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

{"title":"Transforming powder dressing for lower extremity wounds in patients with diabetes: a multinational case series.","authors":"Bradley A Melnick, Shin Young Yu, Antoinette Nguyen, Jeewon Chon, Anmar Abu-Romman, Rahim Laiwalla, Joseph P Weissman, Chitang J Joshi, Tarifa Adam, Robert D Galiano","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Chronic lower extremity wounds in patients with diabetes are a significant clinical and economic burden. Traditional dressings have poor healing rates and require frequent changes, burdening patients and caregivers.</p><p><strong>Objective: </strong>To evaluate if transforming powder dressing (TPD), a hydrophilic polymer powder that forms a moisture-retentive gel conforming to the wound surface, can address these limitations, as clinical data remain limited.</p><p><strong>Materials and methods: </strong>This retrospective, multinational case series evaluated TPD in 17 patients with diabetic lower extremity wounds across Egypt, India, the United Arab Emirates, and the Palestinian territories. Wound types included diabetic foot ulcers (DFUs), venous ulcers, and postamputation wounds. For all patients, previous standard of care efforts had failed.</p><p><strong>Results: </strong>TPD was associated with consistent wound size reduction (mean [standard deviation (SD)] 80% [10%]), granulation tissue formation, and pain relief. DFUs and non-DFUs showed comparable outcomes, with no significant differences in healing time (7.1 weeks and 5.9 weeks, respectively; P = .39). Dressings were changed every 5 to 10 days, and no complications were reported.</p><p><strong>Conclusion: </strong>TPD appears to be a safe, well-tolerated, and effective adjunct for managing diabetic lower extremity wounds. Its ability to promote healing while reducing pain and dressing frequency offers clinical and logistical benefits. Larger, prospective studies are needed to validate these findings and guide treatment protocols.</p>","PeriodicalId":23752,"journal":{"name":"Wounds : a compendium of clinical research and practice","volume":"37 7","pages":"241-248"},"PeriodicalIF":1.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144837936","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 impact of an aggressive clinic-based diabetic foot protocol: a single-center case series.","authors":"Qing Jia, Xiaojing Yin, Wen Qin, Jiaojiao Bai","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The considerable health and economic burden of hard-to-heal wounds has become increasingly prominent. Diabetic foot ulcers (DFUs), as a representative type of these wounds, pose substantial challenges for health care professionals in both treatment and long-term management.</p><p><strong>Objective: </strong>To evaluate the efficacy of a standardized wound hygiene protocol in promoting healing outcomes for DFUs and to provide supplementary clinical evidence to inform wound care practices.</p><p><strong>Materials and methods: </strong>Diabetic foot care specialists administered a wound hygiene protocol to 20 patients with DFUs. The protocol comprised 4 key components: cleansing, debridement, wound edge refashioning, and dressing coverage. Wound healing progress was monitored and documented over a 12-week observation period.</p><p><strong>Results: </strong>After 12 weeks of treatment with the wound hygiene protocol in the multidisciplinary diabetic foot clinic, 16 of the 20 patients achieved complete wound healing, while the remaining 4 patients showed significant wound improvement, resulting in a healing rate of 80%. Wound area, exudate level, and pain scores all showed significant improvement compared to baseline, with statistically significant differences (P < .001). The overall mean (SD) wound area reduction rate was 95.11% (10.46%), with a mean healing rate of 1.32 (0.36) cm² per week. The average healing time for patients with complete healing was 56.44 (25.12) days.</p><p><strong>Conclusion: </strong>This case series demonstrates that the implementation of a wound hygiene protocol significantly enhances healing outcomes in patients with DFUs. These findings provide critical insights for the management of diverse hard-to-heal wounds in clinical practice.</p>","PeriodicalId":23752,"journal":{"name":"Wounds : a compendium of clinical research and practice","volume":"37 7","pages":"269-274"},"PeriodicalIF":1.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144837935","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":"Successful treatment of a scalp arteriovenous malformation with ulcerative hemorrhage and localized alopecia.","authors":"Yuxi Chen, Bin Sun, Xi Yang, Chen Hua, Xiaoxi Lin","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Scalp arteriovenous malformation (AVM) and its clinical course associated with ulcerative hemorrhage and local alopecia are rarely reported.</p><p><strong>Case report: </strong>An 18-year-old male presented to a vascular anomalies center with scalp AVM and ulcerative hemorrhages over a 6-month period due to post-excision recurrence, initially associated with thinning hair and scalp erythema around the AVM lesion. After meticulous debridement, the patient was immediately given an ethanol embolization. He was advised against home wound care to prevent possible hemorrhage. After several effective interventional sessions over an 18-month period, not only was the AVM lesion extensively eliminated, but restoration of hair growth around the lesion was observed. This phenomenon may be attributed to the alleviation of deep, high-flow AVM steal phenomenon, which in turn restored normal blood supply to superficial layers, promoting ulcer healing and hair regrowth.</p><p><strong>Conclusion: </strong>This report suggests that scalp AVMs can be accompanied by AVM-related alopecia, which may recover after ethanol embolization. This report also suggests that restrictive debridement during multiple intervention sessions can be feasible in ulcerated AVMs with a high risk of hemorrhage.</p>","PeriodicalId":23752,"journal":{"name":"Wounds : a compendium of clinical research and practice","volume":"37 7","pages":"249-252"},"PeriodicalIF":1.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144837934","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 combined multistep reconstruction of the heel after skin tumor resection in posttraumatic chronic ulcers: a case series.","authors":"Fedele Lembo, Liberato Roberto Cecchino, Domenico Parisi, Aurelio Portincasa","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Heel reconstruction following wide resection of Marjolin ulcer represents a challenge for surgeons. Local or free flaps are usually used, but they present some disadvantages, such as donor site morbidity, high risk of necrosis, and long surgical time and hospital stay.</p><p><strong>Objective: </strong>To use a combined multistep protocol of heel reconstruction after wide resection of Marjolin ulcer using a biosynthetic extracellular matrix and negative wound pressure therapy.</p><p><strong>Materials and methods: </strong>Demographic, clinical, and surgical data for 4 patients treated at a single institution were retrospectively collected.</p><p><strong>Results: </strong>All patients healed with a good scar appearance and high satisfaction. No complications or tumor recurrence were observed at 12 months postoperative.</p><p><strong>Conclusion: </strong>The findings of this clinical series suggest that the combined protocol described is an effective option for the resolution of these complex wounds.</p>","PeriodicalId":23752,"journal":{"name":"Wounds : a compendium of clinical research and practice","volume":"37 6","pages":"220-225"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660440","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 COVID-19 on diabetic foot ulcer surgery at a safety net hospital.","authors":"Hau Pham, Ewald Mendeszoon, Vitaliy Volansky, Justin Ogbonna, Wei Tseng, Elizabeth Sanders, David Coker, Ashley Daniel","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Management of diabetic foot ulcers requires detailed and continuous work. Social distancing and lockdown restrictions instituted during the COVID-19 pandemic of 2020 were essential to saving lives and preventing hospital overflow, but they caused many difficulties for patients and health care providers.</p><p><strong>Objective: </strong>To show the changes in wound care surgery affected by COVID-19 at a safety net hospital.</p><p><strong>Methods: </strong>All ulcer-related surgeries performed at a single institution from March 2018 through February 2023-that is, 2 years before, the year of, and 2 years after the first year of the COVID-19 pandemic-were reviewed. Because the imposed outpatient and elective surgery restrictions started in March 2020, the period from March through February was used for the review. Wound-related surgeries included wound debridement, incision and drainage, exostectomy, digit amputations, midfoot amputations, and major amputations.</p><p><strong>Results: </strong>During the entire period, 1858 ulcer-related surgeries were performed at the authors' institution. A total of 723 surgeries were performed in the 2 years before COVID (pre), with 368 performed in the initial year of COVID (Covid) and 767 in the 2 years after the first year of the pandemic (post).</p><p><strong>Conclusion: </strong>COVID-19 significantly impacted various aspects of ulcer management at the clinic. The authors' wound clinic remained open on a limited basis, and the number of patients seen was markedly lower. After the restrictions were lifted, wound care visits remained significantly lower than the pre-pandemic level; the fear of COVID-19 had a lasting impact on the number of visits. The number of exostectomy and digit amputations has increased since the first year of the pandemic. Midfoot amputation and major amputation did not change much after the initial year of the pandemic, which may be due to death from COVID-19. The fear and death associated with COVID-19 affected wound care and continue to affect wound care and limb salvage, but determining the actual number affected is challenging.</p>","PeriodicalId":23752,"journal":{"name":"Wounds : a compendium of clinical research and practice","volume":"37 6","pages":"226-231"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660441","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 polyhexamethylene biguanide in the treatment of atopic dermatitis with Staphylococcus aureus hypercolonization.","authors":"Gleice Freire, Leticia Midori Kondo Iwamoto, Tatiana de Fátima Pinto, Caio César de Silva Castro","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Atopic dermatitis (AD) is a chronic inflammatory skin disease with significant global prevalence. Clinically, AD is characterized by xerosis, intense pruritus, and recurrent eczematous lesions. The pathogenesis of AD is complex and multifactorial, involving genetic predisposition, epidermal barrier dysfunction, immune dysregulation, and dysbiosis. These factors collectively increase susceptibility to infections in patients with AD. AD lesions are frequently colonized by Staphylococcus aureus and Staphylococcus epidermidis. An important aspect of Staphylococcus spp is the propensity to form biofilms that exhibit enhanced resistance to antibiotics and host immune responses.</p><p><strong>Case report: </strong>This report describes 2 cases of AD associated with biofilm formation that was successfully treated with polyhexamethylene biguanide (PHMB).</p><p><strong>Conclusion: </strong>This report highlights the potential of PHMB in the treatment of AD lesions and biofilm reduction.</p>","PeriodicalId":23752,"journal":{"name":"Wounds : a compendium of clinical research and practice","volume":"37 6","pages":"232-234"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660442","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":"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":"Health care costs and clinical outcomes of necrotizing soft tissue infections: an evaluation of skin-sparing surgery.","authors":"Travis L Perry, Jordan Silverman, Courtney Johnson, Benjamin Kleeman, Priti Parikh","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Necrotizing soft tissue infection (NSTI) is a debilitating disease process that is characterized by rapid clinical progression and extensive tissue destruction, necessitating early surgical excision. Long-term care and outcomes of the resulting complex morbid wounds remain daunting.</p><p><strong>Objective: </strong>To review the skin-sparing surgery (SSS) approach to NSTIs and patient outcomes, including mortality rate, length of stay (LOS), and health care costs (HCC).</p><p><strong>Methods: </strong>The electronic medical records of patients treated at an adult regional burn and wound center between 2011 and 2021 and who underwent a SSS approach to wound closure were reviewed. Patients were excluded if surgical reports did not characterize widespread fulminant tissue destruction at multiple levels and use of a SSS approach. LOS, mortality rate, readmission rates, and HCC were also evaluated.</p><p><strong>Results: </strong>Seventy-one patients were included in the study. The mean number of SSS per patient during initial hospitalization was 3.56, and the mean number including revisions of all anatomic locations was 7.34. The initial hospital LOS averaged 23 days, and the initial encounter mortality rate was 1.4% (n = 1). The readmission rate within 30 days and within 90 days was 17% (n = 12) and 18% (n = 13), respectively. Further, 39.4% of patients were partially managed as outpatients during wound closure. The mean HCC over the treatment course, including indirect costs and direct costs, was $64 645.18 and $44 543.61, respectively.</p><p><strong>Conclusion: </strong>The results of this study show that the SSS approach to NSTI correlates with low mortality rates, decreased LOS, and low HCC. These findings can inform future studies involving the SSS approach as well as increase awareness of this alternative technique to surgeons caring for patients with NSTI.</p>","PeriodicalId":23752,"journal":{"name":"Wounds : a compendium of clinical research and practice","volume":"37 5","pages":"179-185"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144289675","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 for management of Achilles region defects: a systematic review of the literature.","authors":"Marco Gratteri, Claudia Luciano, Fara Desiree Romano, Luigi Abate, Carlo Mirra, Luca Savani, Giuseppe Francesco Papalia, Rocco Papalia, Pasquale Farsetti, Giovanni Francesco Marangi, Paolo Persichetti","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Despite the efforts of plastic and orthopedic surgeons to elaborate the most appropriate treatment for lesions of the Achilles region and their reconstruction, no universal guideline exists. Regenerative treatments such as negative pressure wound therapy (NPWT) are increasingly being used in the management of these defects.</p><p><strong>Objective: </strong>To research the different usage protocols, roles, and outcomes of NPWT in the management and reconstruction of Achilles region defects.</p><p><strong>Methods: </strong>A scientific literature search was performed by querying Medline and Scopus using the terms \"(Achilles tendon) AND ((vac) OR (vacuum assisted closure) OR (negative pressure) OR (NPWT)).\" The authors used an online screening software. The investigation followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement for systematic review.</p><p><strong>Results: </strong>Of the initial 153 studies identified, only 14 fulfilled the eligibility criteria and were included in this review. Analyzed protocols mainly included surgical debridement combined with the use of NPWT as a primary dressing directly on the tendon or as a secondary dressing covering a split-thickness skin graft (STSG) or a flap. Additionally, the combination of negative pressure with matrices was found to provide optimal results even after STSG failure. Most of the reported complications described in the included studies involved partial loss of graft or flap.</p><p><strong>Conclusion: </strong>NPWT can be used either as a primary dressing (directly on the lesion) or as a secondary dressing (over a flap or a skin graft) for management of Achilles region defects. The combined use of negative pressure with matrices can also aid in wound reduction.</p>","PeriodicalId":23752,"journal":{"name":"Wounds : a compendium of clinical research and practice","volume":"37 5","pages":"186-197"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144289676","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 reduces the number of electrocauterization treatments required for treatment of pyogenic granulation after bromhidrosis surgery.","authors":"Wen-Tsao Ho, Chin-Yi Yang","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Pyogenic granulation is a common complication of bromhidrosis surgery, and multiple electrocauterization sessions are usually required to treat this condition.</p><p><strong>Objective: </strong>To investigate the effectiveness of topical timolol for improving electrocauterization outcomes for pyogenic granulation.</p><p><strong>Methods: </strong>The medical data of 20 patients who underwent bilateral bromhidrosis surgery followed by electrocauterization treatments for pyogenic granulation between January 2021 and December 2022 were retrospectively reviewed. The first 10 patients did not use topical timolol (non-timolol group), and the second 10 patients applied topical timolol maleate 0.5% drops twice daily (timolol group) after each session of electrocauterization. The total number of electrocauterization sessions received by the patients were compared between the 2 groups.</p><p><strong>Results: </strong>The number of electrocauterization sessions was significantly less in the timolol group compared with the non-timolol group (median [range]: 3.5 [2-5] vs 5.5 [2-9]; P = .007). There was no statistically significant difference in age and sex distribution between the groups.</p><p><strong>Conclusion: </strong>Application of topical timolol twice daily is effective in decreasing the number of electrocauterization treatments required to treat pyogenic granulation after bromhidrosis surgery. Topical timolol can enhance wound healing and improve electrocauterization treatment outcomes.</p>","PeriodicalId":23752,"journal":{"name":"Wounds : a compendium of clinical research and practice","volume":"37 5","pages":"174-178"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144289677","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}