International Wound Journal最新文献

{"title":"Diabetic Foot Ulcer-Associated Versus Other Lower-Extremity Necrotising Soft-Tissue Infections: A Retrospective Cohort Study.","authors":"Haowu Tang, Wenchao Guo, Jun He, Xinzhu Song, Kai Wang, Xin Zhang, Zhou Jin, Xiaorui Jiang","doi":"10.1111/iwj.71045","DOIUrl":"10.1111/iwj.71045","url":null,"abstract":"<p><p>To compare clinical characteristics, microbiology, treatment burden and outcomes between lower-extremity necrotising soft tissue infections associated with diabetic foot ulcers (DFU) and lower-extremity necrotising soft tissue infections not associated with DFU. We retrospectively reviewed 86 surgically treated patients at a single tertiary hospital from 2015 to 2025. Twenty patients had diabetic foot ulcer-associated infections and 66 had infections from other causes. Baseline characteristics, laboratory findings, microbiology, resource utilisation, wound healing, amputation and mortality were compared between the cohorts. The diabetic foot ulcer-associated group had a longer diabetes duration, higher glycated haemoglobin and a greater prevalence of hypertension, coronary heart disease and chronic kidney disease. Microbiological profiles showed overlapping distributions of major pathogens. The proportion of patients who were alive with a healed wound at 90 days was lower in the DFU-associated group (35.0% vs. 80.3%), and overall amputation was more frequent (55.0% vs. 15.2%), primarily driven by minor amputation (40.0% vs. 1.5%). Major amputation (15.0% vs. 13.6%) and mortality (10.0% vs. 4.5%) did not differ statistically, although estimates were imprecise. Lower-extremity necrotising soft tissue infections associated with DFU were associated with greater comorbidity, resource utilisation, minor amputation and a lower proportion of patients alive with a healed wound at 90 days. This retrospective study cannot determine whether minor amputation improves survival or prevents major amputation.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"23 9","pages":"e71045"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13613170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038615","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":"Hyperbaric Oxygen Therapy for Diabetic Foot Ulcers in Sub-Saharan Africa: A Critical Review of Clinical Evidence, Health-System Feasibility and Public Health Implications","authors":"Matthew Chibunna Igwe,&nbsp;Esther Ugo Alum,&nbsp;Alphonsus Ogbonna Ogbuabor,&nbsp;Yibala Ibor Oboma,&nbsp;Onyinyechi Bede-Ojimadu,&nbsp;Charles Iyore Idehen","doi":"10.1111/iwj.71027","DOIUrl":"10.1111/iwj.71027","url":null,"abstract":"<p>Diabetic foot ulcers are an important cause of morbidity, amputation, disability and healthcare expenditure in sub-Saharan Africa, where limitations in preventive foot care, referral pathways, vascular services, multidisciplinary wound care and financial protection may contribute to poor outcomes. This critical narrative review evaluates the potential role of systemic hyperbaric oxygen therapy as an adjunct to standard diabetic foot ulcer care in sub-Saharan Africa by integrating evidence on clinical effectiveness and safety with health-system, economic, equity and implementation considerations. Evidence was drawn from clinical studies, systematic reviews, clinical guidelines, economic evaluations and literature relevant to diabetic foot care and health-system capacity in the region. Global evidence suggests that systemic hyperbaric oxygen therapy may improve wound healing in selected patients whose ulcers fail to heal with best standard care, but findings remain heterogeneous; evidence for reducing amputation is uncertain, and direct regional evidence is sparse. Implementation in sub-Saharan Africa would require reliable oxygen, electricity, trained staff, safe maintenance systems, multidisciplinary care, referral pathways, sustainable financing and feasible treatment completion. The therapy should therefore not be considered routine or first-line treatment. Where appropriate infrastructure exists, carefully monitored referral-centre pilots should assess clinical outcomes, safety, treatment completion, affordability, budget impact and equity before wider implementation.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"23 9","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13533615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872921","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: Integrating Microbial Contamination Evidence Into Bedside Nursing Governance for Open-But-Unused Wound Dressings","authors":"Jie Sun,&nbsp;Xiaohui Zhang","doi":"10.1111/iwj.71037","DOIUrl":"10.1111/iwj.71037","url":null,"abstract":"&lt;p&gt;We read with great interest the article by Carrión Jiménez et al. [&lt;span&gt;1&lt;/span&gt;], entitled ‘Microbial Contamination of Open-But-Unused Portions of Wound Dressings in Healthcare Facilities’. This pragmatic prospective observational study provides timely real-world evidence for a common but often underestimated issue in wound care: whether unused portions of sterile dressings can be safely stored and reused after the original package has been opened. By sampling 11 types of non-adhesive wound dressings under routine clinical conditions in both a hospital inpatient unit and a primary care centre, the authors showed that microbial growth could be detected shortly after opening, increased with storage time and handling, and was also found on scissors used for cutting dressings [&lt;span&gt;1&lt;/span&gt;]. These findings should now be translated into bedside nursing governance and systematic infection-control practice.&lt;/p&gt;&lt;p&gt;First, the reuse of open-but-unused wound dressings should not be viewed merely as an individual nurse's compliance problem. In outpatient dressing rooms, surgical clinics, chronic wound clinics and primary care settings, nurses often cut dressings according to wound size. The remaining portion may then be stored for later use because of cost-control pressure, limited dressing sizes, high patient volume and the desire to reduce material waste. A sustainable response should therefore not rely solely on reminding frontline staff to ‘be careful’. Healthcare institutions should review the structural conditions that make this practice common. Procurement catalogues could be evaluated to determine whether more diverse dressing sizes, smaller sterile packages, pre-cut dressings or patient-specific wound care kits can be introduced. Such organisational interventions may reduce the need for trimming, storing and subsequently reusing leftover materials.&lt;/p&gt;&lt;p&gt;Second, the microbiological findings support a risk-stratified bedside decision pathway. For high-risk wounds, such as diabetes-related foot ulcers, ischaemic ulcers, deep cavity wounds, wounds with exposed tendon or bone, recent surgical wounds, graft donor or recipient sites and wounds in immunocompromised patients, opened leftover dressings should preferably be discarded rather than reused. For lower-risk chronic wounds, if reuse is considered unavoidable because of resource constraints, it should be restricted to the same patient only. The leftover dressing should be kept in its original packaging or a clean sealed barrier bag, labelled with the patient's identity and opening date, separated from unopened sterile stock and discarded after a defined institutional time limit. Importantly, these requirements should be embedded in a hospital-approved standard operating procedure that specifies staff responsibilities, documentation rules and audit frequency, rather than remaining as informal individual judgements.&lt;/p&gt;&lt;p&gt;Third, scissors and other cutting instruments deserve particular attention","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"23 9","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13531694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148864892","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 Effectiveness of Fluid Absorption Between Superabsorbent and Foam Dressings in Split-Thickness Skin-Graft Donor Sites: A Randomized Controlled Trial","authors":"Thanapat Chaisudhiphongskul,&nbsp;Akaradech Attainsee,&nbsp;Chairat Burusapat,&nbsp;Suttisun Jankajorn,&nbsp;Nutthapong Wanichjaroen,&nbsp;Nuttadon Wongpakob,&nbsp;Rapeepat Sapruangthong,&nbsp;Chatchai Pruksapong","doi":"10.1111/iwj.71033","DOIUrl":"10.1111/iwj.71033","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <p>Acute wounds with high exudate output, such as split-thickness skin-graft donor sites, require dressings that effectively manage fluid, reduce pain, and support timely epithelialization. Foam dressings are widely used, but superabsorbent materials may provide advantages in exudate handling. This study compared the absorption performance, wound healing, and pain outcomes of foam versus superabsorbent dressings in donor-site wounds. Thirty patients undergoing split-thickness skin grafting were enrolled, with no exclusions or loss to follow-up. Each donor site was divided into two equal zones, with one receiving a foam dressing and the other a superabsorbent dressing according to randomized allocation. Data were collected using coded identifiers. Clinical outcomes, including absorption capacity, wound epithelialization, pain scores, and complications, were evaluated at 3-day intervals through postoperative day 15. Experimental testing showed that a 10 × 10 cm foam dressing weighed 7.5 g and absorbed 75 mL of saline, whereas the superabsorbent dressing weighed 5.5 g and absorbed 93 mL. Clinically, absorption power was significantly higher with the superabsorbent dressing on day 3 (104.09 vs. 71.87 mg/cm²/day; <i>p</i> = 0.034), day 6 (84.45 vs. 40.91 mg/cm²/day; <i>p</i> &lt; 0.001), and day 9 (76.59 vs. 19.74 mg/cm²/day; <i>p</i> = 0.022). Pain scores tended to be lower with the superabsorbent dressing on days 6 and 9, although the differences were not statistically significant. Wound epithelialization was comparable between groups, with no allergic reactions, infections, or other complications observed. Superabsorbent dressing demonstrated superior absorption capacity compared with foam dressing, while achieving comparable epithelialization and healing outcomes. Pain scores tended to be lower with the superabsorbent dressing during the early postoperative period, although the differences were not statistically significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>1.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"23 9","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13532073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148864928","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":"Leg Ulcers in Thalassaemia: A Comparative Retrospective Review of Transfusion-Dependent and Non-Transfusion-Dependent Patients.","authors":"Sacha El Khoury, Nicole Charbel, Farouk Kabbara, Joseph Klim, Ghida Ismail, Farah Ismail, Suzanne Koussa, Ali Taher","doi":"10.1111/iwj.71038","DOIUrl":"10.1111/iwj.71038","url":null,"abstract":"<p><p>To compare clinical and laboratory characteristics of transfusion-dependent and non-transfusion-dependent beta thalassaemia patients with leg ulcers, and to identify contributing and protective factors We retrospectively reviewed 12 patients with beta thalassaemia and leg ulcers (seven transfusion-dependent and five non-transfusion-dependent) at a tertiary centre. We analysed demographics, haemoglobin levels, ferritin, foetal haemoglobin, transfusion status, comorbidities, and ulcer characteristics. Transfusion-dependent patients were predominantly younger males (mean age: 31.9 years), while non-transfusion-dependent patients were older (mean age: 44.0 years). Ulcers were larger in transfusion-dependent patients (mean area: 3.1 cm²) but more frequent in non-transfusion-dependent patients (mean episodes: 2.2). Splenectomy was performed in all transfusion-dependent patients and most non-transfusion-dependent patients. Transfusion-dependent patients had higher ferritin levels, while non-transfusion-dependent patients had higher foetal haemoglobin and slightly better ulcer resolution rates (80% vs. 71%). Major exacerbating factors included chronic anaemia, iron overload, trauma, and hypercoagulability. Protective factors included higher foetal haemoglobin levels, hydroxyurea use, occasional transfusions, and early conservative wound care. Although more commonly reported in non-transfusion-dependent patients, leg ulcers were also clinically significant in transfusion-dependent patients, where they were associated with larger ulcer size, higher iron burden, and incomplete healing despite regular transfusion and chelation. These findings highlight the need for heightened recognition and tailored preventive strategies for leg ulcers in transfusion-dependent thalassaemia.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"23 9","pages":"e71038"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13612969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038581","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":"Full-Body Versus Local Wipe Disinfection With Chlorhexidine Gluconate: No Difference in Surgical Site Infection After Acute Hip Fracture Surgery.","authors":"Eila M Sterner, Henrike Häbel, Gunnar V Edman, Wilhelmina Ekström","doi":"10.1111/iwj.71046","DOIUrl":"10.1111/iwj.71046","url":null,"abstract":"<p><p>Preoperative skin disinfection is essential to reduce surgical site infection. This study compared full body with local skin disinfection and examined additional patient related factors that could influence surgical site infection. This non-randomized intervention study, conducted over two consecutive periods, included patients with a hip fracture who received preoperative full-body disinfection with 4% chlorhexidine gluconate or local skin disinfection of the hip using 2% chlorhexidine gluconate, with 90 days follow up. Postoperative dressing change was documented. 844 patients were included in the study; 556 (65.7%) patients were treated with full body disinfection and 288 patients (34.1%) with local wipes disinfection. Fourteen patients (1.7%) suffered from a surgical site infection, eleven patients in the full body disinfection group, and three patients with local wipes disinfection without any significant difference found between the groups. Seven (50%) patients with infection had the dressing changed < 48 h. Chronic kidney disease was significantly associated with local infection (p = 0.005). Local preoperative skin disinfection with a washcloth showed no increased risk of wound infection in patients with hip fracture compared to full body disinfection, indicating comparable effectiveness. Impaired kidney function may increase susceptibility. Documentation gaps highlight the need to evaluate adherence to dressing routines to strengthen postoperative wound care. Chlorhexidine gluconate, Full body skin disinfection, Hip fracture, Local wipes disinfection, Surgical site infection.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"23 9","pages":"e71046"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13590210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012215","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":"Effectiveness of an Affordable Toa Uzito Offloading Device for Healing Plantar Diabetic Foot Ulcer: A Matched Case–Control Clinical Study","authors":"Zulfiqarali G. Abbas,&nbsp;Roozbeh Naemi","doi":"10.1111/iwj.71026","DOIUrl":"10.1111/iwj.71026","url":null,"abstract":"<p>Diabetic foot ulcers (DFUs) are difficult to manage in resource-limited settings, where access to standard offloading devices is limited for healing of plantar diabetic foot ulcers. This is due to the cost, limited availability, and the need for specialised expertise. <i>Toa Uzito</i> is a low-cost offloading device developed to address this gap. We evaluated the effectiveness of a low-cost offloading device (<i>Toa Uzito</i>) in improving healing outcomes in patients with plantar ulcers. A matched case–control clinical study was conducted at a specialised diabetic foot centre in Dar es Salaam, Tanzania. Patients with a single plantar DFU were enrolled. Those treated with <i>Toa Uzito</i> were compared with matched controls who received standard care without offloading. Controls were matched based on age, body mass index, and diabetes duration. The primary outcome was time to complete ulcer healing. Healing were analysed using Kaplan Meier survival analysis and Cox regression. A total of 621 patients were included (128 intervention, 493 controls), with a mean follow-up of 133.8 days. Ulcer healing was significantly better in the intervention group: 44.9% healed (versus 34.9% in controls) by 12 weeks, and increasing to 85% (versus 75.2% in controls) by 24 weeks. All patients in the intervention group healed, with a shorter mean healing time (125.7 vs. 137.5 days). <i>Toa Uzito</i> also demonstrated significantly superior healing efficacy compared with standard care after stratification by SINBAD classification (χ² = 71.2, <i>p</i> &lt; 0.01) . The low-cost <i>Toa Uzito</i> significantly improves healing rates and reduces time to healing. Its affordability and simplicity makes it an effective offloading strategy for promoting DFU healing in resource-limited settings.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"23 9","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13527527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148864913","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":"Clinical and Financial Outcomes With Minimally Invasive Excision With Epidermal Autografting and Poly-Lactic Acid Skin Substitute in Adult Mid-Deep Dermal Burns","authors":"Tony Zhao,&nbsp;Kaitlyn Malek,&nbsp;Anjay Khandelwal","doi":"10.1111/iwj.71028","DOIUrl":"10.1111/iwj.71028","url":null,"abstract":"<p>Mid-deep dermal burns have traditionally been treated with nonoperative management and split-thickness skin grafting, but minimally invasive excision with epidermal autografting and poly-lactic acid skin substitute (MEP) has offered an alternative approach. Comparative outcomes have remained incompletely defined. We conducted a retrospective cohort study of adult patients with mid-deep dermal burns treated with MEP compared with a propensity score-matched standard-of-care (SOC) cohort. The primary outcome was achievement of ≥ 90% wound healing by postoperative day 10, with secondary outcomes including length of stay, complications and hospital financial outcomes. Among 39 pairs analysed, MEP-treated patients were significantly more likely to achieve early wound healing compared with SOC (82.1% vs. 45.5%, <i>p</i> = 0.001) and experienced fewer complications, without an increase in length of stay. Although MEP was associated with higher upfront hospital costs, reimbursement rates were comparable. MEP was associated with superior early wound healing and fewer complications without prolonging hospitalisation.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"23 9","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13527530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148864962","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":"Angiosarcoma Presenting as a Chronic Non-Healing Lower Extremity Ulcer in Lymphoedema: A Challenge","authors":"Megan Koch,&nbsp;Leena Hani,&nbsp;Erica Friedman,&nbsp;Frank L. Ross","doi":"10.1111/iwj.71002","DOIUrl":"10.1111/iwj.71002","url":null,"abstract":"<p>Cutaneous angiosarcoma is a rare and aggressive malignancy that may arise in chronic lymphoedema. Its presentation as a non-healing ulcer can lead to delayed diagnosis. We describe an atypical case of angiosarcoma presenting as a chronic lower extremity ulcer in the setting of chronic lymphoedema and to highlight the importance of early biopsy. We report on the clinical course, diagnostic evaluation, treatment, and outcome of a patient with chronic lymphoedema who developed a persistent ulcer. A 74-year-old woman with longstanding lower extremity lymphoedema developed a non-healing ulcer initially managed as cellulitis and venous ulceration. Due to failure of conservative therapy, biopsy was performed and revealed angiosarcoma. The patient underwent surgical resection and adjuvant radiotherapy, remaining disease-free for over 4 years before recurrence and eventual death. Malignancy should be considered in chronic non-healing ulcers, especially in the setting of longstanding lymphoedema. Early biopsy is essential to avoid delayed diagnosis and improve outcomes.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"23 9","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/iwj.71002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148828617","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":"Multisite Implementation of a Digital Wound Model of Care: A Post-Implementation Multimethods Evaluation of Patient and Clinician Perspectives and Lessons Learned","authors":"Michelle Barakat-Johnson,&nbsp;Clementine Mak,&nbsp;Michelle Lai,&nbsp;Phillip Baharudin,&nbsp;Darren Dela Rosa,&nbsp;Katja Heuer,&nbsp;Natalie Ko,&nbsp;Thomas Leong,&nbsp;Vivien Low-Clarke,&nbsp;Apryl Repole-Li Vaccari,&nbsp;Melissa T. Baysari","doi":"10.1111/iwj.71016","DOIUrl":"10.1111/iwj.71016","url":null,"abstract":"<p>This study evaluated district-wide implementation of a digital wound model of care combining an artificial intelligence–enabled application with a virtual command centre across four hospitals and five community health centres in Australia. A post-implementation multimethods evaluation (January 2024–January 2026) of patients (<i>n</i> = 94), frontline clinicians (<i>n</i> = 75), and senior wound nurses (<i>n</i> = 9) and a product manager (<i>n</i> = 1) using surveys, semi-structured interviews and analysis of governance meeting minutes. Patient satisfaction was high: 91% rated care as ‘excellent’ or ‘good’, 93% 'agreed' or 'strongly agreed' it was effective and 96% 'agreed' or 'strongly agreed' that they felt confident in the care they received from their wound care provider. Just over half (59%) felt they were meaningfully involved in decisions about their own care, an area identified for targeted improvement in future iterations of the model. The most cited virtual care benefits included improved condition understanding (63%), and reduced travel (49%). Among the 28 patient app users, 89% reported improved communication between them and the wound care provider and 79% self-management confidence. Senior wound nurses rated the app highly for ease of use and continuity of care (both 86%), but poor connectivity was a limitation. Frontline clinicians valued enhanced documentation consistency but reported barriers including time pressures and training burden. This multisite implementation demonstrates that digital wound care models are highly acceptable and deliver perceived clinical benefit, while identifying patient involvement in decision-making and clinician workflow integration as priority areas for future investment.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"23 9","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/iwj.71016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148839512","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}