Journal of wound care最新文献

{"title":"Comparative effectiveness study of a bilayer cellular construct and dehydrated human amnion/chorion membrane in the treatment of pressure injuries.","authors":"Oscar M Alvarez, Tad Archambault, Michael L Sabolinski","doi":"10.12968/jowc.2024.0070","DOIUrl":"10.12968/jowc.2024.0070","url":null,"abstract":"<p><strong>Objective: </strong>Using real-world data, a comparative effectiveness analysis of a bilayer living cellular construct (BLCC) versus a dehydrated human amnion/chorion membrane (dHACM) for use in the treatment of pressure injuries (PIs) was conducted.</p><p><strong>Method: </strong>Real-world data (RWD) in the form of electronic medical records of patients were analysed retrospectively. Patients with no baseline wound measurements or follow-up visits were excluded. Cox and Kaplan-Meier analyses were used to compute percentages and median times to healing, respectively.</p><p><strong>Results: </strong>A total of 1764 PIs were analysed and evaluations performed on 1046 BLCC- and 718 dHACM-treated wounds. The Cox hazard ratio (HR) demonstrated the probability of healing over 36 weeks. Patient populations were comparable. The median time to healing was 19.0 weeks for dHACM and 14.7 weeks for BLCC (i.e., 22.6% reduction in time for BLCC); p<0.0001. The frequency of healing for BLCC versus dHACM was significantly greater at week 8 (29% versus 21%, respectively); at week 12 (42% versus 32%, respectively); at week 24 (64% versus 52%, respectively), and at week 36 (73% versus 62%, respectively); p<0.0001. The HR=1.37 (95% confidence interval: 1.21, 1.56); p<0.0001. BLCC-treated PUs had a 37% greater probability of healing compared to dHACM throughout the study.</p><p><strong>Conclusion: </strong>In this study, findings showed that BLCC improved time, percentage of healed wounds and probability of healing PIs. RWD/comparative effectiveness analysis studies are beneficial to clinicians and help guide policymakers regarding reimbursement decisions.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"34 8","pages":"616-622"},"PeriodicalIF":1.7,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144835488","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":"Effectiveness of periwound regional oxygen saturation as a wound healing predictor of toes in patients with chronic limb-threatening ischaemia.","authors":"Yu Kagaya, Norihiko Ohura, Yuki Morishige, Yuki Take-E, Mine Ozaki","doi":"10.12968/jowc.2023.0042","DOIUrl":"10.12968/jowc.2023.0042","url":null,"abstract":"<p><strong>Objective: </strong>To verify the utility and accuracy of periwound regional oxygen saturation (rSO₂) as a wound healing predictor of toes in patients with chronic limb-threatening ischaemia (CLTI), and compare the results with skin perfusion pressure (SPP) measurements.</p><p><strong>Method: </strong>Patients with hard-to-heal (chronic) toe wounds and CLTI, and who had undergone toe rSO₂ (near wound), forefoot rSO₂ and SPP measurements, were retrospectively selected. Following the measurements, the patients were treated conservatively, and the progress of wound healing was evaluated 28-91 days after the rSO₂/SPP measurements. Toe wounds were classified into two groups: healing and non-healing. Receiver operating characteristic curves were created for rSO₂/SPP to evaluate the accuracy of the wound healing prediction index, and the area under the curve (AUC) was also evaluated.</p><p><strong>Results: </strong>A total of 118 toes from 76 limbs were included in the evaluation and analysis. The AUC of periwound rSO₂ was 0.938 (cut-off value: 44%; sensitivity: 0.955; specificity: 0.793). The AUC of plantar forefoot rSO₂ and SPP were 0.789 and 0.786, respectively. The dorsal forefoot rSO₂ and SPP demonstrated lower accuracy as wound healing predictors compared with the plantar side (AUC: 0.551 and 0.758, respectively).</p><p><strong>Conclusion: </strong>In this retrospective study, periwound rSO₂ was a highly accurate predictor of toe wound healing in patients with CLTI. Both plantar forefoot rSO₂ and SPP demonstrated moderate-to-high accuracy as predictors of toe wound healing, but less than that for periwound rSO₂. Prospective studies in controlled populations are required. New devices that can measure periwound perfusion may provide more accurate wound healing predictions.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"34 8","pages":"580-588"},"PeriodicalIF":1.7,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144835489","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":"Interviews with patients with diabetic foot ulcers in Sweden reveal heavy burdens of constant vigilance and fear.","authors":"Anneli Ringblom, Ingegerd Adlerberth, Agnes E Wold, Axel Wolf","doi":"10.12968/jowc.2023.0120","DOIUrl":"10.12968/jowc.2023.0120","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the experiences of everyday life of patients with diabetic foot ulcers (DFUs) in Sweden.</p><p><strong>Method: </strong>Semi-structured interviews were conducted from 2021-2022 with patients with active DFUs. The results were subjected to qualitative content analysis.</p><p><strong>Results: </strong>Participants included 15 male patients and five female patients (mean age: 68 years). Responses revealed that patients felt that they had to be constantly vigilant to reduce the risk of developing a DFU. Ignoring a subtle sign could lead to disaster, i.e., amputation of the foot. This imposed a heavy burden on the patients. They also expressed sorrow over being unable to engage in cherished habits, such as swimming or walking barefoot. Some felt that doctors lacked interest in their feet, as compared with more 'prestigious' organs, such as the heart and kidneys, and they wished that they had received more information at an early stage of the disease. Pain was a significant problem for some individuals, and they did not receive adequate pain medication.</p><p><strong>Conclusion: </strong>Despite accessible and cost-free care of DFUs in Sweden, these wounds exert profound negative impacts on patient wellbeing, not least because patients assume responsibility for avoiding worsening of their condition. Therefore, it is important for clinicians to acknowledge the patient's resources, needs and concerns, and, together with the patient, devise care goals that are realistic and achievable for both the patient and clinicians.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"34 8","pages":"600-607"},"PeriodicalIF":1.7,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144835503","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 an antimicrobial HydroBalance biocellulose wound dressing: a retrospective cross-sectional survey.","authors":"Angrit Namislo, Angela Odame, Michael Schmitz, Martin Abel","doi":"10.12968/jowc.2024.0362","DOIUrl":"10.12968/jowc.2024.0362","url":null,"abstract":"<p><strong>Objective: </strong>Wound infections are a prevalent healthcare concern that can result in increased mortality and morbidity. It is imperative that antimicrobial-impregnated wound dressings are safe and consistently effective in preventing or treating infections and promoting wound healing. Data to this effect must be continually gathered by manufacturers during post market surveillance (PMS). This study aimed to gather relevant data about the quality, performance and safety of an antimicrobial HydroBalance biocellulose wound dressing, Suprasorb X+PHMB (polyhexamethylene biguanide) (BWD+PHMB), Lohmann & Rauscher International GmbH & Co. KG. Germany), under routine use.</p><p><strong>Method: </strong>In this PMS, cross-sectional, retrospective study, data were obtained via online and paper questionnaires, completed by healthcare professionals.</p><p><strong>Results: </strong>A total of 61 healthcare professionals took part in the survey. The assessed parameters of the BWD+PHMB dressing were positively rated with regards to: intended purpose; indications; contraindications; wound types; performance; safety; and usability. Observed side-effects and additional comments were noted for potential future considerations.</p><p><strong>Conclusion: </strong>Although prospective randomised controlled trials are beneficial and considered the scientific gold standard for real-time clinical data, surveys such as that carried out in this present study are less time-consuming, cost-effective, and provide sufficient data on the clinical use of wound dressings for PMS. The evaluated dressing in this study was reported as safe and effective. It was also confirmed that antimicrobial dressings should be used for treating infected wounds or wounds at risk of infection to support the wound healing process.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"34 8","pages":"644-650"},"PeriodicalIF":1.7,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144835507","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":"A closed-loop audit to assess and improve surgical site infection rates across all surgical specialties.","authors":"Alvin Gardner, Emma Wates, Martin Kawabata, Kavita Sanghera, Basmal Ria, Roland Fernandes","doi":"10.12968/jowc.2024.0185","DOIUrl":"10.12968/jowc.2024.0185","url":null,"abstract":"<p><strong>Objective: </strong>To assess surgical specialty performance against established national data and to assess the impact of a seven-point surgical site infection (SSI) reduction checklist on elective general surgery SSI rates; specifically, SSI rates of <1% following clean procedures and <10% following clean-contaminated surgery.</p><p><strong>Method: </strong>Retrospective data were collected on selected patients undergoing surgery between July-August 2022. Patient demographics, comorbidities, procedure, indication, SSI management, presence of additional complication and type of SSI were recorded. Follow-up telephone calls (with patient consent) were made to capture any additional SSIs. The reaudit period analysed elective general surgical procedures between May-June 2023, with the same data parameters. A perioperative seven-point checklist was implemented during the reaudit period in elective surgical theatres.</p><p><strong>Results: </strong>Overall, 955 patients were included in the retrospective review of data. Of these, 138 patients had developed a SSI, yielding a 14.5% SSI rate, and 249 patients were included in general surgery with 45 (18.1%) developing SSIs. A total of 38 additional SSIs were identified after telephone follow-up across all specialties, representing 3.97% of the total number of patients and 22.46% of total SSIs. The completion rate of the seven-point checklist during the reaudit period was 47% (n=100). The SSI rate was 1%, with the one reported case not having a completed checklist.</p><p><strong>Conclusion: </strong>The results of this audit showed there was scope for improvement to reduce SSIs across specialties. A significant proportion of SSIs required admission to hospital and were only identified after telephone follow-up. The seven-point SSI reduction checklist significantly reduced the SSI rate for elective general surgical procedures.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"34 8","pages":"590-599"},"PeriodicalIF":1.7,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144835486","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":"Wound dressings protect against bacterial environment: results of a prospective clinical study.","authors":"Maurice Moelleken, Sebastian Heinrich Krimphove, Frederik Krefting, Christos Rammos, Anna Ewa Cyrek, Sven Benson, Joachim Dissemond","doi":"10.12968/jowc.2024.0043","DOIUrl":"10.12968/jowc.2024.0043","url":null,"abstract":"<p><strong>Objective: </strong>Numerous bacteria are found in almost all wounds. Multidrug-resistant bacteria are a particular challenge. Wound dressings are primarily intended to improve wound healing. Their protective function for the environment and other people from the potentially pathogenic bacteria has been little studied. The aim of this cross-sectional study was to investigate the effectiveness of wound dressings in protecting the environment from bacterial contamination in a prospective clinical study within routine care.</p><p><strong>Method: </strong>Patients with wounds of different types were studied in an interdisciplinary certified wound care centre. Examinations were performed during routine patient visits. Wound-related data were collected and fluorescence images of all wounds, wound dressings and wound exteriors were taken.</p><p><strong>Results: </strong>Of the 151 patients included, 68 (45%) were male and 83 (55%) were female. The wound duration ranged from 1-1399 weeks, with 77.5% being hard-to-heal (chronic) wounds. Wound care was provided by an ambulatory care service for 75 (49.7%) patients and by the patients themselves in 76 (50.3%) cases. A total of 67 (44.4%) patients used antimicrobial wound therapy. Using fluorescence photography, bacterial colonisation could be detected in 62 (41.1%) wounds; on the inner side of the wound dressings it was detectable in 19 (13.1%) and on the outside only in one wound dressing which had been incorrectly applied.</p><p><strong>Conclusion: </strong>In this study, both antimicrobial and non-antimicrobial dressings were shown to provide an effective barrier to bacterial penetration through the dressings when applied correctly. This ensured adequate protection of the environment and others from bacterial contamination when modern dressings were used correctly.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"34 8","pages":"564-570"},"PeriodicalIF":1.7,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144835509","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":"Commentary on the effects of adding adjunctive hyperbaric oxygen therapy to NPWT for hard-to-heal wounds.","authors":"Pedro S Coltro, Jayme A Farina","doi":"10.12968/jowc.2023.0118","DOIUrl":"10.12968/jowc.2023.0118","url":null,"abstract":"","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"34 Sup8","pages":"lxxii-lxxiii"},"PeriodicalIF":1.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855697","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":"An integrated medical-care wound management strategy in patients with hard-to-heal lower extremity ulcers undergoing negative pressure wound therapy.","authors":"Lijiao Wu, Hongling Guan, Jin Yan, Hongyan Zhang, Qiong Fang, Baoyu Wen, Kefeng Lin, Zhaorong Xu","doi":"10.12968/jowc.2023.0148","DOIUrl":"10.12968/jowc.2023.0148","url":null,"abstract":"<p><strong>Objective: </strong>To explore the clinical effect of an integrated medical‑care wound management strategy in nursing care for patients undergoing negative pressure wound therapy (NPWT) for hard‑to‑heal (chronic) lower extremity ulcers.</p><p><strong>Method: </strong>Patients admitted to Fujian Provincial Hospital, China, from January to December 2022 were assigned to either an experimental group or a control group. Patients in the experimental group received nursing care under the guidance of an integrated medical care wound management strategy, while patients in the control group received clinical primary nursing care. The differences between the two groups before and after NPWT with regards to wound condition, hospital length of stay (LoS), inflammation, pain, quality of life (QoL) and anxiety were analysed.</p><p><strong>Results: </strong>A total of 60 patients were included (30 in each group). Both groups showed wound contraction. The experimental group had significantly shorter wound healing times and LoS. Inflammation (measured by white blood cell counts and C‑reactive protein levels) was reduced and pain was relieved in both groups. Physical function, role‑physical, bodily pain, general health, vitality, mental health and anxiety after NPWT treatment were improved in both groups, while there were no significant differences in social functioning and roleemotional. The experimental group had significantly lower pain (as measured by numerical rating scale scores) and significantly better physical function, general health and mental health, and less bodily pain and anxiety than the control group, with statistically significant differences (p<0.05).</p><p><strong>Conclusion: </strong>The findings of this study showed that an integrated medical care wound management strategy for patients undergoing NPWT effectively promoted wound healing, reduced inflammation, alleviated pain, and improved the QoL of patients with hard‑to‑heal lower extremity ulcers, and deserves further research and promotion.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"34 Sup8","pages":"xiii-xxi"},"PeriodicalIF":1.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855696","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":"Enhancing diabetic foot wound healing with topical macrophage-regulating cream (ON101): a case series.","authors":"Kwan Lok Benjamin Ng, Yun-Nan Lin, Wei-Yu Chen, Yi-Chia Wu, Shu-Hung Huang, Su-Shin Lee, Rong-Fu Chen, Yur-Ren Kuo","doi":"10.12968/jowc.2023.0318","DOIUrl":"10.12968/jowc.2023.0318","url":null,"abstract":"<p><strong>Objective: </strong>A number of treatments have been developed to treat hard-to-heal (chronic) diabetic foot ulcers (DFUs). This case series the use of ON101-a new topical macrophage regulatory cream for the treatment of DFUs, that helped achieve limb-salvage outcomes with an adequate safety profile.</p><p><strong>Method: </strong>Patients with hard-to-heal DFUs-primarily on the toes and plantar surfaces-were enrolled in the study. After infection control, wound debridement or angioplasty intervention, ON101, containing 1.25% extracts of <i>Plectranthus amboinicus</i> (0.25%) and <i>Centella asiatica</i> (1%), was applied topically to the wounds up to twice daily. The condition of the wounds, complications, healing progression and other details were documented.</p><p><strong>Results: </strong>In total, 10 patients, with a mean age of 59.2 years (range: 35-77 years), were included in the study following surgical debridement, sequestrectomy or revascularisation. Wound sizes ranged from 1-66 cm². After receiving ON101 treatment for durations ranging from 14-264 days, most wounds healed without complications, except for one patient with osteomyelitis who did not fully recover. All patients expressed satisfaction with the outcomes and had no reported complications at the six-month follow-up.</p><p><strong>Conclusion: </strong>This case series demonstrated the real-world outcomes of ON101, which exhibited good healing efficacy in the treatment of DFUs, making it a promising strategy for the topical treatment of these ulcers.</p>","PeriodicalId":17590,"journal":{"name":"Journal of wound care","volume":"34 Sup8","pages":"lxxiv-lxxx"},"PeriodicalIF":1.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855698","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 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}