Journal of wound care最新文献

{"title":"Innovative treatment of diabetic ulcers: combining chemical debridement and xenograft applications: a case study.","authors":"William Tettelbach, Nya Akoteu, Katrina-Anne Palu, Emily Walsh, Michelle Moore","doi":"10.12968/jowc.2025.0010","DOIUrl":"https://doi.org/10.12968/jowc.2025.0010","url":null,"abstract":"<p><p>Lower extremity diabetic ulcers (LEDUs) are a common, high-morbidity complication of diabetes, frequently leading to infections, hospitalisations and emergency department visits. This case study examines the treatment effectiveness of a novel wound care approach in a 57-year-old female patient with a hard-to-heal LEDU (a diabetic foot ulcer of the left lower extremity) complicated by poorly controlled diabetes (glycated haemoglobin A1c: 13%). Initially, standard of care (SoC) practices, including alginate dressings, hypochlorous acid gel and sharp debridement, were ineffective in promoting significant healing. This case was further challenged by its occurrence in the remote setting of Tongatopu within the Kingdom of Tonga, where advanced wound care materials and even SoC products are not consistently available, underscoring the need for innovative and adaptable treatment strategies. A new regimen was subsequently initiated that involved preparing the wound bed through chemical debridement using a topical desiccating agent (TDA) with methanesulfonic acid (DEBRICHEM, DEBx Medical, the Netherlands), which has the ability to denature proteins and reduce microbial biofilms, necrotic tissue and inflammatory proteins in the wound bed. This was followed by the application of ovine forestomach matrix (OFM) grafts containing hyaluronic acid (Symphony, Aroa Biosurgery, New Zealand), which was applied at approximately 12-day intervals. Over the 110 days following the initial application of the TDA, the LEDU showed significant improvement as it progressed along the healing cascade towards closure. This case report provides insights into the potential of combined desiccating chemical debridement and xenograft-based wound care in treating hard-to-heal LEDUs, highlighting an approach that could inform future clinical practices in diabetic wound care.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"34 3","pages":"200-204"},"PeriodicalIF":1.5,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567549","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":"Long-term patient satisfaction with their split-thickness skin graft donor site and the need for improved preoperative counselling.","authors":"Daniëlle Rijpma, Annebeth Meij-de Vries, Annika Reuvers, Tsjitske Haanstra, Paul van Zuijlen, Anouk Pijpe","doi":"10.12968/jowc.2023.0037","DOIUrl":"https://doi.org/10.12968/jowc.2023.0037","url":null,"abstract":"<p><strong>Objective: </strong>There is a lack of studies on patient-reported outcomes of split-thickness skin graft (STSG) donor sites, especially on patient satisfaction. Donor site counselling could contribute to realistic patient expectations, which could improve postoperative patient satisfaction. Therefore, this study aimed to investigate donor site counselling and patient satisfaction with the final donor site outcome.</p><p><strong>Method: </strong>Preoperative consultations were observed and given donor site information reviewed by means of a checklist. Next, a dual survey on donor site satisfaction and patient-reported donor site scar quality (measured using the patient scale of the Patient and Observer Scar Assessment Scale 3.0 adapted for this study to cover the donor site) was sent to patients who received STSG surgery 12±3 months prior to the study start. A backward linear regression analysis was used to identify potential satisfaction predictors.</p><p><strong>Results: </strong>A total of 35 preoperative consultations were observed (19 adult and 16 paediatric consultations) and 36 patients (mean age: 41 years) responded to the survey. For the adults, 'location options' was the most discussed item and 'size' was the least discussed. Of the patients, 83% were satisfied with the donor site in general and 50% were dissatisfied with postoperative complaints, such as pain or itching. Most (92%) patients experienced colour differences, which was also a negative predictor for satisfaction with donor sites in general and their appearance. Being male was a positive predictor for satisfaction with donor sites in general, size and colour differences.</p><p><strong>Conclusion: </strong>The majority of patients in the study were satisfied with their donor sites. Dissatisfaction was observed with size, appearance and postoperative complaints. Unrealistic expectations could play a role in dissatisfaction; information tools as illustrations and animations may help in managing patient expectations. Future research should focus on improvement of patient satisfaction with donor site aspects such as size and colour.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"34 3","pages":"228-238"},"PeriodicalIF":1.5,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567550","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":"Use of prolonged closed suction drainage for synovial fluid-draining wounds around the ankle.","authors":"Park Hyun-Jin, You Ki-Han, Hong Seokho, Kim Hyong Nyun","doi":"10.12968/jowc.2022.0029","DOIUrl":"10.12968/jowc.2022.0029","url":null,"abstract":"<p><strong>Objective: </strong>When synovial fluid drains through a wound, cells necessary to form tissue required for healing are washed away. This results in failure of wound closure, often necessitating a pedicled or free flap reconstruction. We hypothesised that prolonged (>48 hours post surgery) closed suction drainage can reduce the fluid draining through the wound, enabling wound healing and eliminating the need for a pedicled or free flap reconstruction. We also aimed to determine whether prolonged application of closed suction drainage would increase postoperative infection.</p><p><strong>Method: </strong>A retrospective study was performed between August 2015 and December 2020. Patients with fluid-draining wounds around the ankle which had failed to respond to treatment with delayed closure and which required the use of prolonged closed suction drainage were included. Closed suction (Jackson-Pratt, JP) drainage was applied from the time of wound closure until the wound healed.</p><p><strong>Results: </strong>A total of 20 patients (12 male: eight female; mean age: 52 years; range: 21-74 years) were included in the study. The results showed the JP drain being kept for a mean of 14.1±1.8 (range: 9-16) postoperative days. Prolonged closed suction drainage helped achieve wound closure in 19 (95%) patients. Only one patient with Achilles tendon exposure underwent sural flap surgery. None of the patients developed an infection due to prolonged use of the JP drain. With regards to patient satisfaction, four (21%), 10 (53%), four (21%) and one (5%) patients were 'very satisfied', 'satisfied', 'fair' and 'dissatisfied', respectively, with the results of the treatment technique at follow-up (mean: 29.9; range: 12-72 months). The remaining patient was lost to follow-up.</p><p><strong>Conclusion: </strong>Prolonged application of closed suction drainage made wound closure possible for synovial fluid-draining wounds, eliminating the need for a pedicled or free flap surgery, without increasing the rates of wound infection. This technique could be used as an adjunct to the local flap, negative pressure wound therapy or other reconstructive techniques at the time of revision surgery.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"34 Sup3","pages":"xxii-xxix"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143582317","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 in secondary wound healing after pilonidal sinus surgery.","authors":"Akyol Hüseyin, Erok Berrin","doi":"10.12968/jowc.2021.0250","DOIUrl":"10.12968/jowc.2021.0250","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluated the utility of vacuum-assisted closure (VAC) in comparison to standard open wound care in patients operated for pilonidal sinus disease (PSD).</p><p><strong>Method: </strong>Patients with PSD who underwent standard pilonidal sinus excision-lay open technique/surgery in the Altınbas University School of Medicine Bahcelievler Medical Park Hospital, Istanbul, Turkey, between May 2015 and May 2018, were included in this study. A retrospective analysis of prospectively collected data was performed. The patients were divided into two groups according to the type of wound care, including the vacuum-assisted closure group (n=30, postoperative vacuum-assisted closure application) and the control group (n=30, standard open wound care). Wound size, postoperative infection rates and wound healing times were compared between study groups.</p><p><strong>Results: </strong>The experimental cohort included 60 patients. There was no statistically significant difference between vacuum-assisted closure and the control groups in terms of preoperative and postoperative infection rates (p>0.05). The total recovery time (time to complete wound healing) was significantly shorter in the vacuum-assisted closure group compared with the control group (21.47±4.38 days versus 67.60±7.83 days, p=0.001).</p><p><strong>Conclusion: </strong>The findings of this study emphasise that the use of vacuum-assisted closure in PSD patients treated with the lay-open technique seems notable in terms of its potential to shorten the otherwise longer secondary recovery time and thus enables the consideration of the lay-open technique once again among the most preferable methods. However, there is a need for larger scale prospective studies addressing the utility of vacuum-assisted closure in patients with PSD to validate these findings.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"34 Sup3","pages":"xxxix-xliii"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143582318","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":"Autologous adipose-derived tissue stromal vascular fraction and intralesional epidermal growth factor combined application in patients with diabetic foot.","authors":"Mustafa Aydın, Simay Akyüz, Hamdullah Yanik, Eda Yildirim, Ali Murat Başak, Hikmet Erhan Güven, Yasin Gülap, Kerim Bora Yilmaz","doi":"10.12968/jowc.2024.0107","DOIUrl":"10.12968/jowc.2024.0107","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to evaluate the effect on wound healing of intralesional epidermal growth factor (iEGF) (Heberprot-p; Hasbiotech, Cuba) and autologous adipose-derived tissue stromal vascular fraction (AD-tSVF) applied in the closure of tissue defects.</p><p><strong>Method: </strong>The patients included in the study were separated into three approximately equal groups: Group 1 with iEGF+AD-tSVF applied; Group 2 with iEGF only applied; and Group 3 with conventional wound care products applied. Granulation tissue was taken from the wound bed before the application of iEGF and AD-tSVF and at intervals thereafter for flow cytometry analysis.</p><p><strong>Results: </strong>Group 1 included 11 patients; Group 2 included 10 patients; and Group 3 included 10 patients. The time to re-epithelialisation was determined as 187.60±68.78 days in Group 3 patients compared with Group 1 (72.27±10.33 days) and Group 2 (70.50±18.02 days) (p<0.001). Following the application of iEGF to the wound bed, an increase was observed in M2 macrophage (CD209+), and M1 macrophage (CD38+) levels. The (CD34+) stem cells obtained from the granulation tissue after the application of AD-tSVF were determined to still be statistically significantly increased in the wound bed on the 21st day.</p><p><strong>Conclusion: </strong>The results of this study demonstrated that the application of iEGF and iEGF+ AD-tSVF significantly shortened the wound healing period compared with conventional methods. AD-tSVF stands as an effective option, especially in the patient group with halted or delayed wound healing despite the application of iEGF. Moreover, the significant increase (p<0.001) in the level of M2 macrophages (CD209+), M1 macrophages (CD38+) and stem cells (CD34+) provided by this treatment modality showed that it contributed to wound healing at the cellular level.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"34 Sup3","pages":"xxx-xxxviii"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143582316","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 inducing effect of epidermal growth factor on acellular dermal matrix in a rat model of skin regeneration.","authors":"Seyedeh-Sara Hashemi, Parisa Sanati, AliReza Rafati","doi":"10.12968/jowc.2021.0286","DOIUrl":"https://doi.org/10.12968/jowc.2021.0286","url":null,"abstract":"<p><strong>Objective: </strong>Tissue engineering, a novel approach in dermatology, has resulted in the development of scaffolds as skin substitutes that have accelerated wound healing. The aim of the present study was to synthesise acellular dermal matrix (ADM) as a dermal alternative and assess the effect of human epidermal growth factor (EGF) on the proliferation and migration of seeded fibroblast cells.</p><p><strong>Method: </strong>ADM from fresh, full-thickness human skin was developed and characterised. Next, foreskin fibroblast cells were isolated, cultured and characterised. The fibroblast cells were sown into the ADM in two groups: one with EGF and one without EGF. We assessed the adhesion and proliferation of the cells on the scaffold by scanning electron microscopy, and thiazolyl blue tetrazolium bromide and 4',6-diamidino-2-phenylindole staining. For the animal study, 30 rats were divided into two equal groups at random (ADM, ADM+EGF). Wound healing was assessed macroscopically, histologically and by real-time polymerase chain reaction for Bax and Bcl-2 gene expression.</p><p><strong>Results: </strong>The ADM characterisation results showed that the scaffold was dense and integral with good stretching. The morphology and phenotype of the isolated fibroblast cells confirmed their identity. The fibroblast cells cultured on the ADM showed proliferation, which improved with the addition of EGF. In the animal model, EGF addition caused significantly (p<0.05) improved wound healing compared with isolated ADM; it also resulted in increased Bcl-2 and reduced Bax expressions.</p><p><strong>Conclusion: </strong>A combination of ADM, fibroblast cells and EGFs could serve as skin substitutes and represent a novel therapeutic methodology for treating burns and hard-to-heal wounds.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"34 2","pages":"137-145"},"PeriodicalIF":1.5,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391206","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 efficacy and safety of acids as topical antimicrobial agents: a review.","authors":"Basavraj S Nagoba, Abhijit S Rayate, Ajay M Gavkare, Arunkumar Rao","doi":"10.12968/jowc.2023.0176","DOIUrl":"https://doi.org/10.12968/jowc.2023.0176","url":null,"abstract":"<p><strong>Objective: </strong>Infected wounds, refractory to conventional therapy, are a major burden on the healthcare system. Available data show that many commonly used antiseptic agents may be toxic to the cells involved in the healing process and may affect the normal tissue repair. The topical use of different acids to control wound infections effectively and promote healing is well known. The present review aims to summarise the safety and efficacy of various acids as topical agents for treating wound infections.</p><p><strong>Method: </strong>A literature search was performed in PubMed and manually from other sources (cross references and journal sites).</p><p><strong>Results: </strong>We reviewed 116 articles, from which data from 86 relevant articles were analysed. The studies showed that various organic acids were clinically effective in treating wound infections.</p><p><strong>Conclusion: </strong>This study found that various organic acids can act as a substitute for antiseptics to control wound infections refractory to conventional antibiotic therapy and local wound care. Various organic acids differ in efficacy, safety and limitations as topical agents to control wound infections and promote healing. Some acids deliver better results than others, particularly in those cases in which antibiotics and routine antiseptic agents yield little lasting success, especially in controlling hospital strains with multiple antibiotic resistance. Among topically used acids, citric acid and acetic acid are associated with better results.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"34 2","pages":"119-127"},"PeriodicalIF":1.5,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391204","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":"Errata.","authors":"","doi":"10.12968/jowc.2025.34.2.163","DOIUrl":"https://doi.org/10.12968/jowc.2025.34.2.163","url":null,"abstract":"","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"34 2","pages":"163"},"PeriodicalIF":1.5,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391135","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":"Usefulness of a negative pressure wound therapy system for stoma closure.","authors":"Chisato Shirakawa, Yuzuru Sakamoto, Shinya Ueki, Hiroki Shomura, Keizo Kazui, Akinobu Taketomi","doi":"10.12968/jowc.2023.0320","DOIUrl":"https://doi.org/10.12968/jowc.2023.0320","url":null,"abstract":"<p><strong>Objective: </strong>Although wound infection rates after stoma closure have decreased, they remain high. Negative pressure wound therapy (NPWT) for stoma closure wounds can shorten healing time for many wound types. The PICO (Smith+Nephew, UK) wound dressing, a single-use NPWT system that can be used for outpatients, was introduced at the Japan Community Health Care Organization Hokkaido Hospital, Japan in November 2017. We evaluated the effectiveness of this dressing in stoma closure wounds.</p><p><strong>Method: </strong>We retrospectively evaluated patients who underwent stoma closure between March 2012 and July 2021. We compared postoperative short-term outcomes (surgical site infection (SSI), number of pain medications, and postoperative hospital stay) by allocating the patients to one of two groups: purse-string closure or purse-string closure with PICO. The purse-string closure group (PC) underwent purse-string closure alone, while the other group underwent purse-string closure and PICO (PCP).</p><p><strong>Results: </strong>A total of 35 patients were evaluated; 20 in the PC group and 15 in the PCP group. No significant differences in characteristics were noted between the groups. Comparisons between stoma closure techniques revealed that the PCP group had shorter hospital stays (p=0.04), lower SSI rates (p=0.04), and less pain medication (p<0.01) than the PC group. Comparisons between SSI occurrence revealed that the group of patients with an SSI had a higher number of colostomies compared with ileostomies (37.5% versus 0%, p<0.01, respectively), used more pain medication (p<0.01), and had longer hospital stays (p=0.04) than patients who did not have an SSI.</p><p><strong>Conclusion: </strong>After stoma closure, combining PICO with purse-string closure may be effective in preventing SSI and controlling postoperative pain.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"34 2","pages":"106-110"},"PeriodicalIF":1.5,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390474","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":"Interruption versus continuation of adalimumab during hidradenitis surgery: secondary wound healing and postoperative complications.","authors":"Pelin Esme, Aysenur Botsali, Ercan Caliskan","doi":"10.12968/jowc.2021.0365","DOIUrl":"https://doi.org/10.12968/jowc.2021.0365","url":null,"abstract":"<p><strong>Objective: </strong>The combination of adalimumab and surgical interventions plays a crucial role in managing severe hidradenitis suppurativa (HS). However, there is still limited scientific evidence regarding administering adalimumab during the perioperative period. This study aimed to evaluate whether adalimumab could adversely affect postoperative complications and the total time of wound closure (TTWC) in patients undergoing cutaneous surgery for HS.</p><p><strong>Method: </strong>In this single-centre cohort study, patients with HS were allocated to two groups. Group 1 (biological cohort) consisted of patients with HS who had continuously received adalimumab for at least three months before the procedure. Group 2 (non-biological cohort) patients underwent cutaneous surgery after only four weeks of anti-inflammatory medication. All patients were left to secondary wound healing.</p><p><strong>Results: </strong>A total of 30 surgical sites in 20 patients were included in the study (Group 1: 15 surgical sites/nine patients; Group 2: 15 surgical sites/11 patients). Disease severity and excised skin areas were significantly higher in Group 1 (p<0.001 and p=0.042, respectively) than in Group 2. While the median TTWC was longer in Group 1 than in Group 2 (p=0.004), multivariate regression analysis showed that TTWC was associated with the excised skin area (p=0.016) and Hurley stage (p=0.032), but was not affected by the use of adalimumab (p=0.076).</p><p><strong>Conclusion: </strong>In this study, the use of adalimumab around surgery was not associated with an increased risk of postoperative complications or a prolonged course of wound closure. The results in this patient cohort suggest that adalimumab should not be discontinued during the perioperative period of HS surgery.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"34 2","pages":"112-118"},"PeriodicalIF":1.5,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391202","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}