Wounds : a compendium of clinical research and practice最新文献

{"title":"Antimicrobial Resistance in Wound Care: Expert Panel Consensus Statements.","authors":"Windy Cole, Emily Greenstein, Ira M Herman, John Lantis, Catherine Milne, Irena Pastar, Ronald Beaulieu, Terry Swanson, Anthony Tickner, Naz Wahab","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Antimicrobial resistance (AMR) presents a growing global health crisis, with significant implications for the management of chronic, hard-to-heal wounds. These wounds often serve as reservoirs for resistant pathogens, particularly when complicated by biofilms that impede healing and shield microbes from host defenses and antimicrobial therapies. In October 2024, a multidisciplinary panel of wound care experts from the United States and Australia convened to develop a consensus document aimed at guiding clinicians in the responsible management of microbial burden throughout wound care. This comprehensive guidance outlines the core physiological processes involved in wound healing, the role of microbial colonization and infection in healing delays, and the mechanisms by which resistance develops and spreads. It provides best practices for wound cleansing, debridement, and the appropriate use of systemic antibiotics, emphasizing that systemic agents should only be used when clinically indicated. The document also explores the use of topical antimicrobials and nonantibiotic alternatives, such as topical oxygen, nitric oxide, probiotics, and chelating agents, to help limit reliance on systemic therapies. A key theme throughout the consensus is the importance of antimicrobial stewardship. The panel calls for targeted therapy guided by culture data, limited treatment durations, and the incorporation of education for clinicians, patients, and caregivers to ensure effective and sustainable wound care practices. By integrating emerging technologies, personalized care approaches, and coordinated interdisciplinary collaboration, these recommendations aim to reduce complications, improve healing outcomes, and slow the spread of AMR in wound care settings. This consensus document serves as a practical, evidence-based guide to support clinicians in making informed decisions that balance infection control with the urgent need to preserve the effectiveness of antimicrobial therapies.</p>","PeriodicalId":23752,"journal":{"name":"Wounds : a compendium of clinical research and practice","volume":"37 5 Suppl","pages":"S1-S24"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209656","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":"Effect of social determinants of health on clinical trials conducted for diabetic foot ulcer and venous leg ulcer at a safety net hospital.","authors":"Nolan Patrick Joyce, Aniket Vazirani, Connor Roddy, Marina A Malikova","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Failure to adhere to study protocol is among the most common observations during inspections conducted by competent authorities for clinical trials.</p><p><strong>Objective: </strong>To evaluate patterns of protocol deviations, and to analyze how social determinants of health (SDoH) correlate with the rate of protocol deviations as indicators of study protocol noncompliance.</p><p><strong>Materials and methods: </strong>Data obtained at a single clinical site from 19 clinical trials with a total of 186 subjects enrolled were analyzed retrospectively, and correlations between SDoH (eg, race/ethnicity, gender [eg, male/female], socioeconomic status, distance traveled, etc) and study protocol noncompliance (ie, rate of deviations) were examined. The Kruskal-Wallis test was performed to compare SDoH variables with rate of deviations per subjects enrolled. Associations between SDoH and deviations were examined using the Spearman correlation test.</p><p><strong>Results: </strong>A retrospective analysis showed that the majority of deviations were attributed to study visits that had not been performed in a timely manner or were missed, and study procedures that either were not performed or were completed late. The tests demonstrated no statistical significance between age, gender, and race and rates of dropout from the study (P = .1857, P = .3836, and P = .2150, respectively). Increased body mass index was associated with higher dropout rates (P = .0340), which can be an indicator of higher disease burden and an obstacle to trial participation.</p><p><strong>Conclusion: </strong>Further studies are warranted to investigate how quality in wound care clinical trials can be improved with identification of patients who need more resources based on their SDoH to efficiently mitigate risks, increase access to trials for disadvantaged populations, and improve study protocol compliance.</p>","PeriodicalId":23752,"journal":{"name":"Wounds : a compendium of clinical research and practice","volume":"37 4","pages":"158-165"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080800","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":"Topical timolol for calciphylaxis: a case report.","authors":"Lamis Elyamani, Ouissal Hormi, Nada Benaini, Nassiba Zerrouki, Nada Zizi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Calciphylaxis is a rare multifactorial skin disease characterized by thrombosis and calcification of skin subcutaneous vessels, leading to chronic and painful ulcers with skin necrosis. Despite its high morbidity and mortality rates, effective treatments are lacking.</p><p><strong>Case report: </strong>A 65-year-old female with chronic kidney disease who developed painful bilateral ulcers was successfully treated with topical timolol. Clinical examination and imaging confirmed the diagnosis of calciphylaxis. Treatment with topical timolol resulted in rapid wound healing and pain relief.</p><p><strong>Conclusion: </strong>This case highlights the potential of topical timolol in promoting wound healing in calciphylaxis ulcers, a novel therapeutic approach not previously reported. Further studies are warranted to validate the efficacy of topical timolol and explore its role in managing calciphylaxis. Despite the challenges in diagnosis and management of calciphylaxis, topical timolol appears promising for improving outcomes in affected patients.</p>","PeriodicalId":23752,"journal":{"name":"Wounds : a compendium of clinical research and practice","volume":"37 4","pages":"141-144"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Negative pressure wound therapy using a new pressure monitoring device for wound treatment: results of an animal model.","authors":"Fengzhen Meng, Jianwen Ye, Xiaomin Wu, Jianchi Li, Bin Bian, Wensong Li, Xiaohua Pan","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Negative pressure wound therapy (NPWT) is a widely used therapeutic approach for skin and soft tissue defects, and selecting an appropriate negative pressure value is critically important.</p><p><strong>Objective: </strong>To develop a wound pressure monitoring dressing (WPMD) integrating a novel pressure sensing chip with a previously developed polyvinyl acetate foam dressing.</p><p><strong>Materials and methods: </strong>Sprague-Dawley male rats were randomly divided into 3 groups to receive -125 mm Hg pressure with the WPMD, -75 mm Hg pressure with the WPMD, or wound dressing without negative pressure (control). Data on pressure changes and wound conditions were collected over 7 consecutive days. Monitoring included pressure changes, gross wound morphology observations, and histopathological analyses.</p><p><strong>Results: </strong>Monitoring data revealed pressure variations during wound healing ranging from -128 mm Hg to -63 mm Hg in the -125 mm Hg preset group, and from -72 mm Hg to -37 mm Hg in the -75 mm Hg preset group. The WPMD groups exhibited higher wound closure rates than the control group. Ki67, vascular endothelial growth factor receptor 2, transforming growth factor β1, and CD31 expression levels were elevated in the WPMD groups compared with the control group.</p><p><strong>Conclusion: </strong>The WPMD accurately and sensitively detected real-time pressure changes on wound surfaces under different preset negative pressure values (-125 mm Hg and -75 mm Hg). Furthermore, NPWT significantly accelerated wound healing in the rat model, and the healing rates were better in the -75 mm Hg group than in the -125 mm Hg group at day 5 and day 7. These results underscore the potential application of the WPMD in investigating the relationship between negative pressure values and wound healing rates across various wound types during treatment.</p>","PeriodicalId":23752,"journal":{"name":"Wounds : a compendium of clinical research and practice","volume":"37 4","pages":"145-151"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080802","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":"Comparison of the effectiveness of two prophylactic single-use negative pressure wound therapy devices in reducing surgical site complications after cesarean delivery: insights from a large US claims database.","authors":"Annmarie Vilkins, Leo Nherera, Richard Searle, Tia Welsh","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Single-use negative pressure wound therapy (sNPWT) has emerged as a promising intervention for patients at high risk of surgical site complications (SSCs) after a cesarean delivery. However, the available studies primarily compare negative pressure wound therapy to standard dressings rather than evaluating differences between negative pressure wound therapy devices or pressure settings.</p><p><strong>Objective: </strong>To compare the effectiveness of 2 commonly used sNPWT devices, a -80 mm Hg device and a -125 mm Hg device, in reducing the risk of SSCs following cesarean delivery.</p><p><strong>Materials and methods: </strong>Real-world data were obtained from a large claims database in the United States from January 2017 through June 2022. Adult patients who had an inpatient encounter in which the -80 mm Hg device or the -125 mm Hg device was used after a cesarean delivery were included. Propensity score matching was used to balance the cohorts. Study end points included incidence of overall surgical site infection (SSI), superficial SSI, dehiscence, seroma, hematoma, deep SSI, length of stay (LOS), and costs.</p><p><strong>Results: </strong>The study included 5332 cases in each group. Overall SSI, superficial SSI, dehiscence, seroma, and costs were significantly lower with the -80 mm Hg device compared with the -125 mm Hg device (P ≤ .05). No differences between the 2 devices were observed for hematoma, deep SSI, and LOS (P > .05).</p><p><strong>Conclusion: </strong>Of the 2 commonly used sNPWT devices, use of the -80 mm Hg device was associated with a lower likelihood of developing overall SSI, superficial SSI, dehiscence, and seroma, and was associated with lower costs after cesarean delivery compared with the -125 mm Hg device. There were nonsignificant differences in LOS, deep SSI, and hematoma. Further studies are required to confirm these findings.</p>","PeriodicalId":23752,"journal":{"name":"Wounds : a compendium of clinical research and practice","volume":"37 4","pages":"152-157"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080799","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":"Bromelain-based debridement versus collagenase ointment debridement of venous leg ulcers: post hoc analysis of the ChronEx trial.","authors":"Cyaandi R Dove, Robert J Snyder, Keren David Zarbiv, Yael Katz Levy, Asi Haviv, Ety Klinger, Yaron Shoham, Felix Sigal","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>A randomized controlled trial reported that bromelain-based enzymatic debridement (BBD) more effectively debrided and granulated venous leg ulcers (VLUs) compared with placebo (gel vehicle, hydrogel) and nonsurgical standard of care (including collagenase ointment [CO]).</p><p><strong>Objective: </strong>To assess the efficacy of BBD vs CO-based enzymatic debridement in VLUs during the ChronEx trial.</p><p><strong>Materials and methods: </strong>The Wilcoxon exact test was used to compare the proportion of wounds in each group that achieved complete debridement and granulation at 2 weeks. Kaplan-Meier analysis was used to compare median times to complete debridement and granulation between groups.</p><p><strong>Results: </strong>Forty-six patients with 46 wounds were treated with BBD, and 8 were treated with CO. Twenty-nine wounds treated with BBD (63%; 95% CI, 48-77) were completely debrided within 2 weeks compared with none treated with CO (P = .001). Twenty-three wounds treated with BBD (50%; 95% CI, 35-65) achieved complete granulation by 2 weeks compared with none with CO (P = .015). The estimated median time to complete debridement and complete granulation, respectively, in the BBD group vs the CO group, respectively, were 9 days vs not achieved (P = .023), and 11 days vs not achieved (P = .014). The groups had comparable safety and pain profiles.</p><p><strong>Conclusion: </strong>BBD appears to be more effective and faster than CO in achieving complete debridement and granulation of VLUs as part of wound bed preparation.</p>","PeriodicalId":23752,"journal":{"name":"Wounds : a compendium of clinical research and practice","volume":"37 4","pages":"166-173"},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080797","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 effect of hyperbaric oxygen therapy on split-thickness skin graft uptake in posttraumatic wounds and donor site healing: a randomized controlled trial.","authors":"Madhur Uniyal, Irshad Ahmad, Ajay Kumar Dhiman, Ajay Kumar, Bhaskar Sarkar, Nilesh Jagne, Vishal Mago, Md Quamar Azam","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Trauma is among the leading causes of skin loss or degloving. Flaps and skin grafts are common surgical procedures to repair or replace the lost skin over open wounds, and split-thickness skin grafting (STSG) is the most common approach.</p><p><strong>Objective: </strong>To assess the effect of hyperbaric oxygen therapy (HBOT) on STSG uptake and donor site healing.</p><p><strong>Materials and methods: </strong>This trial was conducted on patients with traumatic wounds who underwent STSG as per inclusion criteria. The patients were randomized into 2 groups. One group received standard care after skin grafting, and the other received HBOT in addition to standard care. Uptake of STSG was assessed on postoperative day (POD) 4 and POD 7, and donor site healing was assessed on POD 11 and POD 15.</p><p><strong>Results: </strong>A total of 64 patients aged 18 years to 60 years were included in the study. Mean (standard deviation [SD]) percentage graft uptake on POD 4 was 92.44% (5.98%) in the HBOT group and 88.12% (8.92%) in the control group (P = .036), and on POD 7 was 91.69% (8.71%) in the HBOT group and 83.12% (14.94%) in control group (P = .026). Donor site recovery was also significantly faster in the HBOT group, with a mean (SD) of 15.16 (0.88) days in the HBOT group and 17.97 (2.49) days in the control group (P < .001). In the control group, floating grafts were found in 2 patients, flap necrosis occurred in 4 patients, and 1 patient died due to sepsis, whereas in the HBOT group, significant graft contracture and wound recipient site infection occurred in 1 patient each.</p><p><strong>Conclusion: </strong>HBOT significantly improved the percentage graft uptake in posttraumatic wounds and resulted in better donor site healing compared with standard care alone.</p>","PeriodicalId":23752,"journal":{"name":"Wounds : a compendium of clinical research and practice","volume":"37 3","pages":"134-140"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036667","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":"Removing the complexities associated with traditional negative pressure wound therapy (tNPWT) bridging applications.","authors":"Mark E Chariker, Joanne Handsaker, Catherine McCarthy","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Negative pressure wound therapy (NPWT) is an effective intervention for challenging wounds across multiple indications. Its application sometimes requires a technique known as 'bridging\" to prevent ulcerations caused by delivery port and tubing when positioning the device, which requires extra time and resources. The bridging technique may be adopted when it is considered essential to move the NPWT delivery port away from the wound bed or when treating wounds in close proximity to each other.</p><p><strong>Materials and methods: </strong>A survey was undertaken by 200 health care professionals (HCPs) in the United States who are experienced in utilizing traditional negative pressure wound therapy (tNPWT) and bridging. Primary objectives were to explore HCP opinion on 2 types of tNPWT delivery ports (soft and hard) between 2 leading manufacturers. Questions focused on the need for bridging, alleviation of complexity in application, and reducing concerns relating to medical device-related pressure injury when applied to awkward anatomical areas.</p><p><strong>Results: </strong>HCPs (75%; n=150) largely agreed that the bridging technique makes application of tNPWT slightly more challenging. Reasons included additional time taken to apply (74%; n=148), increased dressing resource (67%; n=134), and additional staff required (50%; n=100). Over half (53%; n=106) agreed that the soft port can eliminate the need for bridging. The majority of wound specialists were significantly less likely to favor a hard port (58%; n=116). Two further potential benefits of using a tNPWT soft port include the associated risk of pain/pressure when applying a hard port over a smaller wound size (29%; n=58) and certain anatomical areas which pose a risk of pressure injury or kinked/twisted tubing (31%; n=62).</p><p><strong>Conclusion: </strong>tNPWT soft ports remain effective regardless of kinks or twists and can eliminate bridging in anatomical areas where patients may weight-bear on tubing or delivery ports, saving time and decreasing risks of periwound trauma.</p>","PeriodicalId":23752,"journal":{"name":"Wounds : a compendium of clinical research and practice","volume":"37 3","pages":"107-113"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988763","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":"Post-Mohs surgical wounds treated with intact fish skin graft: a multicenter analysis.","authors":"Ryan O'Quinn, Courtney Aldridge, David S Sax","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Intact fish skin graft (IFSG) has been reported to be an adjunct to healing post-Mohs surgical wounds.</p><p><strong>Objective: </strong>To assess the data that could be found on the use of IFSG in conjunction with Mohs surgery.</p><p><strong>Materials and methods: </strong>A non-interventional observational registry collected data on the use, indications, and outcomes of IFSG over 32 weeks. This registry collected data on IFSG placed for a broad variety of indications. The primary end point was to determine the percentage of wounds closed at 32 weeks, and the secondary objective was to determine the median number of IFSG applications during this period. The registry was queried for patients who had IFSG placed for wounds created by Mohs surgery.</p><p><strong>Results: </strong>As of mid-April 2024, 41 participants enrolled in the registry had undergone placement of IFSG post-Mohs surgery. The mean (standard deviation) patient age was 77.6 (8.9) years, and 24% of participants were female (n = 10). Forty of 41 wounds (97.6%) achieved complete wound closure in a median of 5 weeks, and the median number of visits was 5. For closed wounds, the median number of applications was 2.</p><p><strong>Conclusion: </strong>This registry demonstrates that in a real-world setting, IFSG provides support to aid wound closure. In the post-Mohs setting, only 1 to 2 IFSG applications were required. This study demonstrates how IFSG can be a viable option for Mohs surgeons to consider in the reconstruction paradigm for a variety of wound sizes and anatomic locations.</p>","PeriodicalId":23752,"journal":{"name":"Wounds : a compendium of clinical research and practice","volume":"37 3","pages":"102-106"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050404","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":"Leukocytoclastic vasculitis: a case report.","authors":"Kaitlyn J Loesel, Alexander Schultz, Samual Gracey, Nicholas Laco","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Leukocytoclastic vasculitis (LCV) is a rarely diagnosed dermatologic hypersensitivity vasculitis. LCV manifests as small, pruritic petechiae or purpura that without treatment can develop into painful, necrotic ulcerations or hemorrhagic bullae. Currently, there is no standardized treatment protocol for LCV wounds, which makes resolution of the wounds difficult.</p><p><strong>Case report: </strong>This case report discusses the cutaneous manifestation and the treatment protocol used to treat a single patient diagnosed with LCV of the lower extremities. The multidisciplinary treatment approach involves dermatologic, vascular, and podiatric surgeons and encompasses both pharmaceutical and local wound care modalities.</p><p><strong>Conclusion: </strong>This case further highlights LCV as a rare, challenging condition of the lower extremity that requires a multidisciplinary approach for proper diagnosis and treatment.</p>","PeriodicalId":23752,"journal":{"name":"Wounds : a compendium of clinical research and practice","volume":"37 3","pages":"120-124"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029819","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}