Objective: Diabetic foot ulcer (DFU) is one of the most common complications of diabetes, and causes significant morbidity, mortality and healthcare expenditure. Multidrug-resistant organism (MDRO) infection is considered a major threat to the treatment of DFUs. This study investigated the risk factors for MDRO infections in DFUs.
Method: This was a retrospective case-control study. Patients diagnosed with DFU and MDRO infections were included in the observation group. The same number of patients hospitalised during the same period and who were diagnosed with DFU but without MDRO infection were matched and selected as the control group. Binary logistic regression analysis was performed to evaluate the risk factors for multidrug-resistant organism (MDRO) infections in DFUs by analysing the clinical data. The receiver operating characteristic (ROC) curve was used for evaluation.
Results: The electronic medical records of 110 patients (55 in each group, with similar sex and age) were reviewed. The results of binary logistic regression analysis showed that: history of antibiotic exposure (odds ratio (OR)=11.878; 95% confidence interval (CI): 3.064, 46.046; p<0.001); history of hospitalisation within one year (OR=3.198; 95% CI: 1.156, 8.846; p=0.025); hypertension (OR=3.976; 95% CI: 1.444, 10.951; p=0.008); and osteomyelitis (OR=21.667; 95% CI: 3.427, 137.002; p=0.001) were significant risk factors for MDRO infection in patients with a DFU. The logistic regression model for MDRO infection in patients with a DFU was fitted as follows: Logit (P) = (-3.482) + (2.475) × history of antibiotic exposure + (1.163) × history of hospitalisation within 1 year + (1.380) × hypertension + (3.076) × osteomyelitis. The ROC curve evaluation model was plotted. The area under the curve was 0.861 (95% CI: 0.794, 0.927; p<0.001).
Conclusion: The findings of this study showed that history of antibiotic exposure, history of hospitalisation within one year, hypertension, and osteomyelitis in combination were the risk factors for MDRO infections in patients with DFUs.
{"title":"Microbiological characteristics and risk factors for multidrug-resistant organism infections in diabetic foot ulcer.","authors":"Yiru Bao, Yue Shi, Chaojun Zhu, Zheng Liang, Qiang Xu, Zhaohui Zhang","doi":"10.12968/jowc.2023.0041","DOIUrl":"10.12968/jowc.2023.0041","url":null,"abstract":"<p><strong>Objective: </strong>Diabetic foot ulcer (DFU) is one of the most common complications of diabetes, and causes significant morbidity, mortality and healthcare expenditure. Multidrug-resistant organism (MDRO) infection is considered a major threat to the treatment of DFUs. This study investigated the risk factors for MDRO infections in DFUs.</p><p><strong>Method: </strong>This was a retrospective case-control study. Patients diagnosed with DFU and MDRO infections were included in the observation group. The same number of patients hospitalised during the same period and who were diagnosed with DFU but without MDRO infection were matched and selected as the control group. Binary logistic regression analysis was performed to evaluate the risk factors for multidrug-resistant organism (MDRO) infections in DFUs by analysing the clinical data. The receiver operating characteristic (ROC) curve was used for evaluation.</p><p><strong>Results: </strong>The electronic medical records of 110 patients (55 in each group, with similar sex and age) were reviewed. The results of binary logistic regression analysis showed that: history of antibiotic exposure (odds ratio (OR)=11.878; 95% confidence interval (CI): 3.064, 46.046; p<0.001); history of hospitalisation within one year (OR=3.198; 95% CI: 1.156, 8.846; p=0.025); hypertension (OR=3.976; 95% CI: 1.444, 10.951; p=0.008); and osteomyelitis (OR=21.667; 95% CI: 3.427, 137.002; p=0.001) were significant risk factors for MDRO infection in patients with a DFU. The logistic regression model for MDRO infection in patients with a DFU was fitted as follows: Logit (P) = (-3.482) + (2.475) × history of antibiotic exposure + (1.163) × history of hospitalisation within 1 year + (1.380) × hypertension + (3.076) × osteomyelitis. The ROC curve evaluation model was plotted. The area under the curve was 0.861 (95% CI: 0.794, 0.927; p<0.001).</p><p><strong>Conclusion: </strong>The findings of this study showed that history of antibiotic exposure, history of hospitalisation within one year, hypertension, and osteomyelitis in combination were the risk factors for MDRO infections in patients with DFUs.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"35 1","pages":"59-67"},"PeriodicalIF":1.7,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145959897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Klaus Zobel, Maurice Schmidt, Andrea Knobel, Joana Pinto, Marcus Philipp Moll, Niels Frank Jensen, Henrik Fallesen, Julie Hansen, Martin Vestergaard
Objective: Superabsorbent wound dressings (SWDs) are often applied for the management of excess exudate in moderately-to-highly exuding wounds; however, in vitro performance characteristics, including absorptive capacity and retention of fluid, can vary significantly between SWD brands. The aims of this study were to: i. assess in vitro absorptive and retention capacities of a new non-adhesive SWD (Biatain Superabsorber, Coloplast A/S, Denmark) and four non-adhesive comparator SWDs (Zetuvit Plus (Hartmann, Germany); ConvaMax Superabsorber (Convatec, UK); Mextra Superabsorbent (Mölnlycke, Sweden); and Vliwasorb (Lohmann & Rauscher, Germany)); ii. assess the ability of the SWDs to reduce matrix metalloproteinase (MMP) activity in vitro; iii. assess bacterial retention within the new SWD; and iv. explore the clinical application of the new SWD in three cases studies.
Method: In vitro performance characteristics were assessed for the five SWDs, which included: free swell absorption; absorption under compression (40mmHg); retention of fluid under compression (40mmHg); and sequestration (protease activity reduction) of MMP-2 and MMP-9. Bacterial retention was assessed with the new SWD.
Results: Significant variations in in vitro performance characteristics between the SWDs were observed. The new SWD showed higher free swell absorption, retention of fluid under compression and absorption under compression than the comparators. MMP-2 and MMP-9-activity were reduced by 98% and 80%, respectively, after four hours' incubation with the new SWD, and it effectively absorbed and retained bacteria within the dressing. The three case reports highlighted benefits of using the new SWD in management of moderately-to-highly exuding wounds.
Conclusion: The new SWD, Biatain Superabsorber, showed good performance in the different in vitro comparative assessments, and clinical use of the dressing highlighted benefits in the management of wound exudate and in establishing an environment supporting wound healing.
目的：高吸水性创面敷料（SWDs）常用于中高渗液创面的过量渗液处理；然而，不同SWD品牌的体外性能特征，包括吸收能力和液体潴留，可能会有很大差异。本研究的目的是：1 .评估一种新型无黏附SWD （Biatain超级吸收剂，Coloplast a /S，丹麦）和四种无黏附比较SWD （Zetuvit Plus （Hartmann，德国））的体外吸收和保留能力；ConvaMax超级吸收器（Convatec，英国）；Mextra Superabsorbent （Mölnlycke，瑞典）；Vliwasorb （Lohmann & Rauscher，德国）；2。体外评估SWDs降低基质金属蛋白酶（MMP）活性的能力；3。评估新社署内的细菌潴留情况；iv.透过三个个案研究，探讨新社会福利署的临床应用。方法：评估5种SWDs的体外性能特征，包括：自由膨胀吸收；压缩吸收（40mmHg）；压缩下液体潴留（40mmHg）；以及MMP-2和MMP-9的隔离（蛋白酶活性降低）。使用新的SWD评估细菌保留情况。结果：不同SWDs的体外性能特征有显著差异。新型SWD具有更高的自由膨胀吸收、压缩下的流体滞留和压缩下的吸收。与新SWD孵育4小时后，MMP-2和mmp -9活性分别降低98%和80%，并有效吸收和保留敷料内的细菌。这三个病例报告强调了使用新的SWD治疗中度至高度渗出伤口的好处。结论：新型SWD Biatain superabsorder在不同的体外比较评估中表现出良好的性能，临床应用在处理创面渗出液和建立支持创面愈合的环境方面具有突出的作用。
{"title":"In vitro performance of Biatain Superabsorber and use in management of moderately-to-highly exuding wounds.","authors":"Klaus Zobel, Maurice Schmidt, Andrea Knobel, Joana Pinto, Marcus Philipp Moll, Niels Frank Jensen, Henrik Fallesen, Julie Hansen, Martin Vestergaard","doi":"10.12968/jowc.2025.0447","DOIUrl":"10.12968/jowc.2025.0447","url":null,"abstract":"<p><strong>Objective: </strong>Superabsorbent wound dressings (SWDs) are often applied for the management of excess exudate in moderately-to-highly exuding wounds; however, in vitro performance characteristics, including absorptive capacity and retention of fluid, can vary significantly between SWD brands. The aims of this study were to: i. assess in vitro absorptive and retention capacities of a new non-adhesive SWD (Biatain Superabsorber, Coloplast A/S, Denmark) and four non-adhesive comparator SWDs (Zetuvit Plus (Hartmann, Germany); ConvaMax Superabsorber (Convatec, UK); Mextra Superabsorbent (Mölnlycke, Sweden); and Vliwasorb (Lohmann & Rauscher, Germany)); ii. assess the ability of the SWDs to reduce matrix metalloproteinase (MMP) activity in vitro; iii. assess bacterial retention within the new SWD; and iv. explore the clinical application of the new SWD in three cases studies.</p><p><strong>Method: </strong>In vitro performance characteristics were assessed for the five SWDs, which included: free swell absorption; absorption under compression (40mmHg); retention of fluid under compression (40mmHg); and sequestration (protease activity reduction) of MMP-2 and MMP-9. Bacterial retention was assessed with the new SWD.</p><p><strong>Results: </strong>Significant variations in in vitro performance characteristics between the SWDs were observed. The new SWD showed higher free swell absorption, retention of fluid under compression and absorption under compression than the comparators. MMP-2 and MMP-9-activity were reduced by 98% and 80%, respectively, after four hours' incubation with the new SWD, and it effectively absorbed and retained bacteria within the dressing. The three case reports highlighted benefits of using the new SWD in management of moderately-to-highly exuding wounds.</p><p><strong>Conclusion: </strong>The new SWD, Biatain Superabsorber, showed good performance in the different in vitro comparative assessments, and clinical use of the dressing highlighted benefits in the management of wound exudate and in establishing an environment supporting wound healing.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"35 1","pages":"15-25"},"PeriodicalIF":1.7,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145959857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cutaneous wound healing consists of complex processes involving different types of cells and signalling pathways, and occurs in three phases (inflammatory, proliferative and tissue remodelling). The dysregulation of these processes leads to abnormal wound healing, manifesting as hard-to-heal (chronic) wounds at one extreme and pathological scarring at the other. Recent studies have shown that the tumour necrosis factor-like weak inducer of apoptosis (TWEAK)/fibroblast growth factor-inducible 14 (Fn14) signalling pathway regulates inflammatory, re-epithelialisation, collagen synthesis and angiogenesis processes, suggesting that it can modulate cutaneous wound healing. Despite numerous studies suggesting a relationship between the TWEAK/Fn14 axis and cutaneous wound healing, there has been little attention paid to this relationship to date. There is scarce direct evidence supporting that TWEAK/Fn14 axis-targeted therapies work in cutaneous wounds. This review summarises the evidence that TWEAK/Fn14 signalling is involved in wound repair as well as in tissue remodelling. In addition, TWEAK/Fn14 axis-targeted therapies in other diseases are highlighted, and their therapeutic potential in cutaneous wounds discussed.
{"title":"Fibroblast growth factor-inducible 14 signalling pathway in cutaneous wounds: a potential therapeutic target.","authors":"Fangyan Jia, Qin Chen, Xiaoyu Wang, Yumin Xia","doi":"10.12968/jowc.2023.0091","DOIUrl":"10.12968/jowc.2023.0091","url":null,"abstract":"<p><p>Cutaneous wound healing consists of complex processes involving different types of cells and signalling pathways, and occurs in three phases (inflammatory, proliferative and tissue remodelling). The dysregulation of these processes leads to abnormal wound healing, manifesting as hard-to-heal (chronic) wounds at one extreme and pathological scarring at the other. Recent studies have shown that the tumour necrosis factor-like weak inducer of apoptosis (TWEAK)/fibroblast growth factor-inducible 14 (Fn14) signalling pathway regulates inflammatory, re-epithelialisation, collagen synthesis and angiogenesis processes, suggesting that it can modulate cutaneous wound healing. Despite numerous studies suggesting a relationship between the TWEAK/Fn14 axis and cutaneous wound healing, there has been little attention paid to this relationship to date. There is scarce direct evidence supporting that TWEAK/Fn14 axis-targeted therapies work in cutaneous wounds. This review summarises the evidence that TWEAK/Fn14 signalling is involved in wound repair as well as in tissue remodelling. In addition, TWEAK/Fn14 axis-targeted therapies in other diseases are highlighted, and their therapeutic potential in cutaneous wounds discussed.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"35 1","pages":"48-58"},"PeriodicalIF":1.7,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145959879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-02Epub Date: 2025-12-23DOI: 10.12968/jowc.2025.0535
Rodrigo Rial, Pilar Ruiz Alvarez, Jose Miguel Gallego, Guillermo Moñux, Luis Sanchez Hervás, Serge Bohbot
<p><strong>Objective: </strong>This study was performed to assess the clinical performance of a multicomponent reduced compression system (applying ~20mmHg) and dressings based on lipido-colloid technology with nano-oligosaccharide factor (TLC-NOSF) in the management of patients with venous leg ulcers (VLUs) and mixed leg ulcers (MLUs with arterial component).</p><p><strong>Method: </strong>A prospective, multicentre, non-comparative clinical trial was conducted in the Angiology and Vascular Surgery Units in three hospitals in Madrid, Spain. Adults with VLUs or MLUs, confirmed by an ankle-brachial pressure index >0.6, were treated with UrgoK2 Lite Latex Free and UrgoStart dressings (both Laboratoires Urgo, France) for 12 weeks. The primary endpoint was complete ulcer closure by week 12. Secondary endpoints included time-to-heal, change in wound area, leg oedema resolution, change in ankle circumference, ease of application and adherence to compression therapy, adverse events (AEs), and acceptability of the treatment strategy.</p><p><strong>Results: </strong>A total of 45 patients with LUs (mean age 70.0 years; 64% male; 44% obese) were included. Based on vascular assessment, 24 patients had VLUs and 21 had MLUs, associated with leg oedema in 89% of cases. The LUs were recurrent in 60% of cases, and lasted ≥6 months in 58% of cases. The wound areas were relatively large (median value: 9.4cm<sup>2</sup>, interquartile range (IQR): 5.9-11.8cm<sup>2</sup>), and mostly covered by sloughy tissue. Impaired perilesional skin was reported in 93% of patients. By the final visit, 71% of VLUs had healed, 25% had improved and 4% remained unchanged. Despite an initial poorer healing prognosis than for VLUs, 43% of MLUs healed and 43% improved. The median time-to-heal was nine weeks (IQR: 6-11 weeks), with no relevant difference between the two types of leg ulcer (LU). These good healing progressions were also supported by consistent and steady reductions in wound surface area throughout the 12 weeks of treatment, regardless of LU aetiology, resulting in a relative wound area reduction of 100% (median value; IQR: 93.8-100.0%) in VLUs and 98.6% (median value; IQR: 55.6-100.0%) in MLUs. Leg oedema resolved in all patients by week 8 (except two missing data), while mean ankle circumference reduced from 24.5±2.7cm at baseline to 21.4±2.4cm at final measurement. The application of the compression system was judged 'very easy' in 85% of cases and 'easy' in 15%. Full adherence to compression therapy was reported in 80% of patients during the first weeks of treatment and increased to 97% by week 8. Only two AEs, unrelated to the evaluated treatments, were reported throughout the study period. At the final visit, the association of the multicomponent reduced compression system and TLC-NOSF dressings in the management of VLUs and MLUs was considered 'very satisfactory' in 98% of cases and 'satisfactory' in 2% by the healthcare professionals involved in this study.</p><p>
{"title":"Multicomponent reduced compression therapy and TLC-NOSF dressings in leg ulcers with or without arterial component.","authors":"Rodrigo Rial, Pilar Ruiz Alvarez, Jose Miguel Gallego, Guillermo Moñux, Luis Sanchez Hervás, Serge Bohbot","doi":"10.12968/jowc.2025.0535","DOIUrl":"10.12968/jowc.2025.0535","url":null,"abstract":"<p><strong>Objective: </strong>This study was performed to assess the clinical performance of a multicomponent reduced compression system (applying ~20mmHg) and dressings based on lipido-colloid technology with nano-oligosaccharide factor (TLC-NOSF) in the management of patients with venous leg ulcers (VLUs) and mixed leg ulcers (MLUs with arterial component).</p><p><strong>Method: </strong>A prospective, multicentre, non-comparative clinical trial was conducted in the Angiology and Vascular Surgery Units in three hospitals in Madrid, Spain. Adults with VLUs or MLUs, confirmed by an ankle-brachial pressure index >0.6, were treated with UrgoK2 Lite Latex Free and UrgoStart dressings (both Laboratoires Urgo, France) for 12 weeks. The primary endpoint was complete ulcer closure by week 12. Secondary endpoints included time-to-heal, change in wound area, leg oedema resolution, change in ankle circumference, ease of application and adherence to compression therapy, adverse events (AEs), and acceptability of the treatment strategy.</p><p><strong>Results: </strong>A total of 45 patients with LUs (mean age 70.0 years; 64% male; 44% obese) were included. Based on vascular assessment, 24 patients had VLUs and 21 had MLUs, associated with leg oedema in 89% of cases. The LUs were recurrent in 60% of cases, and lasted ≥6 months in 58% of cases. The wound areas were relatively large (median value: 9.4cm<sup>2</sup>, interquartile range (IQR): 5.9-11.8cm<sup>2</sup>), and mostly covered by sloughy tissue. Impaired perilesional skin was reported in 93% of patients. By the final visit, 71% of VLUs had healed, 25% had improved and 4% remained unchanged. Despite an initial poorer healing prognosis than for VLUs, 43% of MLUs healed and 43% improved. The median time-to-heal was nine weeks (IQR: 6-11 weeks), with no relevant difference between the two types of leg ulcer (LU). These good healing progressions were also supported by consistent and steady reductions in wound surface area throughout the 12 weeks of treatment, regardless of LU aetiology, resulting in a relative wound area reduction of 100% (median value; IQR: 93.8-100.0%) in VLUs and 98.6% (median value; IQR: 55.6-100.0%) in MLUs. Leg oedema resolved in all patients by week 8 (except two missing data), while mean ankle circumference reduced from 24.5±2.7cm at baseline to 21.4±2.4cm at final measurement. The application of the compression system was judged 'very easy' in 85% of cases and 'easy' in 15%. Full adherence to compression therapy was reported in 80% of patients during the first weeks of treatment and increased to 97% by week 8. Only two AEs, unrelated to the evaluated treatments, were reported throughout the study period. At the final visit, the association of the multicomponent reduced compression system and TLC-NOSF dressings in the management of VLUs and MLUs was considered 'very satisfactory' in 98% of cases and 'satisfactory' in 2% by the healthcare professionals involved in this study.</p><p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"35 1","pages":"4-14"},"PeriodicalIF":1.7,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145959893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: Venous leg ulcers (VLU) are a common, recurring condition resulting from venous stasis; they are especially prevalent in Northern Europe and the US. The overall prevalence of this condition is 1%, rising to 3% in patients >65 years of age. This study analysed the effect of a combination of single-use negative pressure wound therapy (sNPWT, VivereX NPWT system (Sunmedic AB, Vällinge, Sweden) and compression bandaging (CB) in the treatment of VLUs.
Method: An experimental in vivo extremity model was used to monitor and validate sub-dressing pressure.
Results: There was no effect of the multilayer CB on the sNPWT therapeutical pressure. To the best of the author's knowledge, this is the first experimental study to examine variations in sub-dressing pressure within sNPWT systems following the application of a CB.
Conclusion: In this study, therapeutical pressure induced by the VivereX device remained unaffected when used in combination with multilayer CB in the treatment of VLUs.
{"title":"Impact of multilayer compression bandages on subdressing pressure generated by a sNPWT: an experimental study.","authors":"Shamisa Adeli","doi":"10.12968/jowc.2024.0036","DOIUrl":"10.12968/jowc.2024.0036","url":null,"abstract":"<p><strong>Objective: </strong>Venous leg ulcers (VLU) are a common, recurring condition resulting from venous stasis; they are especially prevalent in Northern Europe and the US. The overall prevalence of this condition is 1%, rising to 3% in patients >65 years of age. This study analysed the effect of a combination of single-use negative pressure wound therapy (sNPWT, VivereX NPWT system (Sunmedic AB, Vällinge, Sweden) and compression bandaging (CB) in the treatment of VLUs.</p><p><strong>Method: </strong>An experimental in vivo extremity model was used to monitor and validate sub-dressing pressure.</p><p><strong>Results: </strong>There was no effect of the multilayer CB on the sNPWT therapeutical pressure. To the best of the author's knowledge, this is the first experimental study to examine variations in sub-dressing pressure within sNPWT systems following the application of a CB.</p><p><strong>Conclusion: </strong>In this study, therapeutical pressure induced by the VivereX device remained unaffected when used in combination with multilayer CB in the treatment of VLUs.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"35 1","pages":"86-88"},"PeriodicalIF":1.7,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145959822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rory Turnbull, Dominic Jones, Ali Alazmani, Pete Culmer
<p><strong>Objective: </strong>To characterise and compare the effectiveness of sacral dressings at alleviating the transfer of shear forces to the skin and, therefore, to lower the risk of and prevent pressure injury (PI) development in bed-based patients.</p><p><strong>Method: </strong>Dressings were evaluated against a ratio of applied to transferred shear and peak shear force observed on the skin. The evaluation was undertaken using a custom benchtop in vitro experimental setup replicating the skin-bedsheet interface. Forces were applied using an automated test rig within which a pair of load cells (ATI Nano-17; ATI Industrial Automation Inc., US) were embedded, tracking the applied normal and shear forces. Normal loading regimes of 11.1N (6kPa) and 14.8N (8kPa) were applied, to match expected clinically relevant sacral pressures. Pressures were applied with an error of 2.3% and 0.6%, respectively. No significant difference was found in the loading of dressings (p>0.05).</p><p><strong>Results: </strong>The performances of three dressing designs were assessed, with six samples taken for each. All dressings were found to improve significantly (p<0.001) in performance relative to the control dataset for the dynamic coefficient of friction (DCoF), peak shear at skin (Fτ) and shear ratio (τratio). The Allevyn Life dressing (AllLi; Smith+Nephew, UK) showed the lowest DCoF (0.372±0.052), which was significantly lower than all other dressings (p<0.001). There was no significant difference between Mepilex Border (MepB; Mölnlyke Health Care, Sweden) and Avarus Border Foam (AvBF; Medtrade Products Ltd, UK). AllLi recorded the lowest peak shear at the skin (1.01±0.07N), which was significantly lower (p<0.001) than that measured for MepB and AvBF. With regard to the shear ratio, AllLi (0.233±0.007 and 0.283±0.013) and MepB (0.255±0.011 and 0.275±0.013) exhibited a significantly (p<0.001) higher shear ratio at both pressures, respectively, than AvBF.</p><p><strong>Conclusion: </strong>Although significant differences were identified between dressing types, DCoF was not indicative of dressing performance. Dressing compression, rather than thickness, was indicative of peak shear buffering. All dressings reduced the shear observed at the skin with respect to the control. The reduction in shear ratio between the control and all dressings tested was significant, ranging from 0.528-0.567 at 6kPa and 0.510-0.560 at 8kPa. Prophylactic use of these types of dressings to reduce risk of PI (widely specified within hospital and care setting protocols) confirms that this benefit is seen in the clinical setting. However, while there was a significant difference between the three dressing types (p=0.039 at 6kPa and p=0.050 at 8kPa), further work is required to explore how this translates to a clinical setting. Shear buffering is a complex process and performance is dependent on the compound response of the constituent dressing elements, rather than being dominated by a s
{"title":"In vitro assessment of shear force buffering in sacral dressings to alleviate pressure injuries in bed-based patients.","authors":"Rory Turnbull, Dominic Jones, Ali Alazmani, Pete Culmer","doi":"10.12968/jowc.2022.0242","DOIUrl":"https://doi.org/10.12968/jowc.2022.0242","url":null,"abstract":"<p><strong>Objective: </strong>To characterise and compare the effectiveness of sacral dressings at alleviating the transfer of shear forces to the skin and, therefore, to lower the risk of and prevent pressure injury (PI) development in bed-based patients.</p><p><strong>Method: </strong>Dressings were evaluated against a ratio of applied to transferred shear and peak shear force observed on the skin. The evaluation was undertaken using a custom benchtop in vitro experimental setup replicating the skin-bedsheet interface. Forces were applied using an automated test rig within which a pair of load cells (ATI Nano-17; ATI Industrial Automation Inc., US) were embedded, tracking the applied normal and shear forces. Normal loading regimes of 11.1N (6kPa) and 14.8N (8kPa) were applied, to match expected clinically relevant sacral pressures. Pressures were applied with an error of 2.3% and 0.6%, respectively. No significant difference was found in the loading of dressings (p>0.05).</p><p><strong>Results: </strong>The performances of three dressing designs were assessed, with six samples taken for each. All dressings were found to improve significantly (p<0.001) in performance relative to the control dataset for the dynamic coefficient of friction (DCoF), peak shear at skin (Fτ) and shear ratio (τratio). The Allevyn Life dressing (AllLi; Smith+Nephew, UK) showed the lowest DCoF (0.372±0.052), which was significantly lower than all other dressings (p<0.001). There was no significant difference between Mepilex Border (MepB; Mölnlyke Health Care, Sweden) and Avarus Border Foam (AvBF; Medtrade Products Ltd, UK). AllLi recorded the lowest peak shear at the skin (1.01±0.07N), which was significantly lower (p<0.001) than that measured for MepB and AvBF. With regard to the shear ratio, AllLi (0.233±0.007 and 0.283±0.013) and MepB (0.255±0.011 and 0.275±0.013) exhibited a significantly (p<0.001) higher shear ratio at both pressures, respectively, than AvBF.</p><p><strong>Conclusion: </strong>Although significant differences were identified between dressing types, DCoF was not indicative of dressing performance. Dressing compression, rather than thickness, was indicative of peak shear buffering. All dressings reduced the shear observed at the skin with respect to the control. The reduction in shear ratio between the control and all dressings tested was significant, ranging from 0.528-0.567 at 6kPa and 0.510-0.560 at 8kPa. Prophylactic use of these types of dressings to reduce risk of PI (widely specified within hospital and care setting protocols) confirms that this benefit is seen in the clinical setting. However, while there was a significant difference between the three dressing types (p=0.039 at 6kPa and p=0.050 at 8kPa), further work is required to explore how this translates to a clinical setting. Shear buffering is a complex process and performance is dependent on the compound response of the constituent dressing elements, rather than being dominated by a s","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"34 12","pages":"970-980"},"PeriodicalIF":1.7,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145677967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Surgical site infection: time for new definitions.","authors":"David Leaper, Giles Bond-Smith","doi":"10.12968/jowc.2025.0533","DOIUrl":"https://doi.org/10.12968/jowc.2025.0533","url":null,"abstract":"","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"34 12","pages":"959-960"},"PeriodicalIF":1.7,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145678012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Uranus Dasmeh, Ali Akbar Mohammadi, Raha Shahrokhi, Sara Shahriarirad, Reza Shahriarirad, Reyhaneh Naseri
Objective: This study aimed to investigate whether application of autologous platelet-rich plasma (PRP) at split-thickness skin grafting (STSG) donor sites in patients with burns can promote wound healing.
Method: A randomised crossover clinical trial was conducted involving participants, each with a donor site divided into two equal-sized areas for application of PRP and Vaseline gauze (VG) or with VG alone. Wound healing progress was evaluated at days 14, 21 and 30 postoperatively by measuring the healed area and comparing it between the PRP and VG groups.
Results: The study included 20 participants, equally divided into the two groups. Both groups demonstrated significant improvement throughout the study period. The PRP group demonstrated a statistically significant acceleration in wound healing compared to the control group, at days 14 and 21 postoperatively. However, at 30 days' postoperatively, there was no statistically significant difference in healed area between the two groups.
Conclusion: The findings of this study suggest that PRP has the potential to expedite the healing process and may help reduce hospital stay and wound infection rates, even though it did not result in a significantly larger overall healed area. The decision to use PRP should take into account various factors including resources, costs and desired clinical outcomes. Future research is needed to elucidate the role of PRP in the treatment of donor wounds.
{"title":"The effect of autologous platelet-rich plasma on donor site wound healing: a randomised crossover clinical trial.","authors":"Uranus Dasmeh, Ali Akbar Mohammadi, Raha Shahrokhi, Sara Shahriarirad, Reza Shahriarirad, Reyhaneh Naseri","doi":"10.12968/jowc.2023.0210","DOIUrl":"10.12968/jowc.2023.0210","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate whether application of autologous platelet-rich plasma (PRP) at split-thickness skin grafting (STSG) donor sites in patients with burns can promote wound healing.</p><p><strong>Method: </strong>A randomised crossover clinical trial was conducted involving participants, each with a donor site divided into two equal-sized areas for application of PRP and Vaseline gauze (VG) or with VG alone. Wound healing progress was evaluated at days 14, 21 and 30 postoperatively by measuring the healed area and comparing it between the PRP and VG groups.</p><p><strong>Results: </strong>The study included 20 participants, equally divided into the two groups. Both groups demonstrated significant improvement throughout the study period. The PRP group demonstrated a statistically significant acceleration in wound healing compared to the control group, at days 14 and 21 postoperatively. However, at 30 days' postoperatively, there was no statistically significant difference in healed area between the two groups.</p><p><strong>Conclusion: </strong>The findings of this study suggest that PRP has the potential to expedite the healing process and may help reduce hospital stay and wound infection rates, even though it did not result in a significantly larger overall healed area. The decision to use PRP should take into account various factors including resources, costs and desired clinical outcomes. Future research is needed to elucidate the role of PRP in the treatment of donor wounds.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"34 12","pages":"1000-1006"},"PeriodicalIF":1.7,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145677975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yu Hai-Ping, Zhuang Hui-Ren, Gu Ying-Jie, Li Xiao-Jing, Yun Ying Hung, Yao Jia-Li, Gao Yi-Li
Objective: To evaluate the effectiveness of telemedicine in home healthcare for patients with diabetic foot ulcers (DFUs) on wound healing time, wound score and patient self-management.
Method: Participants with DFUs were randomly assigned to either the study group (telemedicine in home healthcare) or to the control group (outpatient face-to-face care). Time to wound healing was identified as the primary outcome.
Results: Overall, 74 patients were randomised, and 64 patients were included in the study in the per-protocol analysis (32 patients in the study group and 32 patients in the control group). No significant difference was found in wound healing time between the two groups. Following eight weeks of treatment, there was also no difference in wound score between the two groups. However, the study group showed improved self-management of DFUs compared to the control group.
Conclusion: In this study, the use of telemedicine in home healthcare for patients with DFUs showed promising results in promoting wound healing, which was comparable to the effects of outpatient face-to-face care. Additionally, it was found to enhance self-management behaviour among patients with DFUs, indicating positive development prospects for this approach. In the future, it would be beneficial to explore the potential of developing a smartphone app specifically designed for wound care to enhance the effectiveness of telemedicine-based hard-to-heal (chronic) wound care services.
{"title":"Application of telemedicine in home healthcare for patients with diabetic foot ulcers: a randomised controlled study.","authors":"Yu Hai-Ping, Zhuang Hui-Ren, Gu Ying-Jie, Li Xiao-Jing, Yun Ying Hung, Yao Jia-Li, Gao Yi-Li","doi":"10.12968/jowc.2023.0158","DOIUrl":"10.12968/jowc.2023.0158","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effectiveness of telemedicine in home healthcare for patients with diabetic foot ulcers (DFUs) on wound healing time, wound score and patient self-management.</p><p><strong>Method: </strong>Participants with DFUs were randomly assigned to either the study group (telemedicine in home healthcare) or to the control group (outpatient face-to-face care). Time to wound healing was identified as the primary outcome.</p><p><strong>Results: </strong>Overall, 74 patients were randomised, and 64 patients were included in the study in the per-protocol analysis (32 patients in the study group and 32 patients in the control group). No significant difference was found in wound healing time between the two groups. Following eight weeks of treatment, there was also no difference in wound score between the two groups. However, the study group showed improved self-management of DFUs compared to the control group.</p><p><strong>Conclusion: </strong>In this study, the use of telemedicine in home healthcare for patients with DFUs showed promising results in promoting wound healing, which was comparable to the effects of outpatient face-to-face care. Additionally, it was found to enhance self-management behaviour among patients with DFUs, indicating positive development prospects for this approach. In the future, it would be beneficial to explore the potential of developing a smartphone app specifically designed for wound care to enhance the effectiveness of telemedicine-based hard-to-heal (chronic) wound care services.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"34 12","pages":"1013-1022"},"PeriodicalIF":1.7,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145677977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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