International Wound Journal最新文献

{"title":"Early Detection of Deep Tissue Pressure Injury in Intensive Care Using Hemodynamics-Based Machine Learning: A Retrospective Cohort Study","authors":"Tuba Sengul,&nbsp;Beren Semiz,&nbsp;Emre Gursoy,&nbsp;Dilek Yilmaz Akyaz,&nbsp;Ayten Dilara Yavuz,&nbsp;Yunus Emre Akyol,&nbsp;Yusuf Ali,&nbsp;Tugba Cevizci,&nbsp;Orhan Zeytun,&nbsp;Violeta Lopez,&nbsp;Holly Kirkland-Kyhn","doi":"10.1111/iwj.71025","DOIUrl":"10.1111/iwj.71025","url":null,"abstract":"<p>This study examines factors associated with deep tissue pressure injury and develops interpretable machine learning models for early risk prediction in adult ICU patients. This retrospective observational cohort study included 336 adult intensive care unit patients, of whom 211 developed deep tissue pressure injury and 125 remained pressure injury-free. For patients who developed deep tissue pressure injury, haemodynamic, laboratory and nursing variables from the 24 h before injury onset were analysed using a physiological time-at-risk framework. For pressure injury-free patients, corresponding variables from the first 24 h after intensive care unit admission were used. Six supervised machine learning classifiers were developed and internally validated using cross-validation and hyperparameter optimization. All models showed good predictive performance. Extreme gradient boosting achieved the highest discriminative ability, with an area under the receiver operating characteristic curve of 0.976. The most influential predictors across feature selection methods were low-molecular-weight heparin use, norepinephrine duration, lower blood pressure values, immobility, nutritional risk, antiplatelet therapy and chronic disease profile. Routinely documented nursing and haemodynamic indicators obtained within a clinically relevant 24-h risk window can support accurate early risk stratification for deep tissue pressure injury in adult intensive care unit patients. A physiology-informed and interpretable machine learning approach may improve recognition of patients at imminent risk.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"23 9","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13574721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148968652","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":"Psychometric Validation of the Spanish Version of the Sheffield Preference-Based Venous Leg Ulcer Questionnaire (SPVU-5D) in Patients With Venous Leg Ulcers","authors":"Miguel Ángel Barbas-Monjo,&nbsp;Eleuterio A. Sánchez-Romero,&nbsp;José Verdú-Soriano,&nbsp;Julio Cabrero García,&nbsp;Juan Nicolás Cuenca-Zaldívar,&nbsp;Rob Sillevis","doi":"10.1111/iwj.71042","DOIUrl":"10.1111/iwj.71042","url":null,"abstract":"<p>Venous leg ulcers are a common manifestation of chronic venous disease and are associated with substantial morbidity and impaired health-related quality of life (HRQoL). Patient-reported outcome measures are essential for capturing the patient perspective of disease burden and treatment outcomes in wound care management. The Sheffield Preference-based Venous Ulcer questionnaire (SPVU-5D) is a concise preference-based instrument designed to assess the quality of life in individuals with venous leg ulcers and to support health-economic evaluation. However, its measurement properties have not been extensively examined in different linguistic contexts. This study aimed to evaluate the psychometric properties of the Spanish version of the SPVU-5D in patients with venous leg ulcers. A methodological validation study was conducted involving 132 patients (264 observations from pre- and post-treatment assessments) with a mean age of 63.76 ± 10.02 years. Cross-cultural adaptation followed the established guidelines for translation and cultural equivalence. Content validity was assessed using Aiken's V coefficient. Structural validity and reliability were examined using multilevel confirmatory factor analysis and measurement performance was further evaluated using a multilevel graded response model based on item response theory. Floor and ceiling effects, minimum detectable change and convergent validity with the RESVECH 2.0 clinical scale were also evaluated. Confirmatory factor analysis supported a unidimensional structure with excellent fit indices and satisfactory internal consistency. Item response theory analyses showed high item discrimination and well-distributed difficulty thresholds for the items. The floor and ceiling effects were minimal, indicating adequate sensitivity across the latent trait continuum. The Spanish version of the SPVU-5D demonstrates satisfactory validity, reliability and measurement precision and represents a useful instrument for assessing the health-related quality of life in patients with venous leg ulcers.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"23 9","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13575328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148968767","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":"Effects of Vacuum Compression Therapy on Healing of Chronic Lower Limb Ulcers: A Randomised Controlled Study","authors":"Lenka Krupová,&nbsp;Miroslav Koliba,&nbsp;Yvetta Vantuchová,&nbsp;Vladimír Jetmar,&nbsp;Martin Olšar,&nbsp;Jakub Muťka,&nbsp;Michaela Nejedlá","doi":"10.1111/iwj.71041","DOIUrl":"https://doi.org/10.1111/iwj.71041","url":null,"abstract":"<p>Chronic lower limb ulcers remain difficult to manage when unresponsive to conventional treatment. This study evaluated the clinical and physiological effects of vacuum compression therapy on wound healing and quality of life. Fifty patients with chronic lower limb ulcers were randomised to receive 12 sessions of vacuum compression therapy plus standard care or standard care alone over 4 weeks. Wound dimensions, exudate, pain intensity and quality of life were assessed at baseline and post-treatment. Estimated wound volume was calculated as length × width × depth. Tissue oxygenation was measured at the dorsum of the foot in the experimental group. The vacuum compression therapy group showed greater improvements in wound width, depth, volume and quality of life. Estimated wound volume decreased by 61% in the intervention group, whereas no statistically significant volume reduction was observed in controls. Local tissue oxygenation in the experimental group increased by 43%. Baseline wound size was associated with poorer quality of life. Vacuum compression therapy may enhance wound healing and quality of life in patients with chronic lower limb ulcers. Observed increases in local tissue oxygenation represent exploratory physiological findings within the treated cohort that warrant controlled comparative evaluation.</p><p><b>Trial Registration:</b> ClinicalTrials.gov identifier: NCT07737184.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"23 9","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/iwj.71041","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148943201","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":"Changing Patterns of Specialty Care for Diabetic Foot Ulcers Among Rural and Urban Veterans Following the VA MISSION Act","authors":"Hiroyuki Suzuki,&nbsp;Mary Vaughan-Sarrazin,&nbsp;Michael Ohl,&nbsp;Bradley Mecham,&nbsp;Kimberly McCoy,&nbsp;Daniel J. Livorsi","doi":"10.1111/iwj.71039","DOIUrl":"10.1111/iwj.71039","url":null,"abstract":"<p>The Veterans Affairs (VA) Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act expanded eligibility for community-based care particularly for Veterans facing geographic or capacity-related barriers. Patients with diabetic foot ulcers (DFU) require timely specialty management and are vulnerable to fragmented care, yet little is known about how the MISSION Act reshaped patterns of DFU-related specialty care within and outside the VA. We conducted a retrospective cohort study of Veterans aged 65 or older with a new DFU diagnosis in VA between 2016 and 2022. We identified DFU-related specialty encounters (podiatry, vascular surgery, infectious diseases and endocrinology) and categorised community encounters as VA-paid or Medicare-paid. We assessed annual trends in community specialty care and changes in the proportion and payer type of care before and after the MISSION Act. Among 76 398 patients, VA-paid community specialty care increased substantially following the MISSION Act, with larger relative growth among rural Veterans (rural: +119%; urban: +96%). In contrast, Medicare-paid DFU specialty care declined during the same period (rural: −12%; urban: −13%). Following the MISSION Act, reliance on VA-paid community specialty care increased markedly for Veterans with DFU, particularly in rural areas, while reliance on Medicare-paid care decreased.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"23 9","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/iwj.71039","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148911717","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":"Berberine-Pretreated Bone Marrow Mesenchymal Stem Cells Accelerate Skin Wound Healing in Rats With Burn Injuries","authors":"Jinglei Tan,&nbsp;Caiqiang Chen","doi":"10.1111/iwj.71029","DOIUrl":"10.1111/iwj.71029","url":null,"abstract":"<p>Berberine (BBR) is a natural isoquinoline alkaloid with antibacterial, anti-inflammatory and pro-angiogenic properties. This study aimed to investigate the therapeutic efficacy and underlying mechanism of a conditioned medium (CM) derived from berberine-preconditioned bone marrow-derived mesenchymal stem cells (BMSCs-BBR). BMSCs were isolated and phenotypically characterised by flow cytometry. A burn wound model was established in Wistar rats, and the model rats were randomly allocated to four groups treated with placebo gel, standard BMSCs-CM gel, BMSCs-BBR CM gel, or silver sulfadiazine cream. Wound healing rates were monitored macroscopically. On Day 21, skin tissues were harvested for histological analysis (H&amp;E and Masson's trichrome staining), followed by immunofluorescence staining (CD31) and Western blot analysis (Collagen I, Collagen III and key proteins in the PI3K/AKT/eNOS signalling pathway). Among all treatments, BMSCs-BBR CM accelerated wound closure the most significantly, accompanied by improved epidermal regeneration, enhanced collagen deposition and organisation and a marked increase in capillary density. Furthermore, wounds treated with BMSCs-BBR CM exhibited notably upregulated Collagen I and Collagen III, and activation of the PI3K/AKT/eNOS pathway, as evidenced by increased phosphorylation of PI3K and AKT and elevated eNOS protein levels. Our findings demonstrate that the topical application of BMSCs-BBR CM gel potently promotes burn wound healing by improving the quality of tissue regeneration and stimulating angiogenesis via the activation of the PI3K/AKT/eNOS signalling pathway. This preconditioning strategy represents a promising acellular therapeutic approach for burn wound management.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"23 9","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900539","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":"Factors Associated With Venous Leg Ulcer Recurrence and Recurrence Risk in Portugal: A Cross-Sectional Study Supporting the Development of an Innovative Preventive Intervention","authors":"Filipe José Paulo Gomes,&nbsp;Andreia Silva da Costa,&nbsp;Paulo Jorge Nogueira,&nbsp;Maria Adriana Pereira Henriques,&nbsp;Cristina Lavareda Baixinho","doi":"10.1111/iwj.71034","DOIUrl":"10.1111/iwj.71034","url":null,"abstract":"<p>Venous ulcers are the most common lower-limb lesions (60%–80%), affecting about 0.3% of the population. Their chronic nature leads to high recurrence rates (up to 70% within 12 months), impacting quality of life and healthcare costs. Although several factors associated with venous leg ulcer recurrence have been identified, evidence integrating clinical, sociodemographic, functional, and behavioural characteristics in relation to both recurrence occurrence and recurrence risk remains limited. This study aimed to analyse factors associated with venous leg ulcer recurrence within the previous 12 months and with 12-month recurrence risk among people with a history of venous leg ulcer recurrence living in inland Portugal. A quantitative, cross-sectional, correlational study was conducted with 208 adults recruited from three Portuguese healthcare institutions. Data were collected using questionnaires and analysed using descriptive statistics, non-parametric tests, binary logistic regression and ordinal logistic regression. Participants were mostly older adults (72.86 ± 12.18 years), had a high mean body mass index, and presented multiple comorbidities. Recurrence within the previous 12 months occurred in 70% of participants with available data. In the adjusted binary logistic regression model, older age (aOR = 1.061; 95% CI: 1.022–1.102), history of deep vein thrombosis (aOR = 17.275; 95% CI: 3.154–94.624), presence of sadness (aOR = 2.558; 95% CI: 1.077–6.075), non-use of preventive compression (aOR = 3.836; 95% CI: 1.584–9.291), and educational attainment were associated with recurrence within the previous 12 months. In the ordinal logistic regression model, older age (aOR = 1.046; 95% CI: 1.013–1.081), walking independently (aOR = 0.286; 95% CI: 0.097–0.844), daily skin hydration (aOR = 0.396; 95% CI: 0.176–0.889), and recurrence within the previous 12 months (aOR = 57.7; 95% CI: 19.5–170.9) were associated with recurrence-risk level. Venous leg ulcer recurrence is a multifactorial phenomenon associated with clinical, functional, behavioural and psychosocial characteristics. These findings support individualised, multidimensional prevention strategies that integrate clinical assessment, functional capacity, preventive behaviours and continued care after ulcer healing.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"23 9","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900262","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":"Abstracts from the 2026 joint meeting between MedStar Georgetown University Hospital's Functional Diabetic Limb Salvage: A Team Approach in collaboration with the Wound Healing Foundation, 8-11th April 2026, Washington, DC, USA","authors":"Laura K. S. Parnell,&nbsp;John Steinberg","doi":"10.1111/iwj.71008","DOIUrl":"10.1111/iwj.71008","url":null,"abstract":"<p>MedStar Georgetown University Hospital's Functional Diabetic Limb Salvage and the Wound Healing Foundation, both nonprofit organizations, recently held their 2026 meeting on the diabetic foot and healing chronic wounds in Washington D.C., USA. These groups chose the International Wound Journal to feature their submitted abstracts to highlight the excellent research ongoing in this important clinical area. If you wish to contact any of the authors to discuss their research, please contact us and we can connect you.</p><p>The top ten abstract authors, denoted below in Abstracts 1-10, were given podium presentations during the meeting in honor of Greg Schultz, PhD. At the time of his passing, Dr. Schultz was the Award Chair and a Board of Director of the Wound Healing Foundation and a Course Director for the joint meeting. Dr. Schultz was a consistent champion for quality clinical and bench science focused on improving wound healing. Presenting the best science in Dr Schultz's honor at the conference seemed like a natural extension to his legacy. Monitor https://www.woundhealingfoundation.org/g-schultz-in-memoriam-2/ for updated information on a future additional program honoring Professor Shultz in accordance with his family's wishes.</p><p>Abstracts selected to be included in conference proceedings as podium presentations are denoted below with the ^ɫ symbol.</p><p>Editorial Note: We recognize the valued contribution of Professor Greg Schultz and his connection with the IWJ. We are pleased to be able to continue honoring his legacy in wound healing.</p><p>The authors declare no conflicts of interest.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"23 9","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887112","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 Decision-Aid Improves Clinician Practice and Associated Patient Compression Stocking Adherence","authors":"Laila Bar,&nbsp;Susan Brandis,&nbsp;Rachel Wenke,&nbsp;Darryn Marks","doi":"10.1111/iwj.71035","DOIUrl":"10.1111/iwj.71035","url":null,"abstract":"<p>Adherence to compression stocking wear is essential for reducing venous leg ulcer recurrence, yet adherence rates remain low. This study examined the relationship between a novel digital clinical decision-aid (the Personalized and Multidimensional Compression Assessment and Intervention [PAMCAI]), clinician practice, and patient adherence with compression stocking use, by embedding a prospective comparative cohort study within a pilot randomized controlled trial. The clinical notes of occupational therapists using PAMCAI were compared with those not using PAMCAI on their documentation of adherence and frequency of wear, identification of patient-specific barriers and attempts to address barriers. The relationship between higher documentation scores and patient adherence was also explored. Thirty-six medical records from 18 patients demonstrated significantly higher documentation scores when PAMCAI was used for all three categories (<i>p</i> &lt; 0.001). Improvements in adherence were positively associated with documentation quality in the targeted categories (<i>p</i> &lt; 0.001). These findings indicate that PAMCAI supports practice changes that translate to improved patient adherence, highlighting the potential value of clinician-focused decision-aids in venous leg ulcer care.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"23 9","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880414","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":"Association Between Charlson Comorbidity Index and Pressure Injury Stage: A Retrospective Cohort Study.","authors":"Jay Hyun Pak, Woo Sung Jang, Dae Won Kwon, Seung Hee Baek, Il-Kug Kim, Joon Seok Lee, Kang Young Choi, Jung Dug Yang, Ho Yun Chung, Jeong Yeop Ryu","doi":"10.1111/iwj.71050","DOIUrl":"10.1111/iwj.71050","url":null,"abstract":"<p><p>Pressure injuries (PIs) are a major clinical burden in patients with multiple comorbidities. The Charlson Comorbidity Index (CCI) is a validated comorbidity measure; however, its quantitative association with PI severity remains poorly characterised. To evaluate the association between CCI scores and PI stage, and to identify individual CCI component diseases independently associated with higher PI stage. This retrospective cohort study included 454 PI patients at a tertiary university hospital (July 2023-December 2025). PI severity was classified into stages 1-4. Both the original and updated CCI were calculated from comorbidities only, without the Charlson age adjustment. Ordinal logistic regression assessed associations between CCI and PI stage, adjusting for age and sex. The median patient age was 73 years (range, 17-95); 63.2% were male. Stage 2 PIs were most prevalent (70.5%). Each 1-point increase in original CCI was associated with 1.10-fold higher odds of a more advanced PI stage (95% CI: 1.02-1.20; p = 0.015) after adjusting for age and sex. Among individual CCI components, rheumatic disease (OR = 2.20; 95% CI: 1.04-4.65; p = 0.039) and hemiplegia/paraplegia (OR = 1.72; 95% CI: 1.07-2.77; p = 0.024) were independently associated with higher PI stage; moderate-to-severe renal disease showed an association of similar direction that did not reach statistical significance (OR = 1.63; 95% CI: 0.99-2.69; p = 0.056). A higher CCI was associated with higher PI severity in this cohort, although the effect size was modest. In a mutually adjusted multi-variable model, rheumatic disease and hemiplegia/paraplegia were independently associated with higher PI stage. These associations are observational and require prospective confirmation before any clinical application can be considered.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"23 9","pages":"e71050"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13590208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012172","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":"Bridging the Gap Between Awareness and Behaviour in Pressure Injury Prevention: A Cross-Sectional Survey of Self-Management in People With Spinal Cord Injury.","authors":"Liang Qin Liu, Evangeline Martinez, Jacinta Kelly, Helen Allan, Sarah Knight","doi":"10.1111/iwj.71049","DOIUrl":"10.1111/iwj.71049","url":null,"abstract":"<p><p>To examine how self-management attitudes, illness perceptions and preventive behaviours relate to adherence to pressure injury prevention in people with spinal cord injury (PwSCI) using a theory-informed framework. A cross-sectional survey of 184 wheelchair-users with a SCI within community and specialist SCI centres. Preventive behaviours (pressure relief, skin inspection), self-management domains (concordance, perceived benefits, perceived negatives, practical barriers) and illness perceptions (mBIPQ) were assessed. Associations and subgroup differences by pressure injury history and education were analysed. Participants reported high perceived benefit of pressure-relief activities (4.02 ± 0.62) but only moderate concordance (3.05 ± 0.79) and persistent practical barriers (3.22 ± 0.75), indicating a gap between awareness and routine behaviour. Concordance was positively associated with pressure-relief activity (r = 0.49, p < 0.001) and negatively with barriers (r = -0.56, p < 0.001). Prior pressure injury education and experience were associated with more positive attitudes and greater engagement. Older age (≥ 55 years), but not injury duration, was associated with higher adherence. Despite high awareness, adherence to preventive routines remains constrained by perceptual and practical barriers. This study provides quantitative evidence explaining why awareness does not consistently translate into preventive behaviour, highlighting the need to address real-world barriers beyond education alone.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"23 9","pages":"e71049"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001639","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}