be square: Should we adopt non-rectangular dressing shapes in single-use negative pressure wound therapy? 是有还是方:一次性负压伤口治疗是否应采用非矩形敷料形状?
IF 2.4 3区 医学 Q2 DERMATOLOGY Pub Date : 2025-12-04 DOI: 10.1016/j.jtv.2025.100977
Ofek Barzilay , Amit Gefen

Background

Single-use negative-pressure wound therapy (suNPWT) dressings for closed surgical incisions are predominantly rectangular, despite long-time evidence from biomechanics that sharp or small-radius corners generate localized stress concentrations in underlying tissues. Optimizing dressing geometry and stiffness distribution may reduce the peri-incisional stress concentrations and improve closure.

Objectives

To determine how dressing shape and regional stiffness variations influence the peri-wound skin stresses and stress concentrations and the incision closure biomechanics under a negative pressure level of −125 mmHg.

Methods

A validated three-dimensional finite element model of a sutured midline incision was developed. Five homogeneous dressing shapes (rectangular, circular, elliptical, stadium, and dome) of identical contact area and material properties were compared for reduction in peak lateral skin stresses (ΔS). The best-performing dressing shape underwent further testing in eight stiffness configurations (homogeneous, or with stiffer/softer peripheral regions in symmetric or axisymmetric patterns). The lateral displacement of the peri-wound skin was used as a measure for the closure work. A sensitivity analysis was conducted on chosen model variants for broader transferability and for exploring potential covariance between dressing shape and material properties.

Results

Among the homogeneous dressing shapes, the circular dressing achieved the greatest stress reduction (ΔS = 2.9 %) versus the rectangular control (0.9 %). In the circular form, incorporating a stiffer peripheral symmetric ring around a softer core improved performance (ΔS = 3.2 %) while maintaining substantial lateral displacement (3.35 mm), achieving an optimal combination of stress relief with closure assistance. A fully stiff homogeneous dressing maximized the ΔS (6.5 %) but provided negligible closure support, whereas a fully soft dressing behaved conversely. The sensitivity analysis did not change these quantitative rankings across the studied model variants.

Conclusions

Eliminating sharp or small-radius geometric discontinuities and tuning the regional stiffness can markedly attenuate peri-incisional stresses without compromising the contribution of the dressing to the closure work. Circular suNPWT dressings with a peripheral stiffer ring offer a biomechanically superior, manufacturable alternative to conventional rectangular designs, warranting further pre-clinical and clinical evaluations.
背景:用于闭合手术切口的一次性负压伤口治疗(suNPWT)敷料主要是矩形的,尽管生物力学长期以来的证据表明,尖锐或小半径的角落会在底层组织中产生局部应力集中。优化修整的几何形状和刚度分布可以减少切口周围的应力集中,提高闭合性。目的探讨- 125 mmHg负压下敷料形状和局部刚度变化对创面周围皮肤应力、应力浓度及切口闭合生物力学的影响。方法建立经sa验证的中线切口缝合三维有限元模型。五种均匀的敷料形状(矩形,圆形,椭圆形,体育场和圆顶)具有相同的接触面积和材料性能,以减少峰值侧皮肤应力(ΔS)。性能最好的修整形状在8种刚度配置下进行了进一步的测试(均匀的,或者在对称或轴对称模式下具有更硬/更软的外围区域)。创面周围皮肤的侧向位移作为闭合工作的衡量标准。对选择的模型变量进行敏感性分析,以获得更广泛的可转移性,并探索修整形状和材料性能之间的潜在协方差。结果在均匀敷料形状中,圆形敷料的应力降低效果最好(ΔS = 2.9%),而矩形敷料的应力降低效果为0.9%。在圆形形式中,在较软的核心周围加入较硬的外围对称环,提高了性能(ΔS = 3.2%),同时保持了相当大的横向位移(3.35 mm),实现了应力释放和闭合辅助的最佳组合。完全坚硬的均质敷料最大限度地提高ΔS(6.5%),但提供的闭合支持可以忽略不计,而完全柔软的敷料则相反。敏感性分析并没有改变所研究模型变量的这些定量排名。结论消除尖锐的或小半径的几何不连续,调整区域刚度可以显著地减弱切周应力,而不影响敷料对闭合工作的贡献。圆形suNPWT敷料具有外围更硬的环,为传统的矩形设计提供了生物力学上优越的可制造替代品,保证了进一步的临床前和临床评估。
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引用次数: 0
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Journal of tissue viability
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