Journal of wound care最新文献

{"title":"Increased morbidities in pyoderma gangrenosum with extensive surgical debridement in Taiwan: a case series.","authors":"Yi-Li Hou, Chih-Hung Lee, Yu-Wen Cheng","doi":"10.12968/jowc.2022.0041","DOIUrl":"https://doi.org/10.12968/jowc.2022.0041","url":null,"abstract":"<p><strong>Objective: </strong>Delayed diagnosis and consequent extensive debridement in cases of pyoderma gangrenosum (PG) may lead to poor wound healing and unfavourable prognosis. We aimed to evaluate the epidemiological and clinical features of PG in Taiwan and investigate the clinical courses of patients who underwent extensive surgical debridement.</p><p><strong>Method: </strong>In this retrospective study, patients diagnosed with PG at a referral centre in Taiwan between 2001 and 2021 were recruited. The patients were divided into a debrided group and a non-debrided group.</p><p><strong>Results: </strong>The cohort comprised a total of 15 patients, five of whom were in the debrided group and 10 in the non-debrided group. Among all 15 patients, the average age at diagnosis was 40 years with a male preponderance (67%). PG tended to involve multiple sites (73%), the lower limbs (87%), ulcerations (80%) and had a diameter <10cm (93%). Seven patients (47%) had medical comorbidities, including inflammatory bowel disease (20%) and hypertension (20%). Ulcerative manifestations, lack of typical associated comorbidities, delayed diagnosis, prolonged lengths of hospitalisation, and high cumulative doses of systemic corticosteroids were observed in the debrided group.</p><p><strong>Conclusion: </strong>This is the first study to describe the epidemiological and clinical characteristics of PG in Taiwan in English to our knowledge. The results were mostly consistent with the existing literature, except an apparent male preponderance. Moreover, we highlight the importance of accurate diagnosis and avoidance of aggressive surgical debridement in patients with PG for both dermatologist and non-dermatologist.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"34 5","pages":"380-384"},"PeriodicalIF":1.5,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029352","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":"Hypervitaminosis D and hard-to-heal wounds: a case report.","authors":"Thomas Steve Jessop, Nicolas Kairinos","doi":"10.12968/jowc.2023.0177","DOIUrl":"https://doi.org/10.12968/jowc.2023.0177","url":null,"abstract":"<p><p>Vitamin D is thought to be safe due to its wide therapeutic index and concentrations are rarely raised to toxic levels in the blood. However, excessive vitamin D supplementation can lead to hypervitaminosis D, causing hypercalcaemia and hyperphosphataemia. Due to its lipid solubility, vitamin D can be stored in adipose tissue, leading to persistent hypercalcaemia, even after supplementation has been discontinued. This case reports an 81-year-old female patient who developed hypervitaminosis D after taking excessive vitamin D supplementation for 30 years. The patient presented with complex bilateral leg wounds and tissue calcification. This case highlights the importance of monitoring vitamin D supplementation and the risks associated with hypervitaminosis D, including soft tissue calcification.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"34 5","pages":"368-371"},"PeriodicalIF":1.5,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015526","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":"Diabetic foot ulcer treatment with a multimodal wound matrix.","authors":"Mostafa Javanian, Mohammad Barary, Fatemeh Rasolpoor, Soheil Ebrahimpour","doi":"10.12968/jowc.2024.0370","DOIUrl":"https://doi.org/10.12968/jowc.2024.0370","url":null,"abstract":"","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"34 5","pages":"372"},"PeriodicalIF":1.5,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017371","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":"Coordination in pathways of care, e-health and AI in wound healing.","authors":"Luc Téot","doi":"10.12968/jowc.2025.0154","DOIUrl":"https://doi.org/10.12968/jowc.2025.0154","url":null,"abstract":"","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"34 5","pages":"339"},"PeriodicalIF":1.5,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006378","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":"Response to: Diabetic foot ulcer treatment with a multimodal wound matrix.","authors":"Richard Simman, Suzanne J Bakewell, Desmond Bell, Susan Shuman, Mary Cheney","doi":"10.12968/jowc.2025.0163","DOIUrl":"https://doi.org/10.12968/jowc.2025.0163","url":null,"abstract":"","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"34 5","pages":"374"},"PeriodicalIF":1.5,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006605","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":"It is time for a consensus on a definition for skin failure.","authors":"Kenneth Olshansky","doi":"10.12968/jowc.2025.0087","DOIUrl":"https://doi.org/10.12968/jowc.2025.0087","url":null,"abstract":"","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"34 Sup5","pages":"S3-S4"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026812","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 hidden costs of limiting access: clinical and economic risks of Medicare's future effective cellular, acellular and matrix-like products (CAMPs) Local Coverage Determination.","authors":"William Tettelbach, David Armstrong, Jeffery Niezgoda, Naz Wahab, Windy Cole, Travis Tucker, Martha R Kelso","doi":"10.12968/jowc.2025.0120","DOIUrl":"https://doi.org/10.12968/jowc.2025.0120","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To evaluate the impact of Medicare's future effective Local Coverage Determination (LCD) for cellular, acellular and matrix-like products (CAMPs), which, while informed by a literature review and expert input, was finalised without incorporating a detailed statistical or cost analysis of its projected clinical and economic impact across diverse wound care delivery settings (e.g., hospital-affiliated, private practice, and post-acute care). This analysis focuses on the clinical consequences for Medicare beneficiaries with chronic or hard-to-heal lower extremity diabetic ulcers (LEDUs) and venous leg ulcers (VLUs). Additionally, it aims to assess the economic implications of implementing a capitated or fixed-fee schedule on CAMPs' use, Medicare expenditures and associated medical outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;A review of retrospective analyses of Medicare claims (2015-2020) was conducted, comparing treatment outcomes for LEDUs and VLUs using CAMPs plus medically accepted standard of care (SoC) versus SoC without CAMPs. Clinical endpoints included rates of hard- to-heal ulcer healing, amputation rates, hospitalisations and healthcare resource use. Cost-effectiveness models evaluated the impact of CAMP reimbursement structures on overall Medicare costs. Analysing the impact of a fixed-fee schedule involved evaluating Medicare claims data from 2016-2023 to determine the number of commercially available CAMPs, along with the most up-to-date average sales price (ASP). A comparative cost analysis model using an activity-based costing approach and a prospective payment system comparison was applied to evaluate two distinct reimbursement structures: an ASP fee-for- service model versus a fixed-fee schedule model.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Medicare beneficiaries receiving SoC plus CAMPs for stalled wounds demonstrated significantly lower amputation rates, reduced hospitalisations and improved wound healing times compared with those receiving SoC without a CAMP during the episode of care. Beneficiaries receiving CAMPs also realised annual cost savings of $3670 USD per patient and a five-year net benefit of $5003 USD per patient. When evaluating over a 12-month window, restricting CAMPs to eight applications in the treatment of hard-to-heal VLUs and LEDUs resulted in estimated treatment failure rates of 10.9% and &gt;30%, depending on the area of investigation. Moreover, the non-real-world restriction of a 16-week treatment episode in the future effective CAMP LCD, which fails to account for care delays (e.g., cellulitis, hospital admissions), will likely drive treatment failure rates even higher. Among failed LEDU cases receiving a CAMP, 1% require an amputation at a reimbursement rate of $23,435 USD per case, 37% are readmitted at a rate of $2079 USD per admission, and 30% seek emergency care at a reimbursement rate of $8292 USD per visit. These complications could result in hundreds of millions of dollars in add","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"34 Sup5","pages":"S5-S14"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042398","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":"Risk-based safety and quality management strategies in wound care trials at a tertiary, safety net hospital.","authors":"Nolan P Joyce, David Coker, Vitaliy Volansky, Marina A Malikova","doi":"10.12968/jowc.2023.0174","DOIUrl":"https://doi.org/10.12968/jowc.2023.0174","url":null,"abstract":"<p><strong>Objective: </strong>An analysis of risk factors affecting wound care clinical trials was performed to develop proactive risk mitigation strategies, and improve the safety and quality of trials conducted. Adherence to study protocol and compliance with regulatory requirements was examined, based on the rate of protocol deviations.</p><p><strong>Method: </strong>Prospective, randomised clinical trials for diabetic foot ulcers (DFUs) and venous leg ulcers (VLUs) were compared for rates/types of deviations from study protocols. Adverse events were analysed in enrolled participants. The rate and patterns of serious adverse events (SAEs) and non-serious adverse events (AEs) were compared between the two wound indications.</p><p><strong>Results: </strong>In all, 15 trials with a total of 261 participants and 223 adverse events were included in the analysis. The DFU group was noted to have a 10.4% higher incidence of SAEs and a 7.3% higher incidence of having any AEs compared with the VLU group. Analysis showed a higher number of deviations (n=325) in VLU trials compared with DFU trials (n=128). Overall, VLUs and DFUs had rates of deviation of 1.9 and 1.4 per enrolled patient, respectively.</p><p><strong>Conclusion: </strong>An understanding of the frequency/types of adverse events can contribute to the development of safety monitoring plans and risk mitigation strategies for wound care trials. Effective training and retention of research coordinators can reduce the number of deviations, and an understanding of the frequency and types of adverse events can inform safety management/risk mitigation plans.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"34 Sup5","pages":"S34-S44"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028620","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":"Automating collection of patient-reported outcome measures in a high-volume tertiary wound care centre.","authors":"Samuel S Huffman, Daisy L Spoer, Lauren E Berger, John S Steinberg, Christopher E Attinger, Kenneth L Fan, Karen K Evans","doi":"10.12968/jowc.2023.0025","DOIUrl":"https://doi.org/10.12968/jowc.2023.0025","url":null,"abstract":"<p><p>Wound care centres offer opportunities to assess and compare treatment strategies and experiences across different sites through clinical research, with the ultimate goal of optimising patient care. However, recruitment of eligible participants is critical to successful and timely study completion. In this article, the authors describe the implementation of a patient-initiated approach to patient-reported outcome measure research in hard-to-heal (chronic) lower extremity wounds. The approach uses quick-response (QR) codes and automated patient identification. This process enables recruitment of patients without the need for in-person research personnel, results in minimal disruptions to clinic workflow, and captures an important dimension of wound care during under-used time in patient waiting rooms.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"34 Sup5","pages":"S45-S48"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989431","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":"Comparing oxygenation assessment methods for the interventional management of hard-to-heal wounds.","authors":"Caroline Mussatto, Adam Nygard, Kris Butler, Lucas Richards, Brenden Bombardier, Lauren Clark, Yanming Li, Kate Young, Carissa Walter, Peyton Ackerman, Steven Orr, Aaron Rohr, Kamal Gupta, Adam Alli","doi":"10.12968/jowc.2023.0022","DOIUrl":"https://doi.org/10.12968/jowc.2023.0022","url":null,"abstract":"<p><strong>Objective: </strong>To compare transcutaneous oxygen measurement (TCOM) and near infrared spectroscopy (NIRS) measurement of tissue oxygen levels in hard-to-heal (chronic) wounds.</p><p><strong>Method: </strong>Patients aged 18-85 years presenting with hard-to-heal lower extremity wounds between 1 December 2019 and 31 July 2020 were included in this cross-sectional study. TCOM and NIRS measurements of tissue oxygenation were obtained. Data were stratified by wound severity (Wagner score), skin pigmentation (Fitzpatrick skin type), and use of melanin correction for NIRS measurement.</p><p><strong>Results: </strong>A total of 76 patients were included. Correlation coefficients between TCOM and NIRS with melanin correction were obtained for: Fitzpatrick I-III (p=0.41); Fitzpatrick IV-VI (p=0.08); Wagner 0-2 (p=0.22); Wagner 3-5 (p=0.34). Results without melanin correction were: Fitzpatrick I-III (p=0.19); Fitzpatrick IV-VI (p=0.08); Wagner 0-2 (p=0.05); and Wagner 3-5 (p=0.34).</p><p><strong>Conclusion: </strong>There was only one significant correlation between TCOM and NIRS measurements of tissue oxygenation in patients with hard-to-heal lower extremity wounds and that was for patients with Wagner scores of 0-2 without melanin correction. Further investigation is needed on the application of NIRS to guide the interventional management of hard-to-heal wounds.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"34 Sup5","pages":"S26-S32"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006983","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}