International Wound Journal最新文献

{"title":"Malignancy in Chronic Leg Wounds: Diagnostic Delay and Clinical Implications in a Tertiary Wound-Care Cohort","authors":"Marcela Nowak,&nbsp;Dorota Piechota,&nbsp;Wioletta Barańska-Rybak","doi":"10.1111/iwj.70991","DOIUrl":"10.1111/iwj.70991","url":null,"abstract":"<p>Chronic leg wounds are common in wound-care practice and are most often attributed to vascular or inflammatory etiologies. Rarely, they may represent or conceal underlying malignancy, and delayed recognition can lead to inappropriate management and poor outcomes. We aimed to evaluate diagnostic delay, clinical warning signs, histopathological findings, management strategies, and outcomes in patients with malignancy-associated chronic leg wounds treated in a tertiary wound-care setting. We conducted a retrospective observational study of consecutive patients with chronic lower-leg wounds (&gt; 6 weeks' duration) diagnosed with underlying malignancy between 2015 and 2022. Clinical characteristics, time to biopsy, histopathological findings, treatment, and outcomes were analysed descriptively. Among 328 patients with chronic leg wounds, eight (2.4%) were diagnosed with malignant etiologies. Mean ulcer duration at biopsy was 11.3 months (range 6–24), exceeding guideline-recommended timelines. All wounds failed to heal despite standard care. Common red-flag features included disproportionate pain, necrosis or bleeding, and atypical appearance. Earlier biopsy and multidisciplinary management were associated with improved wound outcomes, whereas prolonged diagnostic delay correlated with advanced disease and poor prognosis. Malignancy should be considered in any chronic leg wound failing to improve within 4–12 weeks or showing atypical features, and early biopsy is essential to optimise outcomes.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"23 7","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/iwj.70991","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148368378","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":"Compliance With Foot Care Practices Among Patients With Diabetes Mellitus in Sudan","authors":"Izzeldin Ahmed Dawaud,&nbsp;Ahmed Ali,&nbsp;Mohamed ElMakki Ahmed","doi":"10.1111/iwj.70989","DOIUrl":"10.1111/iwj.70989","url":null,"abstract":"<p>Diabetes Mellitus (DM) is frequently complicated by Diabetic Foot Ulcers (DFUs), which contribute to high morbidity, mortality, and healthcare costs. Regular foot care and clinic follow-up can reduce the incidence of DFUs and related complications, yet adherence to these practices remains poorly described in Sudan. To assess compliance with foot care practices and identify factors associated with compliance and barriers to regular foot care clinic attendance among patients with diabetes attending the Jabber Abo Aliz Diabetes Care Center in Khartoum, Sudan. A cross-sectional descriptive study was conducted from December 2021 to February 2022 involving 120 patients with DM attending foot care clinics. Data were collected using structured questionnaires covering demographic and clinical characteristics, foot care behaviours, and perceived barriers. Compliance was measured using a Likert-based scoring system, with scores ≥ 9/17 classified as compliant. Data were analysed using SPSS version 21.0, applying Chi-square tests and ANOVA where appropriate, with statistical significance set at <i>p</i> &lt; 0.05. Among 120 participants (55% female; mean age 49 ± 11 years), 70% were classified as compliant with foot care. Compliance was significantly associated with female gender (<i>p</i> = 0.043), age &lt; 40 years (<i>p</i> = 0.034), urban residence (<i>p</i> = 0.037), higher socioeconomic status (<i>p</i> = 0.002), and good glycemic control (HbA1c ≤ 7%; <i>p</i> = 0.001). Duration of DM showed no significant association (<i>p</i> = 0.184). Transportation and distance were the most reported barriers to clinic attendance (30%). Most patients attending foot care clinics demonstrated good adherence to foot care practices, particularly those with favourable socioeconomic and clinical profiles. However, geographic and economic barriers continue to limit regular attendance. Strengthening outreach strategies, reducing access barriers, and integrating foot care education into routine diabetes management could improve outcomes and reduce DFU-related complications in Sudan.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"23 7","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/iwj.70989","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148360889","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":"Validation and Clinimetric Properties of the Persian Version of the Leg Ulcer Measurement Tool","authors":"Qasem Hajilo,&nbsp;Manigeh Dehi,&nbsp;Zahra Jamshidi,&nbsp;Mehdi Raei,&nbsp;Mehdi Jafari-Oori","doi":"10.1111/iwj.70980","DOIUrl":"10.1111/iwj.70980","url":null,"abstract":"<p>The Leg Ulcer Measurement Tool is a clinician-rated instrument designed to assess wound characteristics and monitor healing in patients with leg ulcers. No validated Persian version exists for use in Iranian healthcare settings. This study aimed to culturally adapt the tool into Persian and evaluate its clinimetric properties. This methodological study was conducted between December 2024 and October 2025 in Iran. Cross-cultural adaptation included forward translation, synthesis, back-translation, expert review and pilot testing. Face and content validity were assessed qualitatively and quantitatively. Construct validity was examined via comparison with the Bates-Jensen Wound Assessment Tool and known-groups analysis based on ulcer severity. Predictive validity was evaluated using logistic regression for amputation and healing outcomes. Intra- and inter-rater reliability were assessed using kappa, Gwet's AC, percent agreement and intraclass correlation coefficients. Predictive accuracy for amputation was analysed with receiver operating characteristic curves. All items demonstrated acceptable face and content validity. Severe ulcers showed significantly higher scores than mild/moderate ulcers (<i>p</i> &lt; 0.001). Convergent validity with the comparative tool was high (<i>r</i> = 0.96–1.00) and total scores were strongly correlated (<i>r</i> = 0.864, <i>p</i> &lt; 0.001). Higher baseline scores predicted increased odds of amputation (odds ratio = 1.13) and lower odds of complete healing (odds ratio = 0.93). Reliability was excellent (intraclass correlation coefficient &gt; 0.99) and predictive accuracy for amputation was good (area under the curve = 0.80). The Persian Leg Ulcer Measurement Tool is valid, reliable and clinically accurate for assessing wound characteristics and predicting outcomes in Iranian patients, supporting its use in clinical practice and research.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"23 7","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/iwj.70980","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148345262","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":"Platelet-Rich Plasma in a Refractory Venous Leg Ulcer Following Multiple Failed Skin Grafts","authors":"Konstantinos Seretis,&nbsp;Dimitra Peponi,&nbsp;Nikolaos Bounas,&nbsp;Afroditi Vergidou,&nbsp;Eirini Christaki","doi":"10.1111/iwj.70988","DOIUrl":"10.1111/iwj.70988","url":null,"abstract":"<p>Chronic lower-extremity ulcers remain a major therapeutic challenge. Conventional treatments—including compression therapy, debridement, dressings, antibiotics, pharmacologic agents, hyperbaric oxygen, and skin grafting—frequently fail to provide durable closure, largely due to limited modulation of the wound-healing cascade. Autologous platelet-rich plasma (PRP) is gaining interest as a regenerative adjunct capable of delivering concentrated endogenous growth factors. We report a 58-year-old woman with more than 20 previous skin grafting procedures for recurrent lower-leg ulcers, arising from self-inflicted trauma and secondary infections. Multidisciplinary care of a 15 cm × 18 cm ulcer incorporating debridement, targeted antibiotics, and mainly PRP, administered in six sessions, contributed substantially to ulcer reduction and finally to complete wound healing. PRP has shown promise in enhancing wound closure rates, healing time, and tissue quality. However, the absence of standardized protocols for preparation, dosing, and application, as well as inconsistent outcome reporting, limits its broader adoption. This case underscores the potential role of PRP as a central component in managing complex, refractory ulcers, particularly when behavioural and infectious factors impede healing. Standardized protocols and robust clinical trials are warranted to clarify its role in chronic wound care.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"23 7","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/iwj.70988","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148345275","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":"Response to Commentary on “Cryopreserved Total Skin Allografts From Living Donors for Complex Wound Management: A New Paradigm in Regenerative Wound Care”","authors":"Marcelo Fonseca,&nbsp;Aldo Cañete,&nbsp;Luana Mandriaza,&nbsp;Jennifer Gómez,&nbsp;Jaume Masiá,&nbsp;Katherine Marcelain,&nbsp;Dino Ibaceta,&nbsp;Cristian Erazo,&nbsp;Brenda Gámez,&nbsp;Monserrat Rius,&nbsp;Florencia Disi","doi":"10.1111/iwj.70985","DOIUrl":"https://doi.org/10.1111/iwj.70985","url":null,"abstract":"&lt;p&gt;We thank Ma et al. for their thoughtful comments regarding our article on cryopreserved total skin allografts (CTSA) derived from living donors [&lt;span&gt;1&lt;/span&gt;]. Their observations provide an important opportunity to clarify several conceptual and methodological aspects of our work.&lt;/p&gt;&lt;p&gt;First, we agree that the term viable allografts used in our original publication may not accurately reflect the biological status of CTSA. Because our protocol incorporates terminal gamma irradiation (25–28 kGy), and formal viability assays were not performed, we believe that these grafts should currently be interpreted as structurally preserved but biologically active, rather than viable from a cellular perspective [&lt;span&gt;2, 3&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Importantly, despite the expected reduction in cellular viability associated with terminal irradiation, both our clinical observations and previous experimental evidence suggest preservation of dermal architecture and the capacity of the extracellular matrix to interact with the host immune response [&lt;span&gt;2, 3&lt;/span&gt;]. In this context, we believe that the principal therapeutic value of CTSA may reside more in the preservation of the dermal extracellular matrix as a biologically active scaffold capable of interacting with the host immune response and less in donor cell survival.&lt;/p&gt;&lt;p&gt;We also appreciate the comments on microbiological governance and cold-chain resilience. Our protocol incorporates sequential microbiological surveillance at four defined processing stages (M0: post-procurement, M1: post-initial processing, M2: during processing, and M3: pre-packaging), combined with strict cold-chain management and terminal gamma irradiation prior to clinical release. The microbiological profile observed in our study was dominated by low-virulence commensal organisms associated with resident skin flora from living donors undergoing elective surgery rather than nosocomial pathogens. The microbiological discard rate was 4%, which is below the lower range reported in the literature for cadaveric skin banking. Furthermore, the only major storage-related incident corresponded to an isolated power failure and backup system malfunction rather than a transport failure, despite the long geographic distances involved in Chile. Corrective measures implemented after this event included redundant real-time temperature monitoring, independent validation sensors, alarm escalation protocols, and thermal mapping of ultra-low freezers [&lt;span&gt;4, 5&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Regarding the regenerative interpretation of CTSA, we fully acknowledge that the mechanisms underlying the observed “neodermis-like” tissue remain incompletely understood. Nevertheless, the consistent clinical pattern observed in our series, characterized by initial graft adherence, subsequent superficial eschar formation, and persistence of vascularized tissue beneath the epidermal component, suggests that CTSA may participate in a host remodelling process more complex than simple t","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"23 7","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/iwj.70985","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148324954","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 Prospective Clinical Study to Confirm the Safety and Performance of a Canister-Based Single-Use Negative Pressure Wound Therapy System in Low-to-Moderately Exuding Chronic Wounds","authors":"Berthold Amann,&nbsp;Michel Danneels,&nbsp;Joao Castro,&nbsp;Diletta Loschi,&nbsp;Mary-Paula Colgan,&nbsp;Gomez Carlos Filipe,&nbsp;Vieira Nuna,&nbsp;Kerstin Kusch,&nbsp;Monira Nou Howaldt,&nbsp;Lorenzo Gibello,&nbsp;Fabio Verzini,&nbsp;Markus Stücker,&nbsp;Paulo Alves,&nbsp;Hilde Beele","doi":"10.1111/iwj.70983","DOIUrl":"https://doi.org/10.1111/iwj.70983","url":null,"abstract":"<p>This clinical investigation was undertaken to confirm the safety and performance of a canister-based single-use negative pressure wound therapy system when used as intended in the management of low-to-moderately exuding chronic wounds, including diabetes-related foot ulcers (<i>n</i> = 34), venous leg ulcers (<i>n</i> = 34), and pressure ulcers (<i>n</i> = 36) for up to 28 days. Using a prospective non-comparative, multi-centre design, device performance was evaluated at 14 sites in seven European countries. The study covered a broad spectrum of wounds, reflecting the inclusion of both inpatients (67.7%) and outpatients (32.3%). The primary outcome measure was wound progress. Overall, wounds were deemed improved since the previous clinic visit in 76.3% of visits and reductions in both absolute and relative wound size were noted over the study period. The device was considered effective and easy to apply by investigators, with no unexpected safety concerns noted.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"23 7","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/iwj.70983","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148322285","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":"Mechanisms and Clinical Manifestations of Age-Related Impairment in Wound Healing","authors":"Daniel A. Rabin,&nbsp;Tiffany Kim,&nbsp;Julia K. Kaniuk,&nbsp;Marlynn P. Lopez,&nbsp;Spencer Green,&nbsp;Aneeq S. Chaudhry,&nbsp;Katherine Kozlowski,&nbsp;Diana Griffin,&nbsp;Tarifa H. Adam,&nbsp;Thomas A. Mustoe,&nbsp;Robert D. Galiano","doi":"10.1111/iwj.70968","DOIUrl":"https://doi.org/10.1111/iwj.70968","url":null,"abstract":"<p>Chronic wounds account for a considerable burden on the overall US healthcare system, affecting an estimated 10.2 million people and costing as much as $148 billion dollars in 2022 alone. Elderly patients suffer disproportionately, as nearly 85% of the chronic wound population is over the age of 65 years old. Despite the burden chronic wounds place on elderly patients and the overall healthcare system, the full mechanism of wound healing changes as one ages has not been fully elucidated. The major deficits in wound healing in the elderly are a function of both skin structural changes and alterations in wound healing kinetics resulting from molecular shifts in gene profiles. Elderly individuals exhibit reduced skin integrity, characterized by a disorganized epidermis, thinned dermis and subcutaneous fat, and a less stable basement membrane, impairing protection from external insults. Simultaneously, wound healing is disrupted across all four stages, as low-level persistent inflammation from increased fibroblast senescence delays the onset of the proliferative phase and limits overall healing capacity. We hope that this review can bridge the knowledge gap in this field and ultimately lead to future discoveries in aiding the prevention of aging skin and the improvement in wound healing outcomes.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"23 7","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/iwj.70968","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148322283","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 Patient Bill of Rights and Responsibilities for Wound Prevention and Care in Canada: Grounded in Stories and Guided by Co-Design and Community-Based Participatory Principles","authors":"Idevania G. Costa,&nbsp;Catherine Philips,&nbsp;Kathleen Stevens,&nbsp;Catherine Schoales,&nbsp;Irmajean Bajnok,&nbsp;Mariam Botros,&nbsp;Robert Strachan,&nbsp;Samantha Santorelli,&nbsp;Pilar Camargo-Plazas","doi":"10.1111/iwj.70962","DOIUrl":"10.1111/iwj.70962","url":null,"abstract":"<p>This project co-created a Patient Bill of Rights and Responsibilities in Wound Prevention and Care grounded in the lived experiences of patients and care partners. Guided by co-design and community-based participatory research principles, digital stories from the ‘Our Voices, Our Stories’ initiative, publicly hosted on the Wounds Canada website, were analysed using thematic and interpretive narrative approaches informed by social constructivism. Initial analysis identified nine themes, later expanded through iterative team-based analysis to capture recurring challenges and systemic barriers in wound care. These informed 36 preliminary statements (18 rights, 18 responsibilities), which were refined into a draft framework of 16 rights and 16 responsibilities. The co-creation process engaged diverse participants including individuals with lived experience, care partners, clinicians, and policymakers through three virtual workshops (May–July 2025). Through facilitated discussions and collaboration, the framework was refined to a final set of 12 rights and 12 responsibilities (<i>n</i> = 24), with over 88% agreement among participants. This framework offers a plain-language, equity-oriented approach that positions patients, care partners, and providers as partners in care. This framework serves as an educational and advocacy tool to strengthen person-centred wound care, enhance communication and continuity, and inform practice, education, and policy development.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"23 6","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/iwj.70962","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148294991","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":"Comparative Diagnostic Accuracy of the Braden and Cubbin/Jackson Scales for Predicting Pressure Injury Development in an Adult Intensive Care Unit: A Prospective Cohort Study","authors":"Gizem Yağmur Yalçın,&nbsp;Meryem Koçaslan Toran,&nbsp;İlayda Okyanuz,&nbsp;Sude Dilan Antep,&nbsp;Hakan Parlak,&nbsp;İsmail Toygar","doi":"10.1111/iwj.70984","DOIUrl":"10.1111/iwj.70984","url":null,"abstract":"<p>This study evaluated and compared the diagnostic accuracy of the Braden and Cubbin/Jackson Pressure Injury Risk Scales for predicting pressure injury development in adult ICU patients. In this prospective cohort study, 153 patients admitted to an adult ICU between September and November 2025 were assessed within 24 h using both scales and followed during their ICU stay. Diagnostic accuracy indices were calculated across cut-off points and optimal cut-offs were selected using the Youden J index. ROC curves were compared using the DeLong test. Precision–recall analysis and adjusted logistic regression analyses were also performed. Pressure injury developed in 37 patients (24.2%). The optimal Braden cut-off was ≤ 12, with sensitivity 43.2%, specificity 67.2%, PPV 29.6%, NPV 78.8%, LR+ 1.32, LR− 0.84 and Youden J 0.105. The optimal Cubbin/Jackson cut-off was ≤ 35, with sensitivity 73.0%, specificity 50.9%, PPV 32.1%, NPV 85.5%, LR+ 1.49, LR− 0.53 and Youden J 0.238. AUCs were 0.546 (95% CI: 0.439–0.653) and 0.605 (95% CI: 0.503–0.707), respectively; the difference was not statistically significant (<i>p</i> = 0.187). Precision-recall analysis showed limited predictive performance and adjusted logistic regression analyses indicated that neither cut-off was a statistically significant independent predictor of pressure injury development (<i>p</i> &gt; 0.05). Both scales showed limited discriminatory accuracy. Cubbin/Jackson performed numerically better, but not significantly so; therefore, both scales should support, rather than replace, comprehensive clinical judgement in intensive care nursing.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"23 6","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/iwj.70984","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148294999","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":"Sinuhe Classification for Pretibial Injuries: Categorising Dermatoporotic Wounds","authors":"Toni Seppälä,&nbsp;Vahur Grünthal,&nbsp;Virve Koljonen","doi":"10.1111/iwj.70981","DOIUrl":"https://doi.org/10.1111/iwj.70981","url":null,"abstract":"<p>Pretibial injuries manifest as lacerations or haematomas. Despite differences in pathogenesis and treatment, these entities have been mixed together in previous classifications. No classification for pretibial haematomas exists, and the Modified Dunkin Classification includes a Type V category that conflates lacerations with haematomas. To present the Sinuhe Classification—a comprehensive system categorising pretibial lacerations and haematomas with evidence-based treatment recommendations—and propose the umbrella term ‘dermatoporotic wounds’ to encompass the full spectrum of cutaneous injuries arising from chronic skin fragility. A narrative literature review of PubMed, MEDLINE and EMBASE was conducted. Treatment recommendations and clinical findings were synthesised from the available literature, including a doctoral thesis on pretibial injuries. The Sinuhe Classification categorises pretibial lacerations into linear lacerations; flap lacerations (vital, i.e., with adequate perfusion and non-vital, i.e., with flap necrosis); and total skin loss. Pretibial haematomas are classified into open (ruptured), closed and necrotic haematomas. Each subtype is paired with specific treatment guidance. The classification eliminates the Modified Dunkin Type V category and provides a classification framework for pretibial haematomas. The Sinuhe Classification offers a unified yet distinct framework for diagnosing and treating pretibial injuries. Adoption into clinical practice and medical education is recommended.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"23 6","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/iwj.70981","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148282438","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}