International Wound Journal最新文献

{"title":"A systematic review of procedural treatments for burn scars in children: Evaluating efficacy, safety, standard protocols, average sessions and tolerability based on clinical studies","authors":"Masoumeh Roohaninasab,&nbsp;Niloufar Najar Nobari,&nbsp;Mohammadreza Ghassemi,&nbsp;Elham Behrangi,&nbsp;Alireza Jafarzadeh,&nbsp;Afsaneh Sadeghzadeh-Bazargan,&nbsp;Azadeh Goodarzi","doi":"10.1111/iwj.70091","DOIUrl":"10.1111/iwj.70091","url":null,"abstract":"<p>Managing burn scars in children presents significant challenges. This study investigates effective treatment methods for burn scars, focusing on efficacy, safety, standard protocols and tolerability. Major databases such as PubMed, Scopus and Web of Science were thoroughly searched up to August 2024, emphasizing procedural treatments for burn scars in children. Key data collected included participant demographics, sample sizes, intervention methods, follow-up protocols, treatment effectiveness and reported adverse events. A total of 256 children were assessed, with all procedural treatments yielding satisfactory outcomes. Among the various methods, trapeze-flap plasty and percutaneous collagen induction showed improvements in all patients. In the laser treatment group, which included 161 children, the Vancouver Scar Scale (VSS) score reduction ranged from 55.55% to 76.31%, with outcomes rated as good (24.61%) to excellent (60%). Laser treatment using local anaesthesia proved to be well tolerated by children. Our findings indicate that various methods—including trapeze-flap plasty, percutaneous collagen induction, phototherapy and fractional CO₂ laser—demonstrate a relatively good response and an acceptable safety profile. Notably, light-based therapies/lasers may serve as safe, effective and tolerable options for scar treatment in this age group, often eliminating the need for general anaesthesia.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"21 10","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11461021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390475","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":"Combination therapy of negative pressure wound therapy and antibiotic-loaded bone cement for accelerating diabetic foot ulcer healing: A prospective randomised controlled trial","authors":"Meifang Zhong,&nbsp;Jiawei Guo,&nbsp;Mulan Qahar,&nbsp;Guangtao Huang,&nbsp;Jun Wu","doi":"10.1111/iwj.70089","DOIUrl":"10.1111/iwj.70089","url":null,"abstract":"<p>Negative pressure wound therapy (NPWT) and antibiotic-loaded bone cement (ALBC) are commonly used treatments for diabetic foot ulcers (DFUs). However, the combined efficacy of these two modalities remains unclear. This clinical study aimed to assess the effectiveness and underlying mechanisms of NPWT&amp;ALBC in the management of DFUs. A total of 28 patients were recruited, 16 of whom served as controls and received only NPWT, whilst 12 received NPWT&amp;ALBC. Both groups underwent wound repair surgery following the treatments. Blood samples were obtained to detect infections and inflammation. Wound tissue samples were also collected before and after the intervention to observe changes in inflammation, vascular structure and collagen through tissue staining. Compared with the NPWT group, the NPWT&amp;ALBC group exhibited a superior wound bed, which was characterised by reduced inflammation infiltration and enhanced collagen expression. Immunostaining revealed a decrease in IL-6 levels and an increase in α-SMA, CD68, CD206 and collagen I expression. Western blot analysis demonstrated that NPWT&amp;ALBC led to a decrease in inflammation levels and an increase in vascularization and collagen content. NPWT&amp;ALBC therapy tends to form a wound bed with increased vascularization and M2 macrophage polarisation, which may contribute to DFUs wound healing.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"21 10","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11461018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390477","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":"Intensive care nurses' knowledge and practices regarding medical device-related pressure injuries: A descriptive cross-sectional study","authors":"Aslı Kurtgöz,&nbsp;Selin Keskin Kızıltepe,&nbsp;Hülya Keskin,&nbsp;Münevver Sönmez,&nbsp;İsmail Aşatır","doi":"10.1111/iwj.70088","DOIUrl":"10.1111/iwj.70088","url":null,"abstract":"<p>This study aims to determine the levels of knowledge and practices of intensive care nurses regarding medical device-related pressure injuries (MDRPIs). This descriptive cross-sectional study was carried out between September 2023 and February 2024, involving 143 nurses working in intensive care units across three hospitals in Türkiye. The data were collected using the demographic form and the Medical Device-related Pressure Injuries Knowledge and Practice Assessment Tool (MDPI-ASSET). Of the nurses, 74.1% have encountered MDRPIs in their unit, 63.6% feel that their knowledge about MDRPIs is insufficient and 90.2% express a desire to receive training about MDRPIs. The participants' total mean MDPI-ASSET score was 11.12 (out of 21). The nurses achieved the highest mean score on the Aetiology/risk factors sub-scale and the lowest mean score on the Staging sub-scale. The analysis revealed significant differences in the mean MDPI-ASSET total scores among nurses based on the status of previous encounters with MDRPIs (<i>t</i> = 2.342; <i>p</i> = 0.021) and their feelings of responsibility for the development of MDRPIs (<i>t</i> = −2.746; <i>p</i> = 0.007). In this study, the knowledge and practices of intensive care nurses regarding medical device-induced pressure injuries were found to be inadequate. Given the frequent occurrence of MDRPIs in intensive care units, it is necessary to support nurses with continuous organizational-level training to improve the quality of care for critically ill patients.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"21 10","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11458881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390479","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":"Does complete resection of infected bone improve clinical outcomes in patients with diabetic foot osteomyelitis?","authors":"Lawrence A. Lavery,&nbsp;Arthur N. Tarricone,&nbsp;Mario C. Reyes,&nbsp;Mehmet A. Suludere,&nbsp;Matthew J. Sideman,&nbsp;Michael C. Siah,&nbsp;Edgar J. G. Peters,&nbsp;Dane K. Wukich","doi":"10.1111/iwj.70072","DOIUrl":"10.1111/iwj.70072","url":null,"abstract":"<p>The objective of the study was to compare outcomes in patients with complete surgical resection versus partial resection of diabetic foot osteomyelitis (OM). A post hoc analysis of 171 patients with OM was performed using data from two randomized clinical trials. OM was confirmed with bone culture or histopathology. Surgical culture specimens were obtained from resected bone and sent for histopathology and microbiology. Residual osteomyelitis (RO) was defined as a positive resected margin on culture or histopathology. No residual osteomyelitis (NRO) was defined as no growth from bone culture and no histopathological inflammation in the biopsy of the resection margin. Data from the 12-month follow-up were used to determine clinical outcomes. During the index hospitalization, NRO patients had significantly shorter duration of antibiotic therapy (NRO 21.0, 13.0–38.0 vs. RO 37.0, 20.8–50.0, <i>p</i> &lt;0.01) and more amputations than patients with RO (NRO 89.9% vs. RO 60.9%, <i>p</i> &lt;0.01). During the 12-month follow-up, patients with NRO also had significantly shorter duration of antibiotic therapy (NRO 42, 21.0–66.5 vs. RO 50.5, 35.0–75.0, <i>p</i> = 0.02). During the 12-month follow-up, there was no difference in ulceration at the same site (NRO 3.7%, RO 4.3% <i>p</i> = 0.85), hospitalization (NRO 32.6%, RO 34.8%, <i>p</i> = 0.76), total re-infections (NRO 25.3%, RO 29.3%, <i>p</i> = 0.56), re-infection with osteomyelitis (NRO 13.3% vs. 13.5%, <i>p</i> = 0.36), amputation (NRO 8.8%, RO 5.4%, <i>p</i> = 0.86) and time to wound healing in days (NRO 94, 41.0–365 vs. RO 106, 42.8–365, <i>p</i> = 0.77). Successful treatment of osteomyelitis was achieved by 86.7% and 86.5% of patients. During the index hospitalization, patients with no residual osteomyelitis had more amputations and were treated with antibiotics for a shorter duration. During the 12-month follow-up, patients with no residual osteomyelitis had shorter durations of antibiotics. There were no differences in re-infection, amputation, re-ulceration or hospitalization.</p><p><b>Level of evidence:</b> 1</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"21 10","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11458324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390478","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":"Meet our North American editorial board members","authors":"Douglas Queen,&nbsp;Keith Harding","doi":"10.1111/iwj.70061","DOIUrl":"https://doi.org/10.1111/iwj.70061","url":null,"abstract":"&lt;p&gt;In our recent editorial, we discussed the expansion of our Editorial Board&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; and introduced you to our Senior Editorial Advisors. We promised a series of further editorials introducing our wider membership. This will be the first in a series of three providing insight into the group of outstanding and distinguished individuals that comprise our board. We have created the largest most internationally diverse board to greatly increase the capabilities and expertise of the journal as it moves to its third decade of life.&lt;/p&gt;&lt;p&gt;Look out for a series of editorials in the coming month introducing our new board members by providing some background on their valued experiences. As the editorial team, we are excited to expand this group to help maintain the high-quality standards of the International Wound Journal moving forward into our third decade of existence.&lt;/p&gt;&lt;p&gt;Please meet the North American Editorial Board Members for the International Wound Journal:&lt;/p&gt;&lt;p&gt;Afsaneh Alavi is a professor of Dermatology at the Mayo Clinic with special interests in inflammatory disorders and wound healing. Prior joining to the Mayo Clinic, Dr Alavi completed her residency in dermatology both in Iran and Canada and a 2-year fellowship in wound healing at the University of Toronto in Canada. She earned her Master of Science in Community Health from the University of Toronto. She has received multiple prestigious awards including the Physician of the Year Award by the Canadian Dermatology Association in 2017 and the Supervisor of the Year Award by Mayo Clinic Dermatology in 2021.&lt;/p&gt;&lt;p&gt;Dr. Alavi has been involved in numerous clinical trials from phase I-IV and basic science research. She is currently the Director of Complex Medical Dermatology Fellowship at the Mayo Clinic and runs the Hidradenitis Suppurativa Specialty Clinic.&lt;/p&gt;&lt;p&gt;Dr. Alper is a podiatric physician who recently retired from working in the private solo practice he started 36 years ago in Belmont, MA. Specializing in preventative diabetic foot care, he is now Emeritus Surgical staff at Mt. Auburn Hospital (a Harvard teaching hospital). He is currently a member of the Leadership Board of the American Diabetes Association (ADA) in New England, having served as its President for over 20 years, and is an elected member of the Board of Trustees of the American Podiatric Medical Association (APMA). He also had the honour of serving as Chair of the Belmont (MA) Board of Health for 30 years, where he was seen as a leader in public health for the community. This led to his being appointed by the Governor to his current position on the Massachusetts Association of Health Boards (MAHB), allowing him to continue his public health work.&lt;/p&gt;&lt;p&gt;Since his retirement, Dr. Alper has spent much of his time in the world of limb amputation prevention, using his connections in diabetes, podiatry and vascular fields to create collaborations between medical societies. He currently serves on the Board ","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"21 10","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/iwj.70061","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142429350","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":"Supplementation of glutamine and probiotics should be emphasised in scar prevention in conservatively managed children post burn injury","authors":"Yongping Xue,&nbsp;Weiwei Li,&nbsp;Zhenyu Gong","doi":"10.1111/iwj.70057","DOIUrl":"10.1111/iwj.70057","url":null,"abstract":"&lt;p&gt;Burns destroy the skin barrier and can lead to fluid exudation, insufficient blood volume, infection and even death.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; The slower the skin wound healed, the greater the more likely the occurrence of scar hyperplasia.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; How to quickly promote the healing of skin wounds in burn patients and reduce the incidence of scar hyperplasia has always been a hot topic for burn plastic surgeons. Recently, we read the published study by Stephanie Ball et al.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; that scar outcomes for conservatively managed children post burn injury: a retrospective study. In this article, the authors mentioned an increasing prevalence of HTS with an increasing number of days to heal. Notably, 7.5%–20% prevalence in children heal conservatively between 14 and 21 days, 45%–56% in children heal conservatively between 21 and 30 days and 81%–94% in children heal conservatively in more than 30 days. Therefore, they believed that promoting skin wound healing and giving appropriate scar intervention measures were effective ways to prevent scar hyperplasia. However, the authors only mentioned interventions to prevent scar hyperplasia in the article, such as pressure, silicone, hydration, ROM/splint, wound dressings, corticosteroid cream and sensory desensitisation exercises, did not mention the intervention to promote rapid skin wound healing.&lt;/p&gt;&lt;p&gt;According to our clinical experience, nutritional support for burn patients is the key to promoting rapid healing of skin wounds.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; In nutritional support therapy, glutamine supplementation is a common treatment for burn plastic surgeons. Glutamine is a non-essential amino acid and is the only amino acid that can pass directly through the cerebrovascular barrier.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; Glutamine can protect gastric mucosa, promote protein synthesis and strengthen muscle. Therefore, glutamine can effectively promote the rapid healing of skin wounds in burn patients. It has been shown that glutamine can provide carbon and nitrogen to promote biosynthesis.&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt; Glutamine derived from macrophages can enhance satellite cells and muscle regeneration. All of these mechanisms can promote the healing of skin wounds. The first 6 months after the burn is the most active scar period, and scarring is most pronounced during this period. Therefore, we recommend that glutamine supplementation be given to burn patients during the first six months of treatment to prevent scar hyperplasia.&lt;/p&gt;&lt;p&gt;In addition, in subsequent studies, we recommend probiotics and glutamine enteral support therapy for paediatric burn patients. Probiotics can regulate the intestinal microecological balance, improve the body immunity of burn patients and increase the absorption and utilisation of glutamine.&lt;span&gt;&lt;sup&gt;7&lt;/sup&gt;&lt;/span&gt; The treatment with these two drugs can effectively shorten the wound healing time of paediatric burn patients, so as to prevent scar hyperpl","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"21 10","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11456368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380835","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":"Protocols in wound healing: Evidence-based or mere rituals?","authors":"Elena Conde-Montero,&nbsp;Axelle Moreau,&nbsp;Justin Gabriel Schlager,&nbsp;Damien Pastor,&nbsp;Jürg Hafner","doi":"10.1111/iwj.70062","DOIUrl":"10.1111/iwj.70062","url":null,"abstract":"&lt;p&gt;Any wound care protocol, whether acute or chronic, begins with the recommendation for wound cleansing, which is considered as a cornerstone of the treatment. In addition, some papers have been published comparing different products (tap water, saline, soap, antimicrobials) and cleansing techniques (different irrigation pressures).&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; However, what is the available evidence that all wounds need cleansing?&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; Moreover, could not a ritual swabbing or scrubbing be detrimental to the neoformed tissue?&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; These same questions could be asked with debridement, which is also often included as a mandatory step in every dressing change. In fact, in the case of venous ulcers, except in certain recalcitrant sloughy wounds,&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; it is not clear that debridement, in a general way, accelerates healing. In other words, just because we get a venous leg ulcer with less sloughy tissue at each dressing does not mean that we will accelerate healing, as it was shown with larval therapy.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; In addition, sharp debridement will have no benefit in cases of white atrophy and will produce pain, and in pyoderma gangrenosum or arteriolosclerotic ulcers, it may worsen the wound. In addition, a recent pilot study shows that, contrary to the traditional belief that slough is a devitalised tissue that delays healing, there are functional proteins in this tissue that can promote healing.&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;The frequency of dressing changes is another aspect that has not been studied, but in many cases, it is done ritually two to three times a week, or even daily. Thanks to the impossibility of making wound dressing changes during the covid pandemic, some of us realized that not touching the wound for 1, 2, 3 or even 4 weeks was not only not harmful to venous leg ulcers, but even allowed their complete epithelialization.&lt;/p&gt;&lt;p&gt;We cannot make protocols that include chronic wounds in general, because wounds that are progressing well should be managed differently.&lt;span&gt;&lt;sup&gt;7&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;On the one hand, each dressing is an opportunity to promote, with cleansing and debridement, the removal of whatever is hindering healing (excess exudate with pro-inflammatory cytokines, non-viable tissue, bacterial load), which is essential in dirty or infected wounds and in cases of resistant biofilm. On the other hand, any manipulation of the wound bed will have an impact on the cells and growth factors that are promoting wound closure, and may induce inflammation&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; that, in those wounds with a good progression, could impede wound healing. Wound exudate, especially in acute wounds and wounds that are having a good evolution, is a source of cells and growth factors that promote healing. Additionally interactions between commensal microbiota and the multiple cell types involved in cutaneous wound healing have been shown to regulate the immune response","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"21 10","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11456369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380834","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":"Does the use of DACC-coated dressings improve clinical outcomes for hard to heal wounds: A systematic review","authors":"Saskia Schwarzer,&nbsp;Jose Luis Lazaro-Martinez,&nbsp;Amanda Killeen,&nbsp;Paulo Alves,&nbsp;Andrea Gledhill,&nbsp;Erik Nygren,&nbsp;Lawrence A. Lavery,&nbsp;Matthew Malone","doi":"10.1111/iwj.70053","DOIUrl":"10.1111/iwj.70053","url":null,"abstract":"<p>Reports of overuse and antimicrobial resistance have fuelled some clinicians to adopt alternative wound dressings termed to be non-medicated or non-antimicrobials, which still claim antimicrobial or antibacterial activity. In this PROSPERO-registered systematic review, we evaluated the in vivo clinical evidence for the effectiveness of DACC-coated dressings in chronic, hard to heal wound-related outcomes. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) Framework was adopted as the template in constructing this systematic review. The PICO format (Population [or patients], Intervention, Comparison [control], Outcome/s) was used to identify key clinical questions in determining patient outcomes under two domains (infection control and wound healing). A systematic search was performed in PubMed, OVID, Cochrane Library, clinical trial registries and data sources from independent committees. Abstracts of all studies were screened independently by two reviewers, with six further reviewers independently assessing records proceeding to full review. The authors rated the quality of evidence for each of the outcomes critical to decision making. After excluding duplicates, 748 records were screened from the databases, and 13 records were sought for full review. After full review, we excluded a further three records, leaving ten records for data extraction. Three records were narrative reviews, three systematic reviews, two prospective non-comparative before/after studies, one prospective head-to-head comparator cohort study and one retrospective head-to-head comparator cohort study. No RCTs or case versus control studies were identified. The overall quality of clinical evidence for the use of DACC-coated dressing to improve wound infection and wound healing outcomes was assessed as very low. There is an urgent unmet need to perform appropriately designed RCTs or case–control studies. The extracted data provide no clarity and have limited to no evidence to support that using a DACC-coated dressing improves wound infection or wound healing outcomes. Further, there is no evidence to suggest this therapy is either superior to standard of wound care or equivocal to topical antimicrobial agents in the management of infected hard to heal wounds.</p>","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"21 10","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11449527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371841","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":"Comments on ‘The impact of inflammatory biomarkers on amputation rates in patients with diabetic foot ulcers’","authors":"Mostafa Javanian,&nbsp;Mohammad Barary,&nbsp;Majid Khalilizad,&nbsp;Soheil Ebrahimpour","doi":"10.1111/iwj.70076","DOIUrl":"10.1111/iwj.70076","url":null,"abstract":"&lt;p&gt;I have read with great interest the article titled ‘The impact of inflammatory biomarkers on amputation rates in patients with diabetic foot ulcers’, recently published in your esteemed journal.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; The study's exploration of the association between hematological inflammatory markers and the likelihood of amputation in patients with diabetic foot ulcers (DFUs) is both timely and relevant, especially given the increasing prevalence of diabetes-related complications. However, while the study offers valuable insights, several methodological limitations warrant further consideration to enhance the findings' robustness and applicability in clinical practice.&lt;/p&gt;&lt;p&gt;Firstly, the selection of inflammatory biomarkers appears somewhat limited. Expanding the scope to include additional markers, such as the Systemic Immune-Inflammation Index (SII) and the Systemic Inflammatory Response Index (SIRI), could provide a more comprehensive understanding of the inflammatory processes driving amputation risk in DFU patients.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; Recent studies have demonstrated that these indices are robust predictors of poor outcomes in various inflammatory conditions, including DFUs.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; Their inclusion could yield a more thorough analysis of the correlation between inflammation and amputation rates.&lt;/p&gt;&lt;p&gt;Moreover, when assessing the relationship with inflammatory biomarkers, the study does not distinguish between major and minor amputations. Differentiating between these categories could reveal essential distinctions in the inflammatory response associated with varying levels of limb loss, providing more nuanced insights into the severity of DFUs and the corresponding inflammatory response.&lt;/p&gt;&lt;p&gt;Another critical aspect that could have been better addressed is determining optimal cut-off values for biomarkers like C-reactive protein (CRP). Establishing precise thresholds is crucial for translating research findings into clinical practice, where they can guide decision-making and help identify patients at the highest risk of adverse outcomes. The lack of such data in the study limits the clinical utility of these biomarkers in predicting amputation risk.&lt;/p&gt;&lt;p&gt;Additionally, while the article acknowledges the role of inflammation in peripheral arterial disease (PAD), it stops short of fully elucidating the connection between vascular involvement and inflammatory biomarkers in the context of DFU-related amputations.&lt;span&gt;&lt;sup&gt;4, 5&lt;/sup&gt;&lt;/span&gt; Given that PAD is implicated in a significant proportion of lower limb amputations, a more in-depth exploration of this relationship could provide a more holistic understanding of the factors influencing amputation risk in DFU patients.&lt;/p&gt;&lt;p&gt;A more detailed statistical analysis could further enhance the study's credibility. For instance, utilizing advanced statistical models that account for confounding variables or conducting a power analysis to ensure the study is adequately","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"21 10","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11449501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371840","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":"β-catenin: An important biomarker for wound healing","authors":"Jonathan Brocklehurst","doi":"10.1111/iwj.70090","DOIUrl":"10.1111/iwj.70090","url":null,"abstract":"&lt;p&gt;Biomarkers are naturally occurring molecules which can be used to predict, diagnose and indicate pathological or physiological processes.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Predictive biomarkers can be used to predict outcomes for wounds or provide the likelihood of benefit from treatment (Pichu et al. 2017).&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; Also, diagnostic biomarkers in wounds can be utilized to identify singular or multiple factors that have the potential to influence a clinical outcome. An indicative biomarker can be used to assess disease progression and response to therapy during treatments.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; This essay will focus on β-catenin as a predictive, diagnostic and indicative biomarker.&lt;/p&gt;&lt;p&gt;β-catenin is defined as a dual function protein responsible for both regulating and coordinating cell-to-cell adhesion and cell migration (Nelson and Nusse, 2004).&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; The key protein which reacts with β-catenin to regulate its expression is called &lt;i&gt;Adenomatous Polyposis Coli&lt;/i&gt; (APC).&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; Recent research&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; suggests that tissue homeostasis is dependent upon the essential multi-protein interactivity between APC and β-catenin. Therefore, the loss of APC protein function leads to a deregulated β-catenin nuclear accumulation.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; Ultimately, this dissociation and deregulation of the multi-protein complex can disrupt the processes of wound healing and thus prolong healing duration in wounds.&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;According to recent research (Cai et al. 2017)&lt;span&gt;&lt;sup&gt;7&lt;/sup&gt;&lt;/span&gt; tissue sampling of β-catenin can be utilized to predict contrasting outcomes in wound healing, such as the inhibition of epithelial cell and keratinocyte migration or the activation of abnormal fibroblast proliferation. The possibility for contrasting outcomes suggests that β-catenin has an important role in regulating wound size through either inhibiting or enhancing remodelling processes.&lt;span&gt;&lt;sup&gt;8&lt;/sup&gt;&lt;/span&gt; Therefore, the relationship between the over-expression of β-catenin on the border of a non-healing wound could enable a predictive assessment for the extent to which wound healing may occur.&lt;span&gt;&lt;sup&gt;9&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;According to recent research,&lt;span&gt;&lt;sup&gt;1, 5&lt;/sup&gt;&lt;/span&gt; tissue sampling of β-catenin can be an effective diagnostic biomarker as this method of testing can identify areas of thickened, hyperproliferative and parakeratotic epidermis. Furthermore, detection of β-catenin can aid in the diagnosis of chronic wounds by indicating aberrant proliferation and inappropriate differentiation of cells in the borders of non-healing wounds.&lt;span&gt;&lt;sup&gt;10&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;On the other hand, according to Shang et al.,&lt;span&gt;&lt;sup&gt;11&lt;/sup&gt;&lt;/span&gt; tissue sampling of β-catenin has limited standardized guidance for specimen retrieval, inadequate logistics of service-based diagnostics and subsequent requirement for the incorporation of established therapeutics into stand","PeriodicalId":14451,"journal":{"name":"International Wound Journal","volume":"21 10","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11449500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371842","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}