Xiaodong Lan, Yong Tang, Zhenjia Huang, Tao Zhou, Chao Wang, Yan Ma, Dan Li, Zhiyong Huang, Yuesheng Huang
{"title":"Global, Regional, and National Burden of Pressure Ulcers From 1990 to 2021 and Projections Over the Next Decade: Results From the 2021 GBD Study.","authors":"Xiaodong Lan, Yong Tang, Zhenjia Huang, Tao Zhou, Chao Wang, Yan Ma, Dan Li, Zhiyong Huang, Yuesheng Huang","doi":"10.1111/wrr.70064","DOIUrl":"10.1111/wrr.70064","url":null,"abstract":"<p><p>Pressure ulcers (PUs) are chronic wounds that pose a significant burden on patients, families, and healthcare systems worldwide. This study evaluates the prevalence, trends, and burden of PUs to inform targeted public health policies. Using data from the Global Burden of Disease (GBD) Study 2021, we analysed PU incidence, mortality, and disability-adjusted life years (DALYs) across 204 countries from 1990 to 2021. Trends were assessed using the estimated annual percentage change (EAPC) in age-standardised rates (ASRs), and future projections were made using the ARIMA model. Globally, PU incident cases increased from 1,142,594.8 in 1990 to 2,468,317.5 in 2021. The ASIR showed a slight decrease, from 31.5 to 30.3 per 100,000. The mortality rose from 16,741.1 to 37,032.7, while the ASMR exhibited numerical stability (0.5 per 100,000). The DALYs increased from 408,887.0 in 1990 to 803,747.4 in 2021, with a decline in ASDR, from 10.7 to 9.7 per 100,000. Absolute numbers, ASRs, and EAPCs exhibit a pronounced correlation with the SDI. Moreover, there exist notable disparities across different regions or nations. The burden of PU was notably higher in elderly females, though the increase among the elderly males was also significant. Projections for 2022-2031 indicate a slight decrease in both ASIR and ASMR, while ASDR is expected to rise. While PU incidence remains high, disparities persist, especially in low-SDI regions. Strengthening prevention strategies and improving healthcare access are critical to reducing the global PU burden.</p>","PeriodicalId":23864,"journal":{"name":"Wound Repair and Regeneration","volume":"33 4","pages":"e70064"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12247018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Enhancing Skin Repair and Photodamage Reversal With 755-nm Picosecond Laser and Bioactive Polymer Dots in a Nude Mouse Model.","authors":"Bing-Qi Wu, Yen-Jen Wang, Chang-Cheng Chang, Tzong-Yuan Juang, Hsiu-Mei Chiang, Yi-Hsuan Tu, Jia-Chee Siew, Siao-Cian Fan","doi":"10.1111/wrr.70069","DOIUrl":"10.1111/wrr.70069","url":null,"abstract":"<p><p>Picosecond laser technology has emerged as a promising intervention for reversing photodamage by promoting epidermal repair and collagen regeneration. Polymer dots (PDs) have shown antioxidant and wound-healing properties. This study evaluates the efficacy of a combined 755-nm picosecond laser and bioactive PDs treatment to enhance skin repair and reverse photodamage in a nude mouse model subjected to UVB irradiation. Using twelve 6-week-old BALB/c nude mice, the experiment was conducted over 10 weeks, with the mice assigned to one of four groups: UVB alone, UVB + PEG1000, UVB + PD + PEG1000 and UVB + Laser +PD + PEG1000. Assessment methods included immunohistochemistry, enzyme-linked immunosorbent assay and Masson's trichrome staining to evaluate collagen content, epidermal thickness and protein expression associated with skin repair. The UVB + Laser + PD + PEG1000 group achieved a significant reduction in epidermal thickness by Day 22 (p = 0.0017) and showed superior collagen retention compared to the UVB group (p < 0.0001). In addition, MMP-9 levels in the UVB + PD + PEG1000 group reduced by 4.2% on Day 11 versus 9.3% in the UVB-only group on Day 1 (p = 0.03), while IL-6 levels markedly decreased in all treated groups compared to the UVB group, indicating diminished inflammation (p < 0.001). Analysis of Smad2/3 signalling on Day 11 in the UVB + PD + PEG1000 group revealed enhanced activation of skin repair pathways, with values reaching 2.8% compared to 1.3% in the UVB group on Day 1 (p = 0.0026). These findings suggest that combining the 755-nm picosecond laser with bioactive PDs offers a novel therapeutic approach for photodamage repair, enhancing collagen synthesis and inflammation reduction and supporting further investigation into its potential in skin ageing and damage reversal.</p>","PeriodicalId":23864,"journal":{"name":"Wound Repair and Regeneration","volume":"33 4","pages":"e70069"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jiajia Zhang, Dongxin Chen, Di Tang, Xianmei Wen, Ling Yue, Guangda Xiang, Tao Li
{"title":"Platelet-Rich Fibrin Promotes Wound Healing by Regulating miR-155 Levels in Diabetic Foot Ulcer.","authors":"Jiajia Zhang, Dongxin Chen, Di Tang, Xianmei Wen, Ling Yue, Guangda Xiang, Tao Li","doi":"10.1111/wrr.70073","DOIUrl":"10.1111/wrr.70073","url":null,"abstract":"<p><p>Diabetic foot ulcer (DFU) is a kind of refractory wound, with elevated miR-155 impeding the healing process. Platelet-rich fibrin (PRF) enhances tissue regeneration after injury, yet its therapeutic role and mechanisms in DFU remain unclear. The miR-155 levels in wound margin tissues from 20 DFU and 20 non-diabetic patients were compared. Sixty DFU patients meeting the inclusion criteria were divided into the control group (n = 36) and the PRF group (n = 24) after receiving basic treatment. Baseline clinical characteristics and healing progress were analysed between groups. The correlation between miR-155 levels in wound margin tissues and baseline clinical data were analysed, and the independent influencing factors of wound healing were explored by COX regression analysis. The effect of PRF on the miR-155, hypoxia inducible factor-1α (HIF-1α), vascular endothelial growth factor (VEGF), and vascular density in the wound margin tissue was measured. Elevated miR-155 expression was observed in DFU compared to non-diabetic wounds. The miR-155 levels were positively associated with Wagner grading (R = 0.578). Accelerated wound healing was demonstrated in the PRF group versus controls via Kaplan-Meier analysis. Multivariate Cox regression found that miR-155 (HR = 0.87, 95% CI: 0.79-0.97) and PRF intervention (HR = 3.21, 95% CI: 1.70-6.06) were statistically significant for wound healing time. After 15-day PRF interventions, miR-155 levels were suppressed, while HIF-1α and VEGF expression and vascular density were increased in PRF-treated wound margin tissues. PRF promotes the DFU healing via decreasing miR-155 levels in the wound margin tissue, enhancing the expression of HIF-1α and VEGF, and accelerating angiogenesis. These findings provide new evidence from evidence-based medicine and mechanistic insights for the application of PRF in treating DFU.</p>","PeriodicalId":23864,"journal":{"name":"Wound Repair and Regeneration","volume":"33 4","pages":"e70073"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144761562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Julie Acosta, Lydia Galarza, Margaret Marsh, Ricardo R Martinez, Mark Eells, Ashley W Collinsworth
{"title":"Effectiveness of Negative Pressure Wound Therapy With Instillation and Dwell in Removing Nonviable Tissue, Promoting Granulation Tissue, and Reducing Surgical Debridements: A Systematic Literature Review.","authors":"Julie Acosta, Lydia Galarza, Margaret Marsh, Ricardo R Martinez, Mark Eells, Ashley W Collinsworth","doi":"10.1111/wrr.70059","DOIUrl":"10.1111/wrr.70059","url":null,"abstract":"<p><p>Surgical debridement is a common treatment for complex wounds but can present risks for patients. Negative pressure wound therapy with instillation and dwell (NPWTi-d) using reticulated open cell foam dressings with 1 cm holes (ROCF-CC) provides hydromechanical wound cleaning and preparation and can be applied outside the operating room at the bedside. This systematic literature review examined the effectiveness of NPWTi-d with ROCF-CC in removing nonviable tissue and infectious material, promoting granulation tissue, and reducing surgical debridements. A systematic search was conducted utilising PubMed, Embase, and ClinicalTrials.gov to identify studies conducted from 1 January 2015-31 August 2022. Study outcomes related to nonviable tissue, granulation tissue, and debridement were summarised and analysed using descriptive statistics. Twenty-one studies including 178 patients who received NPWTi-d with ROCF-CC were included. Evidence of reduction in necrotic and infected tissue following treatment was observed in 97.9% of wounds across 17 studies. Formation of granulation tissue after NPWTi-d with ROCF-CC was reported in 99.2% of wounds across 14 studies. Over 63% of patients avoided surgical debridements in 8 studies, and a statistically significant decrease in surgical debridements was noted in 2 comparative studies. This systematic review provides real-world evidence demonstrating the effectiveness of NPWTi-d with ROCF-CC in the hydromechanical removal of infectious materials, non-viable tissue, and wound debris; reduction of surgical debridements; and promotion of granulation tissue. Thus, NPWTi-d with ROCF-CC may potentially reduce or eliminate the need for surgical debridement by removing non-viable tissue through hydromechanical action.</p>","PeriodicalId":23864,"journal":{"name":"Wound Repair and Regeneration","volume":"33 4","pages":"e70059"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Topical Tranexamic Acid, Adrenaline and Bupivacaine Solution for Pain Management and Healing in Split-Thickness Skin Graft Donor Sites: An Open-Label Interventional Study With Randomised Side Allocation.","authors":"Pattana Ongkasuwan","doi":"10.1111/wrr.70060","DOIUrl":"10.1111/wrr.70060","url":null,"abstract":"<p><p>Split-thickness skin graft donor site wounds present significant challenges in pain management and healing optimization. This intra-individual comparative study evaluated the efficacy and safety of a novel topical solution containing tranexamic acid, adrenaline and bupivacaine versus standard paraffin-chlorhexidine dressings, with side allocation determined by computer randomisation after graft harvesting. Twelve patients received standardised solution application on one donor site and standard treatment on the contralateral site, with each side's dressing changes performed according to protocol. The treatment group demonstrated significantly lower mean pain scores across all time intervals (1.1 vs. 5.3 at 24 h, p < 0.001). Mean epithelialization rates at Days 10-14 were higher in the treatment group (97.1% vs. 94.8%, p < 0.05), with faster time to complete healing (median 12 vs. 16 days, p = 0.002). No significant hemodynamic changes occurred following solution application, with only one case of transient tachycardia reported. Vancouver Scar Scale scores at eight weeks showed a trend favouring the treatment (3.8 vs. 4.2, p = 0.15), although this difference was not statistically significant. No infections were observed in either group. These findings suggest that this novel topical solution with transparent film dressing effectively reduces pain and accelerates healing in donor site wounds without compromising safety, providing a promising new option for managing these challenging surgical wounds.</p>","PeriodicalId":23864,"journal":{"name":"Wound Repair and Regeneration","volume":"33 4","pages":"e70060"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sebastian Willenborg, Katrin Schönborn, Mugdha Sawant, Anna Bornikoel, Takumi Yamane, Isabel Zeinert, Beate Eckes, Sabine A Eming, Thomas Krieg
{"title":"Fibroblast-Derived TGFβ1 Regulates Skin Repair and Fibrosis.","authors":"Sebastian Willenborg, Katrin Schönborn, Mugdha Sawant, Anna Bornikoel, Takumi Yamane, Isabel Zeinert, Beate Eckes, Sabine A Eming, Thomas Krieg","doi":"10.1111/wrr.70065","DOIUrl":"10.1111/wrr.70065","url":null,"abstract":"<p><p>Activation of fibroblasts and formation of myofibroblasts are essential for granulation tissue formation following injury. In fibrotic reactions, excessive deposition of ECM by the activated fibroblasts determines scar formation and functional failure. Although these events critically depend on the activity of a plethora of growth factors and cytokines, TGFβ1 is a unique player controlling the immune response and proliferation of many cell types. Different cell types contribute to its release and activation, which is also regulated by the interaction with the ECM and by mechanical forces. The aim of this study was to elaborate whether fibroblast-derived TGFβ1 plays a critical role during these processes. The data demonstrate a dynamic expression of TGFβ1 during tissue repair. Cell-specific ablation of Tgfb1 in fibroblasts revealed that deletion of TGFβ1 attenuates bleomycin-induced skin fibrosis and perturbs maturation of granulation tissue in skin wounds. Absence of fibroblast-derived TGFβ1 induced vascular alterations (less vascular density and branching, haemorrhage) in early wound healing. This was associated with alterations in the formation of stable ECM structure. This can be explained by paracrine regulation of endothelial cells or pericytes by fibroblast-released TGFβ1 and by impaired expression of pro-angiogenic factors in TGFβ1-deficient fibroblasts. Our findings provide novel mechanistic insights into the central role of fibroblast-derived TGFβ1 for early stages of tissue repair and fibrosis in the skin.</p>","PeriodicalId":23864,"journal":{"name":"Wound Repair and Regeneration","volume":"33 4","pages":"e70065"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12256102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nerdjes Ferhaoui, Mohammed Sebaihia, Tsuyoshi Sekizuka, Makoto Kuroda
{"title":"Shotgun Metagenomic Investigation of the Microbiome in Diabetic Foot Infections Compared to Healthy Skin.","authors":"Nerdjes Ferhaoui, Mohammed Sebaihia, Tsuyoshi Sekizuka, Makoto Kuroda","doi":"10.1111/wrr.70074","DOIUrl":"10.1111/wrr.70074","url":null,"abstract":"<p><p>Diabetic foot infection (DFI) is a major complication of diabetes, causing significant morbidity and mortality. Host factors and microorganisms in DFI can disrupt healing processes, leading to chronic, non-healing wounds. The aim of this study was to characterise the microbiome of DFIs and contralateral healthy foot skin (CHFS). Thirty-two diabetic patients were enrolled in this study. Samples were obtained from DFIs and CHFS from the same patient. The microbiome was profiled using metagenomic shotgun sequencing. All the samples were polymicrobial, with a predominance of the obligate anaerobes belonging to Bacteroidetes in PEDIS 4. While PEDIS 3 and 2 were dominated by Proteobacteria. CHFS showed similar bacterial composition across all grades of severity, and the most abundant genera detected were Corynebacterium, Staphylococcus, Pseudomonas, and Cutibacterium. The CHFS was more diverse than DFIs in PEDIS 3 and 4. However, DFIs and CHFS in PEDIS 2 present similar diversity. In addition, DFIs of this grade exhibited a high proportion of Corynebacterium as well as CHFS. PCoA analysis demonstrated that the community structure of DFIs was different from that of CHFS, with Prevotella, Bacteroides, and Porphyromonas the main contributors to the clustering. Neighbour-Net analyses revealed that DFIs exhibited lower diversity compared to CHFS and harboured a more homogeneous dominant bacterial community. Our study revealed a high abundance of obligate anaerobes, including Bacteroides, Prevotella, Morganella, and Porphyromonas, in more severe infections; along with a decrease in microbial diversity. Additionally, there was a decrease in the abundance of key bacteria from the normal skin microbiota.</p>","PeriodicalId":23864,"journal":{"name":"Wound Repair and Regeneration","volume":"33 4","pages":"e70074"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tim Torsy, Inge Tency, Dimitri Beeckman, Kirsi Isoherranen, Mary Litchford, Flore De Vylder
{"title":"The Role of Glutamine and Arginine in Wound Healing of Pressure Ulcers: A Systematic Review.","authors":"Tim Torsy, Inge Tency, Dimitri Beeckman, Kirsi Isoherranen, Mary Litchford, Flore De Vylder","doi":"10.1111/wrr.70077","DOIUrl":"10.1111/wrr.70077","url":null,"abstract":"<p><p>Pressure ulcers pose a significant health challenge, requiring effective management strategies. Nutrition, particularly arginine and glutamine, supports collagen synthesis and tissue repair. This review evaluates the role of enteral glutamine and arginine supplementation on wound healing outcomes, addressing gaps in previous research. A PRISMA-guided systematic search of five databases identified studies published between 2004 and 2024 on adults with pressure ulcers receiving these supplements. Outcomes assessed included healing time, wound size reduction, local infection, recurrence, and pain. A narrative synthesis was performed due to heterogeneity, with bias assessed via Cochrane RoB2 and JBI checklists. Fifteen studies involving 1085 participants were included. Findings indicated a trend toward improved healing with arginine or combined arginine/glutamine supplements, with relative wound size reductions of 18.6% to 98.2% over 2 to 20 weeks. However, inconsistencies were noted, with seven studies showing non-significant or unreported differences in wound size, and six studies with similar issues for healing time. Glutamine was examined only in combination with arginine, limiting insights into its isolated effects. None of the studies reported on recurrence or pain outcomes. While arginine shows potential for enhancing healing, evidence remains inconclusive. Future research should emphasise follow-up until complete wound closure and explore the independent effects of glutamine on wound healing outcomes.</p>","PeriodicalId":23864,"journal":{"name":"Wound Repair and Regeneration","volume":"33 4","pages":"e70077"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144761563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Andrew Nicholas, Fernando J Salinas, Tammy Gonzalez, Katherine Baquerizo Nole, Robert S Kirsner, Alan B Fleischer
{"title":"Patient Race and Ethnicity Do Not Predict Ulceration Among Ambulatory Patients With Venous Insufficiency.","authors":"Andrew Nicholas, Fernando J Salinas, Tammy Gonzalez, Katherine Baquerizo Nole, Robert S Kirsner, Alan B Fleischer","doi":"10.1111/wrr.70057","DOIUrl":"10.1111/wrr.70057","url":null,"abstract":"<p><p>Venous ulcers are among the most common chronic wounds, considerably impacting quality of life and causing substantial economic burden. This study aimed to determine if race and ethnicity are predictors for ulceration among ambulatory patients with venous insufficiency. Physician-reported data were extracted from the National Ambulatory Medical Care Survey (NAMCS) collected between 2014 and 2019. An estimated 42.7 (95% Confidence Interval (CI) 39.9-45.5) million outpatient visits with a diagnosis of venous insufficiency, unspecified chronic wound, or varicose veins were included in the analysis. Patient race and ethnicity were not associated with differences in the likelihood of ulceration. However, venous ulceration was associated with the male sex (Adjusted Odds Ratio (aOR) 2.5; 95% CI 1.2-5.2, p = 0.02) and was more likely among visits with surgical specialties (aOR 5.2; 95% CI 2.1-13.4, p = 0.0005). While prior studies report greater chronic wound treatment rates among non-White racial minority patients, these findings do not demonstrate differences in ambulatory care for venous ulceration within nationally representative data.</p>","PeriodicalId":23864,"journal":{"name":"Wound Repair and Regeneration","volume":"33 4","pages":"e70057"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}