International Wound Journal最新文献

{"title":"Risk Factors and Nomogram Model for Multidrug-Resistant Bacterial Infections in Diabetic Foot Wounds.","authors":"Guangzhe Meng, Liye Hu, Xuan Gao, Sijia Xu, Xiuhui Wang, Yiwen Yang, Xiaoling Li, Libo Zhang, Shaoling Yang","doi":"10.1111/iwj.70929","DOIUrl":"https://doi.org/10.1111/iwj.70929","url":null,"abstract":"<p><p>To study the risk factors associated with multidrug-resistant bacteria (MDRB) infection in diabetic foot (DF) wounds and to develop a nomogram model to predict the risk of MDRB infection in patients with DF. A total of 157 patients with DF between January 2013 and December 2023 were included in this study. A retrospective analysis was conducted to examine the characteristics of MDRB infections. Univariate and multivariate logistic regression analyses were performed to identify risk factors associated with MDRB infection. Based on these risk factors, a predictive model was built using R software and a nomogram was constructed. Multivariate logistic regression analysis revealed that the wound area, previous hospitalization, prior use of antibacterial agents, lower extremity ischaemia grade, and hypoproteinaemia were independent risk factors for MDRB infection in DF wounds (p < 0.05). Construction of the nomogram model for MDRB infection in DF wounds: A nomogram model was developed using five identified risk factors-wound area, previous hospitalization, previous use of antibacterial drugs, lower extremity ischaemia grade and hypoproteinaemia-as predictors. The area under the receiver operating characteristic (ROC) curve (AUC) was 0.863. The model has a good ability to predict MDRB infections in DF wounds. Wound area, previous hospitalization, previous use of antibacterial drugs, lower extremity ischaemia grade and hypoproteinaemia were identified as independent risk factors for MDRB infections in DF wounds. The nomogram model constructed on the basis of these five factors demonstrated good predictive performance for MDRB infection.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"23 5","pages":"e70929"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13111913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maintenance Debridement in Chronic Hard-to-Heal Wounds: Toward Dynamic Homeostasis and Precision Intervention.","authors":"RuoDi Lu, Yi Zhang, Biao Cheng","doi":"10.1111/iwj.70930","DOIUrl":"10.1111/iwj.70930","url":null,"abstract":"<p><p>Debridement is widely used across various wound types, but its biological significance differs fundamentally between acute and chronic hard-to-heal wounds. In acute wounds, debridement directly triggers the initiation of regeneration; however, in chronic wounds, persistent biofilm, insufficient angiogenesis and dysregulated inflammation lead to a prolonged cycle of inflammation and proliferation, making traditional one-off debridement insufficient to change the healing trajectory. Therefore, the concept of debridement needs to evolve from an acute wound model to a sequential, biologically driven continuous management strategy. Maintenance debridement, by dynamically regulating the microenvironment, reducing pathological load and restoring a 'healable state', has emerged as the crucial bridge between inflammation control and regenerative therapies. This review systematically explains the theoretical basis and clinical value of maintenance debridement and explores the future direction of AI-assisted precision debridement management.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"23 5","pages":"e70930"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13136606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of a Defined Two-Dose Protocol of Autologous Platelet-Rich Plasma (PRP) Injection for Refractory Chronic Non-Healing Wounds: A Prospective Clinical Study.","authors":"Nathathai Wanchutrirat, Kamonwan Jenwitheesuk, Kriangsak Jenwitheesuk, Wiyada Punjaruk, Palakorn Surakunprapha, Kengkart Winaikosol, Pattama Punyawong, Pimthawan Vachirodom, Kaweesak Saothonglang, Weerin Sawangkajohn, Thitinan Kasetthat","doi":"10.1111/iwj.70932","DOIUrl":"10.1111/iwj.70932","url":null,"abstract":"<p><p>Chronic non-healing wounds represent a major global public health challenge. Their persistence is frequently attributed to localized biological deficits that cause them unresponsive to conventional therapeutic modalities. While Platelet-Rich Plasma (PRP) has demonstrated promising results as an adjunctive treatment by delivering highly concentrated growth factors, its clinical application is currently impeded by a lack of clinical standardization, particularly optimal injection frequency, interval, and dosage. The aim of this study is to rigorously evaluate the efficacy and safety of a specific, non-intensive two-dose PRP injection protocol for accelerating the reduction of wound area in patients with various types of refractory chronic wounds. We conducted a prospective, single-arm, pretest-posttest study enrolling 18 patients with refractory non-healing wounds, defined as lesions persisting for a minimum period of 4 weeks which had failed to achieve definitive closure under optimized standard care. Autologous high-concentration PRP was injected intradermally around the wound margin at baseline (Day 0) and again 3 weeks later (Day 21). Wound area was digitally measured at baseline and subsequently at 7, 11 and 15 weeks. The primary outcome was the mean reduction in wound area (cm²) at the 15-week follow-up, assessed using a Paired Samples t-test. The mean patient age was 57.89 ± 15.64 years, and wounds had a mean chronicity of 15.83 ± 19.05 months. The PRP preparation achieved a mean platelet concentration 8.5 times greater than the peripheral blood threshold (first injection) and 7.0 times greater than the threshold (second injection), confirming high therapeutic quality. Analysis of the total cohort demonstrated a statistically significant reduction in mean wound area from baseline 27.41 ± 70.38 cm² to 15 weeks 21.5 ± 68.96 cm². Three patients (16.67%) achieved complete epithelialization. Subgroup trends suggested diabetic and venous ulcers responded more favourably than radiation-induced ulcers. The protocol was safe, with no systemic or severe localized adverse events observed among participants. The defined two-dose PRP injection protocol provides a clinically effective and safe adjunctive therapy that significantly promotes wound area reduction in challenging chronic non-healing wounds. This reproducible, low-frequency protocol offers a rationale for standardization in advanced wound care, warranting validation through future large-scale Randomized Controlled Trials (RCTs).</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"23 5","pages":"e70932"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Calciphylaxis Mimicking Infection in a Patient With End-Stage Renal Disease and Sarcoidosis: A Diagnostic and Wound Management Challenge.","authors":"Nicole Nowak, Aashna Farishta, Rachel Chang, Wanna Zhang","doi":"10.1111/iwj.70928","DOIUrl":"https://doi.org/10.1111/iwj.70928","url":null,"abstract":"<p><p>Calciphylaxis is a rare, life-threatening disorder primarily affecting patients with end-stage renal disease (ESRD) on dialysis. Early lesions can mimic infection, leading to delays in diagnosis and wound-directed care. We describe an atypical early presentation of calciphylaxis in a patient with ESRD and sarcoidosis, initially misdiagnosed as cellulitis. Despite early sodium thiosulfate therapy and metabolic control, the patient developed progressive necrotic wounds. This case underscores that calciphylaxis can progress despite controlled mineral metabolism and standard therapy, particularly when potentiated by conditions like sarcoidosis. Early dermatologic evaluation and a high index of suspicion are critical to avoid misdiagnosis.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"23 5","pages":"e70928"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Retrospective Real-World Data Analysis of Pressure Ulcer Healing With Nitric Oxide-Delivering Foam Among Older Adults.","authors":"Rhonda Sullivan, Zwelithini Mzwandile Tunyiswa, Windy Cole, Lisa Gould, Mervin Low","doi":"10.1111/iwj.70911","DOIUrl":"10.1111/iwj.70911","url":null,"abstract":"<p><p>Pressure ulcers remain a major cause of morbidity in skilled nursing facility populations, where frailty and comorbid conditions hinder healing. Numerous studies have established Nitric oxide's role in tissue repair, angiogenesis, and infection control, suggesting therapeutic potential for nitric oxide in chronic wound healing. A retrospective observational cohort study was conducted using de-identified data from skilled nursing patients presenting with pressure ulcers. Two matched cohorts (200 patients per group) were compared: Those treated with a nitric oxide-delivering foam and historical controls receiving standard of care. Propensity score matching accounted for baseline wound size, stage, sex, comorbidities, and treatment start date. The primary endpoint was complete closure (epithelialized or had an area of zero) within 12 weeks. Bayesian hierarchical hurdle-gamma regression estimated treatment effects using posterior means and 95% credible intervals. Within 12 weeks, closure or resolution rates had a significant benefit in the treatment group across most stages: 94% versus 79% for Stage 1, 80% versus 45% in Stage 2, 64% versus 28% in Stage 3, 39% versus 12% in unstageable, 34% versus 10% in Stage 4, and 67% versus 31% for Deep Tissue Pressure Injuries. Overall, 63% (95% CrI 50%-75%) of NODF-treated wounds healed compared with 34% (21%-47%) of SOC wounds. Posterior probabilities of superior healing with NODF exceeded 99% for most comparisons.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"23 5","pages":"e70911"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Negative Pressure Wound Therapy for Complex Perianal Fistulas: A Case Series.","authors":"Ariella Edina Kondor, Jozsef Baracs, Peter Varga, Yashwanth Sudhendra Gowda, Elisabeth Garcia, Peter Halvax, Andras Vereczkei","doi":"10.1111/iwj.70920","DOIUrl":"https://doi.org/10.1111/iwj.70920","url":null,"abstract":"<p><p>Complex perianal fistulas are difficult to treat because of high recurrence rates and the need to preserve sphincter function. Negative pressure wound therapy (NPWT) improves healing in complex wounds, but its role in perianal fistula surgery is not well defined. This case series evaluated the feasibility, safety and early clinical outcomes of NPWT following surgical excision of complex perianal fistula tracts. A retrospective case series was conducted including eight adults with high or otherwise complex cryptoglandular perianal fistulas treated by surgical debridement followed by portable NPWT. Outcomes assessed were time to epithelialisation, symptom resolution, recurrence, complications and NPWT-related technical issues and refinements. Seven of eight patients achieved complete epithelialisation of the perianal wound after NPWT. One patient developed recurrence and required ongoing seton drainage. Over the course of the series, optimisation of sealing, sponge contouring and use of a bridge technique improved dressing reliability and wound progression. No NPWT device-related adverse events were observed. NPWT appears to be a feasible, well tolerated adjunct to surgery for complex cryptoglandular perianal fistulas, with high early healing rates and no device complications in this small series. Larger prospective studies are warranted to confirm efficacy and define optimal technical parameters.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"23 5","pages":"e70920"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13111146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Negative Pressure Wound Therapy as a Key Strategy in the Management of Severe Diabetic Foot Ulcers in Septic Frail Patients: A Case Series.","authors":"Maria Ignacy Pirski, Silvia Malerba, Luigi Marano, Martyna Kur, Jaroslaw Skokowski, Maciej Świerblewski","doi":"10.1111/iwj.70926","DOIUrl":"10.1111/iwj.70926","url":null,"abstract":"<p><p>Diabetes mellitus represents a major global health challenge, with over 537 million adults currently affected worldwide. Among its complications, diabetic foot ulcers remain a leading cause of morbidity, hospitalization and amputation, imposing a significant socioeconomic burden. Effective management requires a multidisciplinary approach integrating surgical, medical and rehabilitative expertise. Negative pressure wound therapy has demonstrated clinical efficacy in promoting granulation tissue formation, accelerating wound healing, and reducing infection rates compared with conventional dressings. This case series presents the management of four frail, septic patients with severe diabetic foot ulcers treated between 2023 and 2025 in an academic surgical department. All patients required surgical intervention, including debridement or partial amputation, combined with negative pressure wound therapy and, in selected cases, revascularization or skin grafting. One case utilized an electrospun nanofiber dressing which enhanced wound granulation and shortened healing time. Outcomes varied according to systemic comorbidities, vascular status and glycemic control; however, NPWT consistently supported wound stabilization and preparation for definitive closure. These findings reinforce the essential role of interdisciplinary collaboration and advanced wound technologies in the treatment of complex diabetic foot infections, particularly in frail or septic patients, and highlight the potential of nanofiber-based dressings as adjunctive therapies in comprehensive diabetic foot care.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"23 5","pages":"e70926"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pressure Injury Malpractice Litigation: A Retrospective Medicolegal Study.","authors":"Daniel A Rabin, Aneeq S Chaudhry, Tarifa H Adam, Marlynn P Lopez, Katherine Kozlowski, Diana B Griffin, Brigid M Coles, Hibba Sumra, Thomas A Mustoe, Robert D Galiano","doi":"10.1111/iwj.70923","DOIUrl":"https://doi.org/10.1111/iwj.70923","url":null,"abstract":"<p><p>Medical malpractice imposes a substantial clinical and economic burden worldwide. Pressure injuries (PIs) are amongst the most frequently litigated adverse events and represent a major source of preventable patient harm. To characterise the medicolegal landscape of PI-related malpractice, the Westlaw legal database was queried for cases litigated between 1990 and 2024. A total of 590 cases met inclusion criteria, with data extracted from court documents. The mean patient age was 71 years; 53.4% were female and 46.6% male. Nursing homes were the most commonly named defendants (59.8%), followed by hospitals and outpatient surgical practices (37.3%) and individual physicians (14.1%). The mean settlement was $383 099, compared with a mean jury award of $2 100 787. Adverse legal outcomes were strongly associated with allegations of inadequate care, poor clinical outcomes and gross provider negligence. When prevention and timely management fail, the consequences extend beyond patient harm to substantial legal and financial liability. Targeted interventions such as standardised risk assessment, rigorous documentation, staff education, appropriate staffing ratios and institutional accountability may mitigate both PI incidence and litigation risk. Strengthening these measures represents a critical opportunity to improve patient safety whilst reducing medicolegal exposure.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"23 5","pages":"e70923"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13111147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Complications and Recurrence After Pressure Injury Reconstruction in Spinal Cord Injury: A Systematic Review and Meta-Analysis.","authors":"Marlynn P Lopez, Katherine A Kozlowski, Aneeq S Chaudhry, Spencer K Green, Diana B Griffin, Tarifa H Adam, Nicole C Ontiveros, Allison B Kessler, Rachna H Soriano, Robert D Galiano","doi":"10.1111/iwj.70915","DOIUrl":"https://doi.org/10.1111/iwj.70915","url":null,"abstract":"<p><p>Spinal cord injury (SCI) predisposes patients to pressure injuries (PIs) often requiring surgery. Multiple factors influence postoperative complications and recurrence, though their associations remain unclear. We performed a PRISMA-guided systematic review and meta-analysis to assess predictors of acute postoperative complications and PI recurrence in SCI patients undergoing surgery. PubMed, Scopus and Embase were searched. Studies with ≥ 15 participants were eligible; 24 (n = 2566 subjects) were included, with 15 (n = 1976 subjects) quantitatively synthesized. Risk of bias was assessed with the Newcastle-Ottawa Scale. A random-effects model meta-analysis was performed, and odds ratios (OR) were pooled when > 2 studies were available; otherwise, findings were narratively synthesized. Moderate-quality evidence showed prior flap reconstruction increased complication risk (aOR = 4.98). Low-quality evidence linked diabetes (OR = 1.39) and smoking (OR = 1.35) with complications. Higher recurrence risk was associated with prior flap reconstruction (OR = 1.80) and thoracic injury (OR = 2.21), while cervical injury was protective (OR = 0.37). Prior flap reconstruction resulted as the strongest predictor of complications and significantly increased the odds of recurrence. These findings underscore the importance of a multidisciplinary approach for preventing the first occurrence of flap reconstruction and subsequent procedures.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"23 5","pages":"e70915"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Pilonidal Surgery Performed in the Setting of Standard Adjunct Laser Hair Removal: A Retrospective Cohort Study.","authors":"Alberto Jarrin Lopez, Kenneth Williams, Andrea Gochi, Brandon Cowan, Preston Carroway, Kristin Kanka, Akhil Wadhera","doi":"10.1111/iwj.70938","DOIUrl":"10.1111/iwj.70938","url":null,"abstract":"<p><p>Pilonidal sinus disease (PSD) is associated with substantial morbidity because of wound complications and recurrence after surgery. Adjunct laser hair removal (LHR) has been incorporated into postoperative management in some settings, but real-world outcomes in cohorts treated uniformly with LHR remain incompletely described. This study aimed to characterize postoperative outcomes after PSD surgery in a large integrated healthcare system in which adjunctive LHR was standard practice and to compare outcomes by surgical approach. We performed a retrospective descriptive cohort study of patients aged 14-89 years who underwent operative treatment of PSD with adjunctive LHR at Kaiser Permanente Northern California between 2012 and 2024. Outcomes included repeat procedures, 30-day surgical site infection (SSI), and unplanned clinic visits. Outcomes were summarized as proportions overall and by surgical approach. Exploratory bivariable logistic regression examined associations between sex or body mass index (BMI) and outcomes. Multivariable modeling was not performed because of low event counts and sparse covariate distributions, which resulted in unstable models. Among 168 patients, the overall repeat procedure rate was 16.7%, the 30-day SSI rate was 14.4%, and 39.3% had at least one unplanned clinic visit. Patients treated with Bascom flap closure had fewer repeat procedures (10.4% vs. 20.8%) and fewer unplanned visits (33.8% vs. 43.6%) than those undergoing pilocystectomy, with similar SSI rates (14.9% vs. 14.0%). In exploratory analyses, sex and BMI were not significantly associated with outcomes in either surgical group. In this real-world cohort managed uniformly with adjunctive LHR, postoperative outcomes appeared to vary more by surgical approach than by sex or BMI. These findings are descriptive and do not estimate the independent effect of LHR. Controlled comparative studies are needed to determine the contribution of LHR to PSD outcomes.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"23 5","pages":"e70938"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13148142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}