Wound Repair and Regeneration最新文献_第10页

Dysregulation of miR‐146a is associated with exacerbated inflammation, oxidative and endoplasmic reticulum stress in the progression of diabetic foot ulcer miR-146a 的失调与糖尿病足溃疡恶化过程中的炎症、氧化和内质网应激有关

IF 2.9 3区医学 Q2 CELL BIOLOGY

Wound Repair and Regeneration

Pub Date : 2024-04-24 DOI: 10.1111/wrr.13186

Pooja Prathyushaa Vikraman, Karan Amin, Sundhar Mohandas, Dhamodharan Umapathy, Rajesh Kesavan, Kunka Mohanram Ramkumar

Recent evidence has implicated the role of microRNA‐146a (miR‐146a) in regulating inflammatory responses. In the present study, we investigated the role of miRNA‐146a in the progression of diabetic foot ulcer (DFU) in type 2 diabetes mellitus patients (T2DM) and studied its correlation with stress mediators such as Endoplasmic Reticulum (ER) and oxidative stress. Ninety subjects were enrolled and evenly distributed among three groups: Controls (n = 30), T2DM without complications (n = 30) and T2DM with foot ulcers (n = 30). Subsequently, each group was further subdivided based on the University of Texas classification. Peripheral blood was collected from all the study subjects, while tissue biopsies were taken only from DFU patients. Total RNA from both PBMCs and wound tissues were isolated using miRNA isolation kit and qPCR was performed to check the expression of miR‐146a, ER stress and oxidative stress markers. Our findings revealed a significant decrease in miR‐146a expression among T2DM patients with Grade 2 and Grade 3 DFUs compared with those with Grade 0 and Grade 1 DFUs. Notably, inflammatory genes regulated by miR‐146a, including TRAF6, IRAK‐1 and ADAM, were all upregulated in T2DM patients with Grade 2 and Grade 3 DFUs. Moreover, reduced miR‐146a levels were correlated with increased markers of ER stress and oxidative stress in Grade 2 and Grade 3 DFU patients. Furthermore, our in vitro experiment using mouse 3T3 fibroblasts demonstrated a downregulation of miR‐146a following induction of hyperglycaemia, ER stress and oxidative stress in these cells. These findings suggest a potential link between diminished miR‐146a expression and heightened oxidative and ER stress in T2DM patients with more severe grades of DFUs. Our results imply that targeting miR‐146a may hold therapeutic promise for managing disease progression in DFU patients, as it could help alleviate oxidative and ER stress associated with diabetic complications.

最近有证据表明，microRNA-146a（miR-146a）在调节炎症反应中起着重要作用。在本研究中，我们探讨了 miRNA-146a 在 2 型糖尿病患者（T2DM）糖尿病足溃疡（DFU）进展中的作用，并研究了其与内质网（ER）和氧化应激等应激介质的相关性。90 名受试者平均分为三组：对照组（30 人）、无并发症的 T2DM 组（30 人）和有足部溃疡的 T2DM 组（30 人）。随后，每组又根据得克萨斯大学的分类法进一步细分。研究人员采集了所有研究对象的外周血，而仅从 DFU 患者身上提取了组织活检样本。使用 miRNA 分离试剂盒从 PBMCs 和伤口组织中分离出总 RNA，并进行 qPCR 检测 miR-146a、ER 应激和氧化应激标记物的表达。我们的研究结果显示，与0级和1级DFU相比，2级和3级DFU的T2DM患者的miR-146a表达量明显下降。值得注意的是，在2级和3级DFU的T2DM患者中，受miR-146a调控的炎症基因，包括TRAF6、IRAK-1和ADAM，都出现了上调。此外，在2级和3级DFU患者中，miR-146a水平的降低与ER应激和氧化应激标志物的增加相关。此外，我们使用小鼠 3T3 成纤维细胞进行的体外实验表明，在诱导高血糖、ER 应激和氧化应激后，这些细胞中的 miR-146a 出现下调。这些研究结果表明，在患有较严重DFU的T2DM患者中，miR-146a表达的减少与氧化应激和ER应激的增加之间存在潜在联系。我们的研究结果表明，以miR-146a为靶点可能有助于缓解与糖尿病并发症相关的氧化应激和ER应激，从而有望控制DFU患者的疾病进展。

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引用次数: 0

Further psychometric evaluation of the WOUND‐Q: A responsiveness study WOUND-Q 的进一步心理计量评估：响应性研究

IF 2.9 3区医学 Q2 CELL BIOLOGY

Wound Repair and Regeneration

Pub Date : 2024-04-24 DOI: 10.1111/wrr.13179

Lucas Gallo, Charlene Rae, Sophocles Voineskos, Nina Vestergaard Simonsen, Andrea L. Pusic, Lotte Poulsen, Jens Ahm Sørensen, Anne F. Klassen, Stefan J. Cano

The WOUND‐Q is a modular patient‐reported outcome measure (PROM) with 13 scales measuring constructs across 4 domains (i.e., wound characteristics, health related quality of life, experience of care and wound treatment). The psychometrics of the WOUND‐Q were previously assessed and the 13 scales evidenced good validity and reliability. However, the responsiveness (i.e., ability to detect clinical change) of the WOUND‐Q has yet to be assessed. The objective of this study was to evaluate responsiveness for 9 WOUND‐Q scales that assess outcomes, in a sample of people 18 years of age or older with chronic wounds that were present for at least 3 months. This study conducted a 4 month follow‐up of 421 participants who completed the WOUND‐Q as part of a previous psychometric study. Participants completed an online survey answering questions about their current wound state (e.g., number, type, size, smell, drainage), anchor questions about change, as well as the WOUND‐Q scales that they had completed in their initial assessment. Pre‐defined hypotheses were tested with a 75% acceptance threshold indicating sufficient evidence of responsiveness. Minimally important differences (MIDs) were also calculated using both anchor‐based and distribution‐based methods. Of 390 invited participants, 320 provided responses, ranging in age from 19 to 84 years. Acceptance of hypotheses ranged from 60% to 100%, with only the Symptom scale not meeting the 75% threshold. The findings of this study provide evidence that the WOUND‐Q can validly measure clinical change in patients with chronic wounds.

WOUND-Q 是一种模块化的患者报告结果量表 (PROM)，共有 13 个量表，测量 4 个领域（即伤口特征、与健康相关的生活质量、护理体验和伤口治疗）的结构。此前曾对 WOUND-Q 的心理测量学进行过评估，13 个量表具有良好的有效性和可靠性。然而，WOUND-Q 的反应性（即检测临床变化的能力）还有待评估。本研究的目的是评估 9 个 WOUND-Q 量表的响应性，这些量表评估的是 18 岁或以上、有慢性伤口且伤口存在至少 3 个月的人群的结果。这项研究对 421 名参与者进行了为期 4 个月的跟踪调查，这些参与者在之前的心理测量研究中完成了 WOUND-Q 的测试。参与者完成了一项在线调查，回答了有关其当前伤口状态（如数量、类型、大小、气味、引流情况）的问题、有关变化的锚定问题以及他们在初次评估中完成的 WOUND-Q 量表。对预先确定的假设进行了测试，接受阈值为 75%，表明有足够的证据表明存在响应性。此外，还使用基于锚和基于分布的方法计算了最小重要差异（MID）。在 390 名受邀参与者中，有 320 人做出了回应，他们的年龄从 19 岁到 84 岁不等。对假设的接受度从 60% 到 100% 不等，只有症状量表没有达到 75% 的临界值。这项研究结果证明，WOUND-Q 可以有效测量慢性伤口患者的临床变化。

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引用次数: 0

Teleconsulting in wound care: Connecting the primary care to the wound specialist reduces unnecessary referrals 伤口护理方面的远程咨询：将初级保健与伤口专科医生联系起来，减少不必要的转诊

IF 2.9 3区医学 Q2 CELL BIOLOGY

Wound Repair and Regeneration

Pub Date : 2024-04-24 DOI: 10.1111/wrr.13185

W. Brekelmans, B. L. S. Borger van der Burg, R. J. Brouwer, J. N. Belo, R. Hoencamp

In the Netherlands the primary care (General Practitioner or homecare nurse) encounter a variety of wounds ranging from traumatic to diabetic foot ulcers. According to a recent study 82.4% of the patients with a wound can be treated in a primary setting with the GP as medical supervisor. The remaining 17.6% of patients need more extensive care including advice by a specialised doctor, diagnosis and treatment. Prompt analyses and treatment of underlying causes by specialised doctors in a multidisciplinary setting is necessary for treating patients with complicated wound. This article describes the impact of Electronic Health Consultation on all wounds treated in the primary care. And describes the effect on the duration until referral to the hospital and the influence on the amount of unnecessary referrals to the hospital. All data was collected prospectively from June 2020 until October 2021. The study involved a process where primary care could seek advice from a Wound Physician at the Alrijne Wound Centre through a specialised Electronic Health Consultation. A total of 118 patients were analysed. 41/118 (34.7%) patients required a physical consultation with analysis and treatment in the hospital, after teleconsultation. The remaining 77/118 (65.3%) could be treated in primary care after Electronic Health Consultation. The mean duration of wound existence until Electronic Health Consultation was 39.3 days (range 5–271, SD: 38.5). 3/41 (7.3%) of the referrals were unnecessary. Electronic Health Consultation serves as a valuable and efficient tool for enhancing wound care, ultimately contributing to improved patient management and resource allocation within the healthcare system. This article describes the impact of Electronic Health Consultation on all wounds treated in the primary care and the influence on the duration until referral to the hospital and the influence on the amount of unnecessary referrals to the hospital.

在荷兰，基层医疗机构（全科医生或家庭护理护士）会遇到从外伤到糖尿病足溃疡等各种伤口。根据最近的一项研究，82.4%的伤口患者可以在全科医生的指导下在基层医疗机构得到治疗。其余 17.6% 的患者则需要更广泛的护理，包括专科医生的建议、诊断和治疗。在治疗复杂伤口患者时，有必要由专科医生在多学科环境下对潜在病因进行及时分析和治疗。本文介绍了电子健康咨询对基层医疗机构治疗的所有伤口的影响。并描述了电子健康咨询对转诊到医院的时间的影响，以及对不必要转诊到医院的数量的影响。所有数据都是在 2020 年 6 月至 2021 年 10 月期间进行的前瞻性收集。研究过程中，基层医疗机构可通过专门的电子健康咨询向阿尔里耶恩伤口中心的伤口医生寻求建议。共对 118 名患者进行了分析。41/118（34.7%）名患者需要在远程会诊后到医院进行分析和治疗。其余 77/118 名患者（65.3%）可在电子健康咨询后在基层医疗机构接受治疗。在接受电子健康咨询之前，伤口存在的平均时间为 39.3 天（范围为 5-271，标准差：38.5）。3/41（7.3%）的转诊是不必要的。电子健康咨询是加强伤口护理的重要而有效的工具，最终有助于改善医疗系统内的患者管理和资源分配。本文介绍了电子健康咨询对基层医疗机构治疗的所有伤口的影响，以及对转诊至医院的时间和不必要的转诊量的影响。

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引用次数: 0

Low‐temperature plasma jet suppresses bacterial colonisation and affects wound healing through reactive species 低温等离子射流通过活性物种抑制细菌定植并影响伤口愈合

IF 2.9 3区医学 Q2 CELL BIOLOGY

Wound Repair and Regeneration

Pub Date : 2024-04-11 DOI: 10.1111/wrr.13178

Yang Ge, Jun Wang, DongHua Gu, Wei Cao, Yongtong Feng, Yanfan Wu, Han Liu, Zhengping Xu, Zhe Zhang, Jinsong Xie, Shuang Geng, Junrui Cong, Yi Liu

An argon‐based low‐temperature plasma jet (LTPJ) was used to treat chronically infected wounds in Staphylococcus aureus‐laden mice. Based on physicochemical property analysis and in vitro antibacterial experiments, the effects of plasma parameters on the reactive nitrogen and oxygen species (RNOS) content and antibacterial capacity were determined, and the optimal treatment parameters were determined to be 4 standard litre per minute and 35 W. Additionally, the plasma‐treated activation solution had a bactericidal effect. Although RNOS are related to the antimicrobial effect of plasma, excess RNOS may be detrimental to wound remodelling. In vivo studies demonstrated that medium‐dose LTPJ promoted MMP‐9 expression and inhibited bacterial growth during the early stages of healing. Moreover, LTPJ increased collagen deposition, reduced inflammation, and restored blood vessel density and TGF‐β levels to normal in the later stages of wound healing. Therefore, when treating chronically infected wounds with LTPJ, selecting the medium dose of plasma is more advantageous for wound recovery. Overall, our study demonstrated that low‐temperature plasma jets may be a potential tool for the treatment of chronically infected wounds.

利用氩基低温等离子体射流（LTPJ）治疗含有金黄色葡萄球菌的小鼠慢性感染伤口。根据理化性质分析和体外抗菌实验，确定了等离子参数对活性氮和氧物种（RNOS）含量和抗菌能力的影响，并确定最佳处理参数为每分钟 4 标准升和 35 瓦。虽然 RNOS 与血浆的抗菌效果有关，但过量的 RNOS 可能会不利于伤口重塑。体内研究表明，在伤口愈合的早期阶段，中等剂量的 LTPJ 可促进 MMP-9 的表达并抑制细菌生长。此外，在伤口愈合后期，LTPJ 还能增加胶原蛋白沉积、减少炎症反应，并使血管密度和 TGF-β 水平恢复正常。因此，在用 LTPJ 治疗慢性感染伤口时，选择中等剂量的血浆对伤口恢复更有利。总之，我们的研究表明，低温等离子射流可能是治疗慢性感染伤口的一种潜在工具。

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引用次数: 0

In the face and neck, keloid scar distribution is related to skin thickness and stiffness changes associated with movement 在脸部和颈部，瘢痕疙瘩的分布与皮肤厚度和与运动相关的僵硬变化有关

IF 2.9 3区医学 Q2 CELL BIOLOGY

Wound Repair and Regeneration

Pub Date : 2024-04-11 DOI: 10.1111/wrr.13180

Hoyu Cho, Teruyuki Dohi, Hanae Wakai, Whitney Laurel Quong, Nguyen Doan Tien Linh, Satoshi Usami, Rei Ogawa

Keloid scars tend to occur in high‐tension sites due to mechanical stimuli that are involved in their development. To date, a detailed analysis of keloid distribution focused specifically on facial and neck areas has not been reported, and limited literature exists as to the related mechanical factors. To rectify this deficiency of knowledge, we first quantified the facial and neck keloid distribution observed clinically in 113 patients. Subsequently, we performed a rigorous investigation into the mechanical factors and their associated changes at these anatomic sites in healthy volunteers without a history of pathologic scarring. The association between keloid‐predilection sites and sebaceous gland‐dense and acne‐prone sites was also examined. To assess skin stretch, thickness and stiffness, VECTRA, ultrasound and indentometer were utilised. Baseline skin stiffness and thickness were measured, as well as the magnitude of change in these values associated with facial expression and postural changes. Within the face and neck, keloids were most common near the mandibular angle (41.3%) and lateral submental (20.0%) regions. These areas of increased keloid incidence were not associated with areas more dense in sebaceous glands, nor linked consistently with acne‐susceptible regions. Binomial logistic regression revealed that changes in skin stiffness and thickness related to postural changes significantly predicted keloid distribution. Skin stiffness and thickness changes related to prolonged mechanical forces (postural changes) are most pronounced at sites of high keloid predilection. This finding further elucidates the means by which skin stretch and tension are related to keloid development. As a more detailed analysis of mechanical forces on facial and neck skin, this study evaluates the nuances of multiple skin‐mechanical properties, and their changes in a three‐dimensional framework. Such factors may be critical to better understanding keloid progression and development in the face and neck.

由于瘢痕疙瘩的形成与机械刺激有关，因此瘢痕疙瘩往往发生在高张力部位。迄今为止，还没有专门针对面部和颈部瘢痕疙瘩分布进行详细分析的报道，有关机械因素的文献也很有限。为了弥补这一知识缺陷，我们首先量化了临床上观察到的 113 名患者的面部和颈部瘢痕疙瘩分布情况。随后，我们对无病理瘢痕史的健康志愿者的这些解剖部位的机械因素及其相关变化进行了严格的调查。我们还研究了瘢痕疙瘩选取部位与皮脂腺密集和痤疮易发部位之间的关联。为了评估皮肤的伸展性、厚度和硬度，使用了 VECTRA、超声波和压痕仪。测量了基线皮肤硬度和厚度，以及与面部表情和体位变化相关的这些值的变化幅度。在面部和颈部，瘢痕疙瘩最常见的部位是下颌角（41.3%）和外侧下颌角（20.0%）。这些瘢痕疙瘩发病率较高的区域与皮脂腺较密集的区域没有关联，也与痤疮易发区域没有一致的联系。二项式逻辑回归显示，与体位变化有关的皮肤硬度和厚度变化可显著预测瘢痕疙瘩的分布。与长期机械力（体位变化）相关的皮肤硬度和厚度变化在瘢痕疙瘩高发部位最为明显。这一发现进一步阐明了皮肤拉伸和张力与瘢痕疙瘩发展的关系。作为对面部和颈部皮肤机械力的更详细分析，本研究评估了多种皮肤机械特性的细微差别及其在三维框架中的变化。这些因素对于更好地了解瘢痕疙瘩在面部和颈部的进展和发展可能至关重要。

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引用次数: 0

3D skin bioprinting as promising therapeutic strategy for radiation‐associated skin injuries 三维皮肤生物打印是治疗辐射相关皮肤损伤的有效方法

IF 2.9 3区医学 Q2 CELL BIOLOGY

Wound Repair and Regeneration

Pub Date : 2024-04-11 DOI: 10.1111/wrr.13181

Xiaofan Lv, Na Zhao, Shuang Long, Guojian Wang, Xinze Ran, Jining Gao, Junping Wang, Tao Wang

Both cutaneous radiation injury and radiation combined injury (RCI) could have serious skin traumas, which are collectively referred to as radiation‐associated skin injuries in this paper. These two types of skin injuries require special managements of wounds, and the therapeutic effects still need to be further improved. Cutaneous radiation injuries are common in both radiotherapy patients and victims of radioactive source accidents, which could lead to skin necrosis and ulcers in serious conditions. At present, there are still many challenges in management of cutaneous radiation injuries including early diagnosis, lesion assessment, and treatment prognosis. Radiation combined injuries are special and important issues in severe nuclear accidents, which often accompanied by serious skin traumas. Mass victims of RCI would be the focus of public health concern. Three‐dimensional (3D) bioprinting, as a versatile and favourable technique, offers effective approaches to fabricate biomimetic architectures with bioactivity, which provides potentials for resolve the challenges in treating radiation‐associated skin injuries. Combining with the cutting‐edge advances in 3D skin bioprinting, the authors analyse the damage characteristics of skin wounds in both cutaneous radiation injury and RCI and look forward to the potential value of 3D skin bioprinting for the treatments of radiation‐associated skin injuries.

皮肤辐射损伤和辐射合并损伤（RCI）都可能造成严重的皮肤创伤，本文统称为辐射相关皮肤损伤。这两种皮肤损伤需要对伤口进行特殊处理，治疗效果仍有待进一步提高。皮肤辐射损伤常见于放疗患者和放射源事故受害者，严重时可导致皮肤坏死和溃疡。目前，皮肤放射损伤的治疗仍面临许多挑战，包括早期诊断、病变评估和治疗预后。辐射合并损伤是严重核事故中特殊而重要的问题，往往伴随着严重的皮肤创伤。辐射综合损伤的大规模受害者将成为公共卫生关注的焦点。三维（3D）生物打印作为一种多用途的有利技术，为制造具有生物活性的仿生结构提供了有效方法，为解决辐射相关皮肤损伤的治疗难题提供了可能性。结合三维皮肤生物打印技术的前沿进展，作者分析了皮肤辐射损伤和RCI中皮肤伤口的损伤特征，并展望了三维皮肤生物打印技术在治疗辐射相关皮肤损伤方面的潜在价值。

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引用次数: 0

Porcine‐derived collagen peptides promote re‐epithelialisation through activation of integrin signalling 源自茯苓的胶原蛋白肽通过激活整合素信号促进再上皮化

IF 2.9 3区医学 Q2 CELL BIOLOGY

Wound Repair and Regeneration

Pub Date : 2024-04-04 DOI: 10.1111/wrr.13177

Krishan Mistry, Grant Richardson, Sara Vleminckx, Robert Smith, Elien Gevaert, Penny E. Lovat

Chronic non‐healing cutaneous wounds represent a major burden to patients and healthcare providers worldwide, emphasising the continued unmet need for credible and efficacious therapeutic approaches for wound healing. We have recently shown the potential for collagen peptides to promote proliferation and migration during cutaneous wound healing. In the present study, we demonstrate that the application of porcine‐derived collagen peptides significantly increases keratinocyte and dermal fibroblast expression of integrin α2β1 and activation of an extracellular signal‐related kinase (ERK)‐focal adhesion kinase (FAK) signalling cascade during wound closure in vitro. SiRNA‐mediated knockdown of integrin β1 impaired porcine‐derived collagen peptide‐induced wound closure and activation of ERK‐FAK signalling in keratinocytes but did not impair ERK or FAK signalling in dermal fibroblasts, implying the activation of differing downstream signalling pathways. Studies in ex vivo human 3D skin equivalents subjected to punch biopsy‐induced wounding confirmed the ability of porcine‐derived collagen peptides to promote wound closure by enhancing re‐epithelialisation. Collectively, these data highlight the translational and clinical potential for porcine‐derived collagen peptides as a viable therapeutic approach to promote re‐epithelialisation of superficial cutaneous wounds.

长期不愈合的皮肤伤口是全球患者和医疗服务提供者的一大负担，这凸显了对可靠有效的伤口愈合治疗方法的需求仍未得到满足。最近，我们证明了胶原蛋白肽在皮肤伤口愈合过程中促进增殖和迁移的潜力。在本研究中，我们证明了在体外伤口闭合过程中，应用孔源性胶原蛋白肽可显著增加角质形成细胞和真皮成纤维细胞整合素α2β1的表达，并激活细胞外信号相关激酶（ERK）-病灶粘附激酶（FAK）信号级联。SiRNA 介导的整合素 β1 基因敲除损害了孔源性胶原蛋白肽诱导的伤口闭合和角质形成细胞中 ERK-FAK 信号的激活，但没有损害真皮成纤维细胞中的 ERK 或 FAK 信号，这意味着激活了不同的下游信号通路。在体内外人体三维皮肤等同物中进行的研究证实，猪源性胶原蛋白肽能通过增强再上皮化来促进伤口闭合。总之，这些数据凸显了猪源性胶原蛋白肽作为一种可行的治疗方法促进表皮伤口再上皮化的转化和临床潜力。

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引用次数: 0

Update of biomarkers to diagnose diabetic foot osteomyelitis: A meta‐analysis and systematic review 诊断糖尿病足骨髓炎的生物标志物的更新：荟萃分析和系统综述

IF 2.9 3区医学 Q2 CELL BIOLOGY

Wound Repair and Regeneration

Pub Date : 2024-04-03 DOI: 10.1111/wrr.13174

Elizabeth A. Ansert, Arthur N. Tarricone, Tyler L. Coye, Peter A. Crisologo, David Truong, Mehmet A. Suludere, Lawrence A. Lavery

The aim of this study was to evaluate the diagnostic characteristics of biomarker for diabetic foot osteomyelitis (DFO). We searched PubMed, Scopus, Embase and Medline for studies who report serological markers and DFO before December 2022. Studies must include at least one of the following diagnostic parameters for biomarkers: area under the curve, sensitivities, specificities, positive predictive value, negative predictive value. Two authors evaluated quality using the Quality Assessment of Diagnostic Accuracy Studies tool. We included 19 papers. In this systematic review, there were 2854 subjects with 2134 (74.8%) of those patients being included in the meta‐analysis. The most common biomarkers were erythrocyte sedimentation rate (ESR), C‐reactive protein (CRP) and procalcitonin (PCT). A meta‐analysis was then performed where data were evaluated with Forrest plots and receiver operating characteristic curves. The pooled sensitivity and specificity were 0.72 and 0.75 for PCT, 0.72 and 0.76 for CRP and 0.70 and 0.77 for ESR. Pooled area under the curves for ESR, CRP and PCT were 0.83, 0.77 and 0.71, respectfully. Average diagnostic odds ratios were 16.1 (range 3.6–55.4), 14.3 (range 2.7–48.7) and 6.7 (range 3.6–10.4) for ESR, CRP and PCT, respectfully. None of the biomarkers we evaluated could be rated as ‘outstanding’ to diagnose osteomyelitis. Based on the areas under the curve, ESR is an ‘excellent’ biomarker to detect osteomyelitis, and CRP and PCT are ‘acceptable’ biomarkers to diagnose osteomyelitis. Diagnostic odds ratios indicate that ESR, CRP and PCT are ‘good’ or ‘very good’ tools to identify osteomyelitis.

本研究旨在评估糖尿病足骨髓炎（DFO）生物标志物的诊断特征。我们在PubMed、Scopus、Embase和Medline上搜索了2022年12月之前报告血清学标记物和DFO的研究。研究必须至少包括以下一项生物标记物诊断参数：曲线下面积、敏感性、特异性、阳性预测值、阴性预测值。两位作者使用诊断准确性研究质量评估工具对研究质量进行了评估。我们共纳入了 19 篇论文。在这篇系统综述中，共有2854名受试者，其中2134名（74.8%）患者被纳入荟萃分析。最常见的生物标记物是红细胞沉降率（ESR）、C反应蛋白（CRP）和降钙素原（PCT）。然后进行了荟萃分析，利用福斯特图和接收器工作特征曲线对数据进行了评估。PCT 的集合敏感性和特异性分别为 0.72 和 0.75，CRP 为 0.72 和 0.76，ESR 为 0.70 和 0.77。血沉、CRP 和 PCT 的集合曲线下面积分别为 0.83、0.77 和 0.71。血沉、CRP 和 PCT 的平均诊断几率分别为 16.1（范围 3.6-55.4）、14.3（范围 2.7-48.7）和 6.7（范围 3.6-10.4）。在诊断骨髓炎方面，我们所评估的生物标志物中没有一个能被评为 "优秀"。根据曲线下面积，血沉是检测骨髓炎的 "优秀 "生物标志物，而 CRP 和 PCT 是诊断骨髓炎的 "可接受 "生物标志物。诊断几率比表明，血沉、CRP 和 PCT 是识别骨髓炎的 "良好 "或 "非常好 "的工具。

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引用次数: 0

Healing rates and outcomes following closed transmetatarsal amputations: A systematic review and random effects meta-analysis of proportions. 闭合性跨跖截肢术后的愈合率和疗效：系统回顾和随机效应比例元分析》。

IF 3.8 3区医学 Q2 CELL BIOLOGY

Wound Repair and Regeneration

Pub Date : 2024-03-01 Epub Date: 2024-01-20 DOI: 10.1111/wrr.13143

Tyler Coye, Elizabeth Ansert, Mehmet A Suludere, Jayer Chung, Gu Eon Kang, Lawrence A Lavery

Transmetatarsal amputation (TMA) is a common surgical procedure for addressing severe forefoot pathologies, such as peripheral vascular disease and diabetic foot infections. Variability in research methodologies and findings within the existing literature has hindered a comprehensive understanding of healing rates and complications following TMA. This meta-analysis and systematic review aims to consolidate available evidence, synthesising data from multiple studies to assess healing rates and complications associated with closed TMA procedures. Following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, a systematic search of Medline, Embase, and Cochrane databases was conducted for articles published from January 1st, 1988, to June 1st, 2023. Inclusion criteria comprised studies reporting healing rates in non-traumatic transmetatarsal amputation patients with more than 10 participants, excluding open TMAs. Two independent reviewers selected relevant studies, with disagreements resolved through discussion. Data extracted from eligible studies included patient demographics, healing rates, complications, and study quality. Among 22 studies encompassing 1569 transmetatarsal amputations, the pooled healing rate was 67.3%. Major amputation rates ranged from 0% to 55.6%, with a random-effects pooled rate of 23.9%. Revision rates varied from 0% to 36.4%, resulting in a pooled rate of 14.8%. 30-day mortality ranged from 0% to 9%, with a fixed-effects pooled rate of 2.6%. Post-operative infection rates ranged from 3.0% to 30.7%, yielding a random-effects pooled rate of 16.7%. Dehiscence rates ranged from 1.7% to 60.0%, resulting in a random-effects pooled rate of 28.8%. Future studies should aim for standardised reporting and assess the physiological and treatment factors influencing healing and complications.

经跖骨截肢（TMA）是一种常见的外科手术，用于治疗严重的前足病变，如外周血管疾病和糖尿病足感染。现有文献中的研究方法和研究结果存在差异，这阻碍了人们对 TMA 术后愈合率和并发症的全面了解。本荟萃分析和系统综述旨在整合现有证据，综合多项研究数据，评估闭合式 TMA 手术的愈合率和相关并发症。根据系统综述和荟萃分析首选报告项目（PRISMA）指南，对 Medline、Embase 和 Cochrane 数据库中 1988 年 1 月 1 日至 2023 年 6 月 1 日期间发表的文章进行了系统检索。纳入标准包括报告非创伤性经趾跖截肢患者愈合率的研究，参与者超过 10 人，不包括开放性经趾跖截肢。两位独立审稿人挑选了相关研究，并通过讨论解决了分歧。从符合条件的研究中提取的数据包括患者的人口统计学特征、愈合率、并发症和研究质量。22 项研究共进行了 1,569 例经跖骨截肢手术，汇总的愈合率为 67.3%。大截肢率从 0% 到 55.6% 不等，随机效应汇总率为 23.9%。翻修率从 0% 到 36.4% 不等，综合比率为 14.8%。30天死亡率从0%到9%不等，固定效应汇总死亡率为2.6%。术后感染率从3.0%到30.7%不等，随机效应汇总感染率为16.7%。开裂率从1.7%到60.0%不等，随机效应集中率为28.8%。未来的研究应以标准化报告为目标，并评估影响愈合和并发症的生理和治疗因素。本文受版权保护。保留所有权利。

{"title":"Healing rates and outcomes following closed transmetatarsal amputations: A systematic review and random effects meta-analysis of proportions.","authors":"Tyler Coye, Elizabeth Ansert, Mehmet A Suludere, Jayer Chung, Gu Eon Kang, Lawrence A Lavery","doi":"10.1111/wrr.13143","DOIUrl":"10.1111/wrr.13143","url":null,"abstract":"Transmetatarsal amputation (TMA) is a common surgical procedure for addressing severe forefoot pathologies, such as peripheral vascular disease and diabetic foot infections. Variability in research methodologies and findings within the existing literature has hindered a comprehensive understanding of healing rates and complications following TMA. This meta-analysis and systematic review aims to consolidate available evidence, synthesising data from multiple studies to assess healing rates and complications associated with closed TMA procedures. Following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, a systematic search of Medline, Embase, and Cochrane databases was conducted for articles published from January 1st, 1988, to June 1st, 2023. Inclusion criteria comprised studies reporting healing rates in non-traumatic transmetatarsal amputation patients with more than 10 participants, excluding open TMAs. Two independent reviewers selected relevant studies, with disagreements resolved through discussion. Data extracted from eligible studies included patient demographics, healing rates, complications, and study quality. Among 22 studies encompassing 1569 transmetatarsal amputations, the pooled healing rate was 67.3%. Major amputation rates ranged from 0% to 55.6%, with a random-effects pooled rate of 23.9%. Revision rates varied from 0% to 36.4%, resulting in a pooled rate of 14.8%. 30-day mortality ranged from 0% to 9%, with a fixed-effects pooled rate of 2.6%. Post-operative infection rates ranged from 3.0% to 30.7%, yielding a random-effects pooled rate of 16.7%. Dehiscence rates ranged from 1.7% to 60.0%, resulting in a random-effects pooled rate of 28.8%. Future studies should aim for standardised reporting and assess the physiological and treatment factors influencing healing and complications.","PeriodicalId":23864,"journal":{"name":"Wound Repair and Regeneration","volume":" ","pages":"182-191"},"PeriodicalIF":3.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138804318","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 use of hyperbaric oxygen therapy in the treatment of hand crush injuries. 使用高压氧疗法治疗手部挤压伤。

IF 3.8 3区医学 Q2 CELL BIOLOGY

Wound Repair and Regeneration

Pub Date : 2024-03-01 Epub Date: 2024-01-18 DOI: 10.1111/wrr.13134

Dun-Hao Chang, Chi-Ying Hsieh, Che-Wei Chang, Hsu-Hui Wang, Hou-Tai Chang

Hyperbaric oxygen therapy (HBOT) has been used as an adjuvant treatment for crush injury because it can improve tissue hypoxia and stimulate wound healing. However, the actual role of HBOT in crush hand injury is still unknown. This study is to assess the efficacy of HBOT for crush hand patients, as well as the impact of HBOT initiation timing. Between 2018 and 2021, 72 patients with crush hand injury were retrospectively reviewed. The patients were divided into the HBOT and control group, and each group had 36 patients. The average session of HBOT was 18.2 (5-32 sessions) per patient, and no patient had a complication related to the treatment. The two groups had similar demographics, but HBOT group had larger injured area (73.6 ± 51.0 vs. 48.2 ± 45.5 cm² , p = 0.03). To better control the confounding factors, we performed the subgroup analysis with cut-off injured area of 50 cm² . In the patients with smaller injured area (≦50 cm² ), the HBOT group had shorter wound healing time (29.9 ± 12.9 vs. 41.0 ± 18.9 days, p = 0.03). The early HBOT group (first session ≤72 h post-operatively) had shorter hospital stay (8.1 ± 6.4 vs. 15.5 ± 11.4 days, p = 0.04), faster wound healing (28.7 ± 17.8 vs. 41.1 ± 18.1 days, p = 0.08) and less operations (1.54 ± 0.78 vs. 2.41 ± 1.62, p = 0.06) although the latter two didn't achieve statistical significance. HBOT is safe and effective in improving wound healing of hand crush injury. Early intervention of HBOT may be more beneficial. Future research is required to provide more evidence.

高压氧疗法（HBOT）可改善组织缺氧状况并促进伤口愈合，因此一直被用作挤压伤的辅助治疗手段。然而，高压氧疗法在手挤压伤中的实际作用尚不清楚。本研究旨在评估 HBOT 对手部挤压伤患者的疗效，以及 HBOT 启动时机的影响。在 2018 年至 2021 年期间，对 72 例手部挤压伤患者进行了回顾性研究。患者被分为 HBOT 组和对照组，每组 36 人。每位患者平均接受 18.2 次（5-32 次）HBOT 治疗，没有患者出现与治疗相关的并发症。两组的人口统计学特征相似，但 HBOT 组的受伤面积更大（73.6±51.0 VS 48.2±45.5 cm2，P= 0.03）。为了更好地控制混杂因素，我们进行了亚组分析，截断损伤面积为 50 平方厘米。在受伤面积较小（≦50 平方厘米）的患者中，HBOT 组的伤口愈合时间较短（29.9 ± 12.9 天 VS 41.0 ± 18.9 天，P=0.03）。早期 HBOT 组（第一次治疗时间≦术后 72 小时）的住院时间更短（8.1±6.4 天 VS 15.5±11.4天，P=0.04），伤口愈合更快（28.7±17.8 天 VS 41.1±18.1天，P=0.08），手术更少（1.54±0.78 VS 2.41±1.62，P=0.06），但后两者均未达到统计学意义。HBOT 能安全有效地改善手部挤压伤的伤口愈合。早期干预 HBOT 可能更有益。未来的研究需要提供更多证据。本文受版权保护。保留所有权利。

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引用次数: 0