Journal of wound care最新文献

{"title":"Intermittent pneumatic thigh compression for the treatment of lower limb wounds (IPCOTT): a randomised control trial.","authors":"David C Bosanquet, Jane H Davies, Nicola Ivins, Sarah Bradbury, Kirsty Kettley, Kim Cocks, Keith Harding","doi":"10.12968/jowc.2026.0047","DOIUrl":"https://doi.org/10.12968/jowc.2026.0047","url":null,"abstract":"<p><strong>Objective: </strong>Hard-to-heal (chronic) venous leg ulcers (VLUs) are challenging to heal with standard of care (SoC) alone. This study evaluated whether adding a thigh-administered intermittent pneumatic compression (IPC) device (WoundExpress, Huntleigh Healthcare Ltd., UK) to SoC improved outcomes in patients with hard-to-heal venous or mixed leg ulcers (venous and arterial), was suitable for home use and was safe.</p><p><strong>Method: </strong>A multicentre, pragmatic, open-label, randomised controlled trial (RCT) was conducted across the UK, US, Germany and France. Adults with hard-to-heal lower limb VLUs and mixed ulcers already receiving compression were randomised 1:1 to adjunctive IPC (two hours/day; intervention) plus SoC, or SoC alone (control), for 16 weeks. The primary outcome was percentage change in wound area. Secondary outcomes included: complete healing; wound pain; quality of life (QoL); acceptability; usage; and safety.</p><p><strong>Results: </strong>A total of 136 patients were randomised (n=65 IPC; n=71 control); 116 patients completed the study. Median wound area reduction at 16 weeks was similar: (intervention: 64.0% versus control: 67.7%; p=0.35). Complete healing occurred in 16.9% (IPC) and 18.3% (control) patients (p=0.80). Pain scores and QoL improved modestly in both groups, with no between-group differences. The IPC device was well tolerated: 64% of patients rated it 'very good' or 'excellent'. Mean use was ~2.0 hours/day, as reported in patient diaries. Adverse events were primarily mild and comparable (54% IPC; 59% control); only one mild event was device-related.</p><p><strong>Conclusion: </strong>In this RCT, thigh-administered IPC did not improve healing beyond SoC in this patient population, although it was safe, well-tolerated, and feasible for home use.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"35 10","pages":"901-914"},"PeriodicalIF":2.0,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127855","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":"Angiosome-directed revascularisation and the woundosome paradigm in chronic limb-threatening ischaemia: a narrative review.","authors":"Windy Cole, John Kirby, Steven Sauk, Walaya Methodius-Rayford, Marshall Medley, Amy Couch, Jacob Wielgomas, Raymond Abdo, Lauren McCarthy","doi":"10.12968/jowc.2026.0397","DOIUrl":"https://doi.org/10.12968/jowc.2026.0397","url":null,"abstract":"<p><strong>Objective: </strong>Revascularisation is central to limb salvage in chronic limb-threatening ischaemia (CLTI) and diabetic foot ulceration (DFU); however, the optimal method for selecting target vessels remains uncertain. The angiosome model has traditionally guided revascularisation planning, while the emerging woundosome concept emphasises wound-level perfusion, collateral circulation, microvascular function, wound severity and multidisciplinary care. This review evaluated whether current evidence supports angiosome-guided revascularisation alone or a more wound-centred approach.</p><p><strong>Method: </strong>A structured review of PubMed/MEDLINE, Embase, Scopus and Cochrane Library databases was conducted from inception to May 2026. Eligible studies included guidelines, systematic reviews, meta-analyses, randomised trials and comparative cohort studies reporting wound healing, limb salvage, major amputation, amputation-free survival or mortality in adults with CLTI and/or DFU undergoing revascularisation.</p><p><strong>Results: </strong>Direct angiosome revascularisation was associated with improved wound healing and limb salvage compared with indirect revascularisation without collateral support. Across multiple evidence syntheses, direct revascularisation and indirect revascularisation with preserved collaterals achieved comparable outcomes and both outperformed indirect revascularisation without collaterals. Functional measures of perfusion, particularly wound blush, were stronger predictors of healing and limb salvage than angiosome alignment alone. Wound severity, assessed by Wound, Ischaemia, Foot Infection (WIfI) stage classification, independently predicted outcomes, whereas the significance of direct angiosome perfusion diminished after adjustment for wound characteristics. Contemporary guidelines emphasise maximising perfusion to the wound bed rather than strict anatomic angiosome targeting.</p><p><strong>Conclusion: </strong>The angiosome model remains an important anatomical framework but does not fully account for perfusion heterogeneity, collateral circulation and wound-specific factors. The woundosome concept may complement angiosome-guided planning by emphasising functional wound-level perfusion. Current evidence supports an integrated strategy that prioritises direct revascularisation when feasible while incorporating collateral assessment, wound blush, WIfI staging and multidisciplinary care. Prospective validation of the woundosome concept is warranted.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"35 10","pages":"931-941"},"PeriodicalIF":2.0,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127878","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":"Retrospective analysis of combined EMTT and ESWT for hard-to-heal lower extremity ulcers: a single-centre outcome study.","authors":"Eric J Lullove, Karsten Knobloch","doi":"10.12968/jowc.2026.0192","DOIUrl":"https://doi.org/10.12968/jowc.2026.0192","url":null,"abstract":"<p><strong>Objective: </strong>Hard-to-heal (chronic) lower extremity ulcers represent a significant clinical challenge with substantial morbidity and healthcare costs. Extracorporeal shockwave therapy (ESWT) has emerged as a promising adjunctive treatment modality for hard-to-heal wounds, though evidence for combined electromagnetic transduction therapy (EMTT) and ESWT remains limited. The aim of this study was to describe wound healing and pain outcomes associated with combined EMTT and ESWT, used as an adjunct to standard of care (SoC), in patients with hard-to-heal lower extremity ulcers, and to investigate whether the outcomes warrant further prospective study.</p><p><strong>Method: </strong>This retrospective chart review analysed consecutive patients with hard-to-heal post-Mohs excisional lower extremity wounds that had failed primary closure after four weeks of SoC, treated with combined Storz Medical AG EMTT (Storz Medical AG, Switzerland) and ESWT using the Storz Medical AG ESWT with C-ACTOR device (Storz Medical AG, Switzerland) between December 2025 and March 2026. All patients received twice-weekly treatments for four weeks (eight treatments in total). Ankle-brachial pressure index (ABPI) was measured at baseline to assess arterial perfusion. Following completion of shockwave therapy, all patients underwent surgical debridement and received standardised wound dressings consisting of non-adherent foam, gauze and Conforming Stretch Gauze Bandage (Medline, US). Primary outcomes included wound surface area (WSA) reduction at weeks 4 and 8, time to complete wound closure, and pain scores at baseline, at week 4 and at wound closure.</p><p><strong>Results: </strong>The cohort consisted of 15 patients (mean age: 82.2±7.1 years; 66.7% female; 80.0% White; 20.0% Hispanic). Mean baseline ABPI was 1.05±0.13 (range: 0.82-1.33). Mean WSA decreased from 2.89±1.08cm² at baseline to 0.88±0.93cm² at week 4 (p<0.001), representing a 69.5% reduction. A total of 13 patients (86.7%) achieved complete wound closure, with a mean time to closure of 5.2±1.3 weeks (range: 3-8 weeks). Visual analogue pain scores decreased from 8.1±1.2 at baseline to 2.3±0.9 at week 4 (p<0.001), representing a 71.9% reduction in pain severity. All patients who achieved complete wound closure reported complete pain resolution. All patients completed the full eight-treatment protocol without reported adverse events.</p><p><strong>Conclusion: </strong>In this small, retrospective, uncontrolled, single-centre case series of 15 patients, combined EMTT/ESWT used as an adjunct to SoC was associated with wound closure (86.7%) and positive pain outcomes (71.9% reduction). Because the study lacked a comparator group, randomisation and blinding, these findings should be interpreted as a preliminary hypothesis rather than as evidence of efficacy. They warrant confirmation in prospective controlled studies.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"35 10","pages":"942-949"},"PeriodicalIF":2.0,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127911","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":"Safety and cost-effectiveness of a pure hypochlorous acid cleansing solution in wounds and non-intact skin management: a narrative review.","authors":"Rene Amaya, David G Armstrong, Abigail E Chaffin, Paul J Kim, Luis G Fernandez, Kara S Couch, John C Lantis, M Mark Melin, Alisha Oropallo, Dennis P Orgill, Kevin Woo, Leanne Atkin, Daniel Chaverri, Hester Colboc, Joachim Dissemond, Viviana Gonçalves, Natalia Maella Rius, Marcin Malka, Dieter O Mayer, Harikrishna Nair, Monira Nou Howaldt, Sebastian Probst, Ewa Klara Stuermer, Laetitia Thomassin, Serge Bohbot, Robert S Kirsner","doi":"10.12968/jowc.2026.0428","DOIUrl":"https://doi.org/10.12968/jowc.2026.0428","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Wound cleansing is an essential part of wound bed preparation and its importance in wound management is supported by numerous international guidelines and consensus documents. Cleansing solutions are used by healthcare professionals for wounds and non-intact skin. However, some of these solutions may not be effective in addressing the condition of the wound or safe enough to be used in certain patients due to the solution's potential for irritation or toxicity. According to guidelines, solution of pure hypochlorous acid (pHA; free of hypochlorite derivatives) provides a good balance between safety and efficacy. This narrative review discusses the clinical evidence available on the use of a pHA solution (Vashe Wound Solution; Urgo Medical North America, US) formulated at 330ppm with a tightly controlled, slightly acidic pH (pH 3.5-5.5).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;A literature search of the Embase, MEDLINE, Google Scholar and TRIP databases was conducted (firstly in December 2025 and updated in June 2026), for original clinical studies reporting the use of the pHA solution, including randomised controlled trials, comparative studies, observational studies, case series/reports and health economic evaluations. Outcomes relating to efficacy, safety, tolerability, acceptability and costs were synthesised narratively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 56 publications were identified and included in the analysis. These clinical evaluations analysed the data of 2968 wounds in 2682 patients, including 140 preterm infants, neonates and children. The treated indications were wounds presenting with risk or clinical signs of local infection, infected wounds, skin tissue or mucosa, including wounds at debridement stage or requiring thorough cleansing, and patients with fragile, immature or non-intact skin. Across the different studies, consistent and concordant outcomes were noted, with a favourable benefit/risk profile of the solution, regardless of the method of application, treated indications and patient populations. Cleansing with the pHA solution, using soaked gauze or different irrigation techniques, to remove debris, slough and foreign bodies from the wound and skin, was found to significantly reduce bacterial growth compared to saline, soap and water, or standard of care, resulting in fewer wound-related complications. The cleanser solution also appeared to facilitate wound debridement, promote wound healing and be cost-effective in numerous indications. The safety profile of the pHA solution was 'very good', and no complication related to its use was reported in any of the clinical evaluations, including in preterm infants.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The clinical evidence identified in this review consistently supported the pHA solution with a slightly acidic pH as a useful option in the management of wounds and non-intact skin, aligned with its intended use, particularly in situations where infectio","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"35 10","pages":"887-x"},"PeriodicalIF":2.0,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128035","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":"Evaluating the efficacy and safety of Neothelium FT placental allograft in the management of hard-to-heal open wounds: a prospective case series.","authors":"John Lantis, Angelina Ferguson, Daniel Kapp, Sarah Moore, Garrett Johnson, Abigail Keaton","doi":"10.12968/jowc.2026.0456","DOIUrl":"https://doi.org/10.12968/jowc.2026.0456","url":null,"abstract":"<p><strong>Objective: </strong>The aetiology of hard-to-heal (chronic) wounds is usually categorised as either 'diabetic foot', 'venous leg ulcer (VLU)', 'arterial', 'pressure injury', 'postoperative' and 'other'. Due to the homogeneity of patients with a diabetic foot ulcer, the majority of studies regarding the efficacy of placental allografts have been in this population of patients, with a small fraction conducted with patients with VLUs. However, insufficient research has been performed regarding advanced modalities for the treatment of other, open hard-to-heal wounds resulting from alternative aetiologies, such as trauma or failed surgical procedures. The aim of this case series was to evaluate the efficacy and safety of a placental allograft in the treatment of hard-to-heal VLUs.</p><p><strong>Method: </strong>This prospective case series encompassed patients with hard-to-heal open wounds on various parts of their body and who received weekly applications of a placental allograft (Neothelium FT, Surgenex, LLC., US). Wound surface area was measured weekly prior to each application of the placental allograft to quantify wound size and calculate percent area reduction (PAR).</p><p><strong>Results: </strong>A total of 10 patients-three males and seven females- were included. Mean initial wound area was 11.98cm². Of the eight patients who achieved complete healing (80% closure rate), the average number of allograft applications was 5.13 (median: 5). The patients demonstrated an average PAR of 87.48% by study completion.</p><p><strong>Conclusion: </strong>The findings of this study suggest that the placental allograft used may offer an effective treatment option for patients with hard-to-heal open wounds.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"35 10","pages":"868-875"},"PeriodicalIF":2.0,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127840","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":"Biomechanical influence of cavity fillers on periwound soft tissue strains in sacral pressure injuries.","authors":"Coraline Staub-Milants, Grégory Chagnon, Noémie Briot, Laurent Pasquinet, Yohan Payan","doi":"10.12968/jowc.2026.0310","DOIUrl":"https://doi.org/10.12968/jowc.2026.0310","url":null,"abstract":"<p><strong>Objective: </strong>Deep cavity pressure injuries (PIs) are commonly managed with wound fillers, the biomechanical role of which remains poorly understood. This study aimed to assess how the mechanical properties of filler influence periwound soft tissue strains.</p><p><strong>Method: </strong>The study combined hydrated mechanical testing of commercial cavity fillers with finite element modelling of sacral stage 3 PIs to assess how filler-related parameters affected periwound soft tissue shear strains.</p><p><strong>Results: </strong>Sensitivity analysis showed that filling ratio was the dominant factor governing the volume of mechanically preserved tissue, outweighing filler stiffness, friction and compressibility. High filling ratios markedly reduced strain concentrations, while more compliant, adipose-like fillers further improved tissue protection.</p><p><strong>Conclusion: </strong>The findings of this study highlight the importance of dead-space elimination and tissue-matched filler design to mechanically protect the surrounding tissues and thereby improve healing.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"35 10","pages":"950-957"},"PeriodicalIF":2.0,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127845","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":"Native collagen matrix plus PHMB antimicrobial in hard-to-heal diabetic foot ulcers: results from the PREPARE randomised controlled trial.","authors":"Leandro Tapia Garcia, Jaminelli Banks, Manuel Rodriguez, Shawn M Cazzell, Joseph M Caporusso, Windy Cole, Dereck Shi, Emily Cook, Brianna Tramelli, Thomas E Serena","doi":"10.12968/jowc.2026.0369","DOIUrl":"https://doi.org/10.12968/jowc.2026.0369","url":null,"abstract":"<p><strong>Objective: </strong>PREPARE was a prospective, multicentre, randomised controlled trial evaluating purified native type 1 collagen extracellular matrix plus polyhexamethylene biguanide (PCMP) with standard of care (SoC) versus SoC alone in patients with hard-to-heal diabetic foot ulcers (DFUs).</p><p><strong>Method: </strong>Across 25 US sites, patients with type 1 or type 2 diabetes and hard-to-heal DFUs measuring 1-25cm² were enrolled. Patients demonstrating ≥40 percent area reduction (PAR) during four weeks of screening were excluded to restrict the study population to those with hard-to-heal wounds. SoC included sharp debridement, saline cleansing, use of moisture-balancing dressings and offloading. The primary endpoint was complete wound closure within 12 weeks, confirmed two weeks later. Secondary endpoints included time to closure, PAR and adverse events (AEs).</p><p><strong>Results: </strong>A total of 170 patients were randomised (PCMP+SoC, n=96; SoC alone, n=74). Complete wound closure occurred in 42% of patients receiving PCMP+SoC versus 27% of patients receiving SoC alone (absolute difference 14.6%; 95% confidence interval: 0.15%, 27.9%; p=0.047). Mean PAR was greater with PCMP+SoC than with SoC alone (75.23% versus 58.06%, respectively). No AEs or serious AEs were attributed to PCMP.</p><p><strong>Conclusion: </strong>In this study, use of PCMP+SoC significantly improved 12-week closure outcomes in patients with hard-to-heal DFUs compared with SoC alone, supporting its use as an adjunctive antimicrobial barrier for these types of wounds.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"35 10","pages":"876-886"},"PeriodicalIF":2.0,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127850","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":"Rare aetiologies of leg ulcers: a prospective analysis.","authors":"Dorota Piechota, Marcela Millberg, Wioletta Barańska-Rybak","doi":"10.12968/jowc.2023.0269","DOIUrl":"https://doi.org/10.12968/jowc.2023.0269","url":null,"abstract":"<p><strong>Objective: </strong>As treatment guidelines differ based on the causal effects of hard-to-heal (chronic) leg ulcers, correct diagnosis is essential for the best therapeutic outcomes. The aim of the study was to ascertain the prevalence of patients displaying atypical and uncommon manifestations of hard-to-heal leg ulcers and to explore the corresponding diagnostic challenges.</p><p><strong>Method: </strong>This was a prospective analysis of the aetiologies of hard-to-heal leg ulcers in patients hospitalised at the University Clinic of Dermatology, Venereology and Allergology, Poland, between 2015-2022. Data were coded into a database. Patients had an initial diagnosis of L97 according to the International Classification of Disease (ICD)-10-a non-pressure hard-to-heal ulcer of the lower limb, not elsewhere classified. Ulcer duration was >6 weeks, as this is the most used definition of a hard-to-heal wound.</p><p><strong>Results: </strong>Of the 327 patients who took part in the study, 119 had a diagnosis other than vascular. Patients were aged between 18-97 (mean 67.5) years; 163 were male and 164 were female. In patients with ulcers of rare aetiology, the most common was pyoderma gangrenosum, followed by vasculitis, then neoplasms or complication after antineoplastic treatment.</p><p><strong>Conclusion: </strong>It is important to be acquainted with rare aetiologies of leg ulcers for best therapeutic outcome, as atypical ulcers may require different treatment modalities.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"35 10","pages":"926-930"},"PeriodicalIF":2.0,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127883","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":"Review and analysis of healing durability in lower extremity wounds treated with intermittent cyclically pressurised topical wound oxygen.","authors":"John Steinberg, Dot Weir, Michael Pierides, Barry Rosenblum, Kathleen Ozsvath","doi":"10.12968/jowc.2026.0475","DOIUrl":"10.12968/jowc.2026.0475","url":null,"abstract":"<p><strong>Objective: </strong>Diabetic foot ulcers and venous leg ulcers (VLUs) frequently recur after closure, and because the underlying disease persists, a more meaningful endpoint to consider is durable healing: sustained closure with low recurrence and fewer complications. Mechanistically, topical wound oxygen supports antimicrobial defence, angiogenesis and collagen cross-linking, while cyclical compression reduces oedema and enables timely resolution of inflammation, improving the structural quality of repaired tissue rather than merely closing the wound. Combining both modalities in one device offers a plausible mechanism for the durability observed across diverse wound aetiologies and comorbid populations.</p><p><strong>Method: </strong>Clinical and mechanistic evidence was synthesised on the durability of healing achieved by intermittent cyclically pressurised topical wound oxygen (CPTWO) therapy in hard-to-heal (chronic) lower extremity wounds.</p><p><strong>Results: </strong>In a double-blind randomised trial, adjunctive CPTWO therapy doubled the proportion of ulcers closed at 12 months (56% versus 27%) and tripled 12-week closure (41.7% versus 13.5%; adjusted odds ratio: 6.00). In refractory VLUs, an observational comparative study reported 36-month recurrence with CPTWO of 5.9% versus 46.7% without. In a large retrospective cohort study among 3126 previously refractory wounds, 64.8% healed completely with 2.7% recurrence-related retreatment with CPTWO, and a propensity score-matched Veterans Affairs cohort showed 73% fewer amputations and 82% fewer hospitalisations. As most meta-analyses pool mechanistically different oxygen devices, durability-specific evidence rests uniquely on the CPTWO studies.</p><p><strong>Conclusion: </strong>Randomised, real-world, and mechanistic evidence converge in support of durable healing with reduced recurrence in hard-to-heal lower extremity wounds. Together with its home-based, patient-administered delivery, these findings favour earlier, durability-focused adoption of CPTWO therapy in refractory wounds.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"35 10","pages":"856-867"},"PeriodicalIF":2.0,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127936","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":"Vacuum-assisted closure therapy in the management of patients with necrotising fasciitis.","authors":"Fei Long, Elan Yang, Zhi Wang, Zhifei Liu, Huaiwu He, Xiaojun Wang","doi":"10.12968/jowc.2021.0052","DOIUrl":"https://doi.org/10.12968/jowc.2021.0052","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to compare vacuum-assisted closure (VAC) and conventional wound dressings in patients with necrotising fasciitis (NF).</p><p><strong>Method: </strong>In this retrospective study, patients presenting with soft tissue infection and who were diagnosed with NF were enrolled, and divided into those treated with VAC therapy after the first surgical debridement (VAC group) and those patients treated with conventional dressing after surgery (non-VAC group).</p><p><strong>Results: </strong>A total of 72 patients were included (43 patients in the VAC group and 29 patients in the non-VAC group). In the VAC group, VAC dressings were changed every 3-5 days, and patients had an average of five (range: 3-8) treatment sessions with an average hospital stay of 22.3 days (range: 14-39 days). In the non-VAC group, patients had an average of nine (range: 6-14) treatment sessions with five (range: 3-8) dressing changes every day during treatment, and had longer lengths of hospital stay of 41.1 days (range: 29-84 days). When compared to the non-VAC group, patients treated with VAC had a lower mortality rate and enabled the use of a simpler method of wound reconstruction (such as direct suture or skin graft).</p><p><strong>Conclusion: </strong>In this study, findings showed that VAC therapy promoted infection control, reduced daily nursing care and increased wound healing, and patients had a shorter hospital stay and lower mortality rate.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"35 10","pages":"958-964"},"PeriodicalIF":2.0,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127942","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}