Journal of wound care最新文献

{"title":"Cost-effectiveness of a nitric oxide-generating medical device in managing hard-to-heal diabetic foot ulcers.","authors":"Julian F Guest, Michael E Edmonds","doi":"10.12968/jowc.2024.0417","DOIUrl":"https://doi.org/10.12968/jowc.2024.0417","url":null,"abstract":"<p><strong>Objective: </strong>To explore the potential cost-effectiveness of using a nitric oxide-generating medical device (EDX110, ConvaNiox, Convatec Ltd., UK) in the management of hard-to-heal diabetic foot ulcers (DFUs) among patients with type 1 or 2 diabetes, from the perspective of the UK's health services.</p><p><strong>Method: </strong>Markov modelling simulated the management of infected and non-infected hard-to-heal (chronic) DFUs with EDX110 or standard care in the community and secondary care over a 24-week period. The model was constructed using data from a previous randomised controlled trial and was used to estimate the potential cost-effectiveness of EDX110 in terms of the incremental cost per quality-adjusted life year (QALY) gained at 2021/22 prices.</p><p><strong>Results: </strong>There was a 63% improvement in healing by 24 weeks in the EDX110 group compared with standard care (49% versus 30%, respectively). This led to a 6% improvement in health-related quality of life and a 20% reduction in the total cost of DFU management. At a purchase price of £40 per EDX110 dressing, it was found to afford a cost-effective treatment in >80% of a cohort. However, the location where the dressing is administered (i.e., the community or secondary care) can potentially influence EDX110's cost-effectiveness.</p><p><strong>Conclusion: </strong>Within the limitations of the study, EDX110 could potentially afford the UK's health services a cost-effective treatment for DFUs; however, this is dependent on the location of the healthcare professionals administering the dressing.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"34 7","pages":"476-486"},"PeriodicalIF":1.5,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-inferiority randomised controlled trial of two contact layer dressings for the treatment of acute wounds (SLALOM).","authors":"Sylvie Meaume, Jean-Charles Kerihuel, Andres Malatesta, Flavien Roux, Daria Trofimenko, Martin Abel","doi":"10.12968/jowc.2024.0312","DOIUrl":"10.12968/jowc.2024.0312","url":null,"abstract":"<p><strong>Objective: </strong>Pain induced by dressing removal is an important clinical problem in the management of acute wounds. Contact layer dressings are intended to protect the wound and minimise pain. This study was designed to compare two dressings of this type in terms of pain induced at the first dressing removal.</p><p><strong>Method: </strong>Patients with acute wounds were randomly assigned to treatment with either an investigational product (n=78) or a comparator (n=81), and received treatment until their wound healed, or for a maximum period of 23 days.</p><p><strong>Results: </strong>By the first dressing change (day 3±2), minimal pain (<30mm on a 100mm visual analogue scale) was observed by 97.4% of patients in the intervention group and 97.5% of patients in the control group (modified intention-to-treat population (mITT)). For both mITT and per protocol populations, the lower bound of the unilateral 97.5% confidence interval did not exceed the prespecified -10.0% non-inferiority margin; thus, the non-inferiority of the investigational product to comparator was confirmed. In total, 64.8% of patients achieved wound healing by day 21±2. Time to wound closure, estimated for 50% of the patients using the Kaplan-Meier model, was 20±1.9 days for the intervention group and 19±2.7 days for the control group. The re-epithelialisation area doubled from baseline to day 21±2 in both groups. The opposite trend was observed for granulation, fibrin and necrosis areas. The number of periwound skin abnormalities significantly decreased in both groups. A good safety profile was demonstrated.</p><p><strong>Conclusion: </strong>The results of this study showed that the investigational product supported healing and was non-inferior to the comparator in minimising dressing-associated pain in acute wounds.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"34 7","pages":"496-505"},"PeriodicalIF":1.5,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of hard-to-heal ulcerative wounds with manually separated allogeneic platelets mixed with cryoprecipitate: three case reports.","authors":"Wendong Ju, Gaoming Ding, Feng Ge, Jun Huang, Li Wang, Qing Ou, Xiaodan Huang, Minmin Zheng, Xiaoyou Wang","doi":"10.12968/jowc.2023.0203","DOIUrl":"10.12968/jowc.2023.0203","url":null,"abstract":"<p><strong>Objective: </strong>To report the effectiveness of allogeneic manual platelet separation and cryoprecipitate gel on hard-to-heal (chronic) wound healing in patients of older age.</p><p><strong>Method: </strong>Three patients aged 70-72 years were selected for this study. Among them, one had hard-to-heal diabetic foot ulcers (DFUs), one had developed large pressure injuries on the gluteal area, and one suffered from a purulent ulcer of the lower extremity. After thorough debridement, one unit (U) of allogeneic artificial platelets and 1-1.5U of cryoprecipitate were used to make the gel preparation which was subsequently applied to the wound surface every two to four days to treat these hard-to-heal wounds.</p><p><strong>Results: </strong>The wounds in the three patients had healed after 35-86 days with the application of the allogeneic manual platelet separation and cryoprecipitate gel. The patient with the large gluteal ulcer and sinus formation experienced rapid healing after applying the gel preparation for one month, while the patient with a DFU avoided high re-amputation after the gel preparation treatment. The patient with secondary acute myeloid leukaemia from myelodysplastic syndrome had their purulent wound completely healed after thorough debridement with the gel preparation treatment.</p><p><strong>Conclusion: </strong>Manual separation of platelets and cryoprecipitate can effectively treat hard-to-heal ulcers or refractory wounds in elderly patients of older age as well as promote the quick development of granulation tissue and the wound-healing process.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"34 7","pages":"488-495"},"PeriodicalIF":1.5,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between serum vitamin D and mortality in adult patients with burns: a cohort study.","authors":"Amir Ghaffarzad, Kavous Shahsavarinia, Paria PoorZare, Afshin Ghodrati, Mehrdad Karimi, Mohammad Saadati, Alireza Razzaghi","doi":"10.12968/jowc.2024.0016","DOIUrl":"https://doi.org/10.12968/jowc.2024.0016","url":null,"abstract":"<p><strong>Objective: </strong>Evidence has shown debatable and challenging results related to vitamin D levels and outcomes in patients with burns. The objective of this study was to examine the association between the serum vitamin D levels in adult patients with burns and their hospital outcomes, particularly with regards to mortality and length of stay.</p><p><strong>Method: </strong>This prospective cohort study included patients admitted to Sina Hospital, Tabriz, Iran. Demographic data and patient outcomes were collected by trained general physicians. The patients' blood samples were taken at time of admission to measure serum vitamin D level. Pearson's correlation test and logistic regression modelling were used to reach the study goals regarding the normal distribution of data.</p><p><strong>Results: </strong>Of the 205 patients, approximately 57% were male, with a mean age of 37.67±13.61 years. Mean vitamin D level was 23.15±3.86ng/ml, with a range of 7.2-28.7ng/ml. Only 11.7% of patients had sufficient serum vitamin D levels (≥20ng/ml), while 4.4% had severe insufficiency (<10ng/ml). Logistic regression revealed a significant relationship, as a preventable factor, between serum vitamin D level and mortality in the patients (odds ratio=0.72; 95% confidence interval: 0.56, 0.94).</p><p><strong>Conclusion: </strong>The findings of this study support the notion that serum vitamin D levels (<20ng/ml) could have a preventive role in mortality in patients with burns. We conclude that supplementation with vitamin D is necessary after burn injury among adult patients with diabetes in order to prevent death.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"34 7","pages":"460-465"},"PeriodicalIF":1.5,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of infected wounds with cold atmospheric plasma: a case series.","authors":"Elia Ricci, Monica Pittarello, Andrea Ricci, Stefanie Ascher, Lisa Gebhardt","doi":"10.12968/jowc.2025.0132","DOIUrl":"https://doi.org/10.12968/jowc.2025.0132","url":null,"abstract":"<p><p>Due to its inactivating effect on bacteria, cold atmospheric plasma (CAP) has been shown to be successful in the treatment of hard-to-heal (chronic) and infected wounds. In this case series, 15 patients with a total of 20 wounds were treated with a mobile CAP device and the bacterial load of the wound simultaneously observed using a MolecuLight i:X (MolecuLight Inc., US) camera. In 60% of cases, the bacterial load could be brought under control despite minimal CAP application. This procedure offers the advantage of being able to directly visualise wound bacterial load and, therefore, the inactivation of bacteria is also directly visible. The use of the two devices complemented each other; supporting wound management and analysis of its effectiveness.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"34 7","pages":"506-512"},"PeriodicalIF":1.5,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biofilm detection-based wound management in diabetic foot ulcers: a randomised controlled trial.","authors":"Adam Astrada, Gojiro Nakagami, Kosuke Kashiwabara, Hiromi Sanada","doi":"10.12968/jowc.2024.0051","DOIUrl":"10.12968/jowc.2024.0051","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the effectiveness of wound blotting-guided biofilm management in diabetic foot ulcers (DFUs) and to compare it to standard of care (SoC).</p><p><strong>Method: </strong>This double-blinded, randomised controlled trial was conducted at an outpatient clinic in Pontianak City, Indonesia in September-November 2017 and June 2018-November 2019. Adults with diabetes with at least a two-week DFU located below the knee were included. Patients in the control group received SoC followed by the application of any appropriate dressings. Patients in the intervention group in addition to SoC also received additional wound cleansing according to the wound blotting result and antimicrobial dressing. Wound treatment was performed weekly for three weeks. Primary and secondary objectives were: the reductions in total depth; maceration; inflammation/infection; size; tissue type; type of wound edge; tunnelling/undermining (DMIST) score; and percentage of biofilm removal.</p><p><strong>Results: </strong>A total of 162 participants were recruited. There were significant differences in the total DMIST score at week 3 (p<0.01) between groups and biofilm percentage reduction at week 1 (p=0.01) and week 2 (p=0.03).</p><p><strong>Conclusion: </strong>The findings of this RCT showed that the intervention could significantly improve DFU healing and maximise biofilm elimination, especially after two weeks of treatment. A further study with a longer period of intervention, such as 12 weeks, is suggested to further evaluate the effectiveness of this intervention.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"34 7","pages":"514-524"},"PeriodicalIF":1.5,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness of subepidermal moisture measurement to prevent hospital-acquired pressure ulcers.","authors":"John Posnett, Joe Moss, Lewis Michaelwaite","doi":"10.12968/jowc.2024.0427","DOIUrl":"https://doi.org/10.12968/jowc.2024.0427","url":null,"abstract":"<p><strong>Objective: </strong>A pressure ulcer (PU) develops initially at the cellular level, progressing through damage to subepidermal cells and surrounding tissues before it becomes visible on the surface of the skin. Changes in subepidermal moisture (SEM) are a biomarker for the early stages of PU development. The objective of this study was to evaluate the cost-effectiveness of adding measurement of SEM to current standard of care (SoC), with the aim of reducing the incidence of hospital-acquired pressure ulcers (HAPUs).</p><p><strong>Method: </strong>A decision-tree model was developed. Outcomes were the incidence of HAPUs, quality-adjusted life-years (QALYs) and costs to the UK National Health Service (NHS) at 2022/23 prices. The effects of parameter uncertainty were tested in univariate and probabilistic sensitivity analysis.</p><p><strong>Results: </strong>In a typical NHS acute hospital with 480 beds, the addition of SEM assessment as an adjunct to SoC is expected to reduce the incidence of HAPUs by 32.9% and lead to a cost saving of £26.53 per admission. The probability that adjunctive SEM is cost-effective at a threshold of £30,000 per QALY is 69%.</p><p><strong>Conclusion: </strong>SEM assessments make it possible to implement early and anatomy-specific interventions which can improve the effectiveness of PU prevention and reduce healthcare costs.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"34 7","pages":"466-475"},"PeriodicalIF":1.5,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Graduated compression is not mandatory.","authors":"Giovanni Mosti","doi":"10.12968/jowc.2025.0238","DOIUrl":"https://doi.org/10.12968/jowc.2025.0238","url":null,"abstract":"","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"34 7","pages":"457-458"},"PeriodicalIF":1.5,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Negative pressure wound therapy for colorectal incisions: a systematic review and meta-analysis of controlled trials.","authors":"Ting-Kuang Wang, Chien-Hsin Chen, Wen-Kuan Chiu, Cheng-Hua Ni, Chin-Yun Wang, Kee-Hsin Chen, Chiehfeng Chen","doi":"10.12968/jowc.2022.0219","DOIUrl":"https://doi.org/10.12968/jowc.2022.0219","url":null,"abstract":"<p><strong>Objective: </strong>Negative pressure wound therapy (NPWT) has demonstrated promising results in reducing surgical site infection (SSI) rates following orthopaedic, vascular, cardiothoracic, plastic and abdominal surgery. The literature on use of NPWT on colorectal incisions is growing, with several randomised controlled trials (RCTs); however, findings have been inconsistent. This review evaluated the effectiveness and safety of NPWT for colorectal incisions in elective and emergency surgery.</p><p><strong>Method: </strong>The Cochrane Central Register of Controlled Trials, PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature, and ClinicalTrials.gov databases were searched for RCTs and non-RCTs comparing NPWT with standard of care.</p><p><strong>Results: </strong>A total of five RCTs and six non-RCTs were included (with a total number of patients 2193). NPWT significantly reduced the rate of infection in colorectal incisions (odds ratio (OR): 0.57; 95% confidence interval (CI): 0.41, 0.78; I²=14%; p<0.0005) and wound complications of the colorectal surgical incisions (OR: 0.33; 95% CI: 0.13, 0.88; I²=59%; p=0.03). NPWT also shortened the wound healing time by three days (mean difference: -2.98; 95% CI: -4.99, -0.97; I²=0%; p=0.004). Subgroup analysis revealed that NPWT conferred greater benefits on wounds resulting from life-threatening emergency surgery, and contaminated or dirty-infected wounds.</p><p><strong>Conclusion: </strong>The findings of this review showed that NPWT is an effective intervention for the closure of wounds in patients following colorectal surgery, and lead to a significant reduction in SSIs, overall wound complications, and mean complete wound healing time. It was particularly effective in emergency cases and in contaminated to dirty-infected wounds. Treatment options should be considered in terms of cost-benefits and adequate patient selection during shared decision-making.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"34 7","pages":"526-537"},"PeriodicalIF":1.5,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bacteriological profiles of diabetic ulcers in cases of major limb amputation: insights from Solomon Islands.","authors":"Maguire E Anuszewski, Dylan M Bush, Adrian Garcia Hernandez, Hugo Bugoro, Rooney Jagilly, Micky Olangi, Thomas H Fitzpatrick, Michael Buin, Stallone Kohia, Mark Love, Alexandra L Martiniuk","doi":"10.12968/jowc.2025.0201","DOIUrl":"https://doi.org/10.12968/jowc.2025.0201","url":null,"abstract":"<p><strong>Objective: </strong>Solomon Islands, a Western Pacific nation, faces a growing burden of type II diabetes amid chronic healthcare shortages. Surgeons report increased incidence of diabetic amputations; however, data on infection rates and pathology remain scarce. This study describes the microbiology of diabetic ulcers in cases of major limb amputation.</p><p><strong>Method: </strong>Demographic, microbiological and outcome data were extracted from records of patients with diabetes who underwent major limb amputation from 2018-2023 in Solomon Islands.</p><p><strong>Results: </strong>Among 356 adults who underwent major limb amputation, microbiological data were available for 113 (32%). Pus and tissue cultures identified 20 bacterial species-predominantly <i>Pseudomonas aeruginosa</i> (n=27; 24%), mixed enteric organisms (n=25; 23%) and <i>Klebsiella pneumoniae</i> (n=18; 16%). Meticillin-resistant <i>Staphylococcus aureus</i> was identified in one patient. Antibiotic resistance was observed in 62 (55%) cultures, with the highest resistance rates against: ampicillin (31 cases); amoxicillin (31 cases); gentamicin (21 cases); and trimethoprim/sulfamethoxazole (21 cases). <i>Escherichia coli, Klebsiella pneumoniae</i> and <i>Enterococcus</i> spp. were significantly associated with resistance.</p><p><strong>Conclusion: </strong>The bacterial diversity and high resistance rates identified in this study are concerning given limited access to next-generation antibiotics in Solomon Islands. Further research is needed to evaluate infection management, resistance drivers and clinical outcomes of antibiotic-resistant infections in Solomon Islands.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"34 Sup7","pages":"S13-S22"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}