Wound Repair and Regeneration最新文献_第3页

Clinical management of chronic wound infections: The battle against biofilm. 慢性伤口感染的临床管理：对抗生物膜

IF 3.8 3区医学

Wound Repair and Regeneration Pub Date : 2025-01-01 Epub Date: 2024-11-27 DOI: 10.1111/wrr.13241

Jennifer Hurlow, Randall D Wolcott, Philip G Bowler

{"title":"Clinical management of chronic wound infections: The battle against biofilm.","authors":"Jennifer Hurlow, Randall D Wolcott, Philip G Bowler","doi":"10.1111/wrr.13241","DOIUrl":"10.1111/wrr.13241","url":null,"abstract":"Bacteria constitute the most abundant life form on earth, of which the majority exist in a protective biofilm state. Since the 1980s, we have learned much about the role of biofilm in human chronic infections, with associated global healthcare costs recently estimated at ~$386 billion. Chronic wound infection is a prominent biofilm-induced condition that is characterised by persistent inflammation and associated host tissue destruction, and clinical signs that are distinct from signs of acute wound infection. Biofilm also enables greater tolerance to antimicrobial agents in chronic wound infections compared with acute wound infections. Given the difficulty in eliminating wound biofilm, a multi-targeted strategy (namely biofilm-based wound care) involving debridement and antimicrobial therapies were introduced and have been practiced since the early 2000s. More recently, acknowledgement of the speed at which biofilm can develop and hence quickly interfere with wound healing has highlighted the need for an early anti-biofilm strategy to combat biofilm before it takes control and prevents wound healing. This strategy, referred to as wound hygiene, involves multiple tools in combination (debridement, cleansing, and antimicrobial dressings) to maximise success in biofilm removal and encourage wound healing. This review is intended to highlight the issues and challenges associated with biofilm-induced chronic infections, and specifically address the challenges in chronic wound management, and tools required to combat biofilm and encourage wound healing.","PeriodicalId":23864,"journal":{"name":"Wound Repair and Regeneration","volume":" ","pages":"e13241"},"PeriodicalIF":3.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733119","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}

引用次数: 0

Indications for the use of dermal substitutes in patients with acute burns and in reconstructive surgery after burns: A systematic review. 在急性烧伤患者和烧伤后重建手术中使用皮肤替代品的适应症：系统回顾。

IF 3.8 3区医学

Wound Repair and Regeneration Pub Date : 2025-01-01 DOI: 10.1111/wrr.13248

Anna S van den Bosch, Robin A F Verwilligen, Anouk Pijpe, Lex B Jansen, Cornelis H van der Vlies, Merit E van Eck, George L Burchell, Paul P M van Zuijlen, Esther Middelkoop

{"title":"Indications for the use of dermal substitutes in patients with acute burns and in reconstructive surgery after burns: A systematic review.","authors":"Anna S van den Bosch, Robin A F Verwilligen, Anouk Pijpe, Lex B Jansen, Cornelis H van der Vlies, Merit E van Eck, George L Burchell, Paul P M van Zuijlen, Esther Middelkoop","doi":"10.1111/wrr.13248","DOIUrl":"10.1111/wrr.13248","url":null,"abstract":"Deep dermal and full-thickness burns often result in scar sequelae such as contractures, hypertrophy, pain and itching following split-thickness skin grafting. Dermal substitutes are currently employed alongside split-thickness skin grafting to enhance clinical outcomes, though their indications remain a subject of ongoing debate. This systematic review aims to clarify the indications for the application of dermal substitutes in burn patients, in both acute and reconstructive settings. A comprehensive search across various databases was conducted. Studies (n = 190) assessing the indications and outcomes of dermal substitutes in acute burn patients and those requiring reconstructive surgery were included. Data extraction included the applied dermal substitute, age, total body surface area, wound depth, burn aetiology, anatomical site and exclusion criteria. The indications were derived from predetermined indications, i.e. inclusion and exclusion criteria and patient characteristics. The depth of the wound emerged as the primary indication for dermal substitute use. A one-stage approach is recommended for deep dermal to full-thickness wounds larger than 10 cm2, while a two-stage approach is advised for wounds of this depth with limited donor sites or exposed bone or tendon. No definitive age or burn/scar location thresholds were identified, and careful consideration is advised for electrical and chemical burns. Contraindications include wound infections and allergies to matrix components. Limited data exist on use in patients with diabetes mellitus, chronic vascular disease, or immunocompromised status. This is the first review to address the indications for dermal substitutes in burn patients, providing valuable insights for the development of international evidence-based treatment guidelines.","PeriodicalId":23864,"journal":{"name":"Wound Repair and Regeneration","volume":"33 1","pages":"e13248"},"PeriodicalIF":3.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11672668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898536","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}

引用次数: 0

Repurposing selective serotonin reuptake inhibitors for wound infection management: Expanding the scope of non-antibiotic therapeutics.

IF 3.8 3区医学

Wound Repair and Regeneration Pub Date : 2025-01-01 DOI: 10.1111/wrr.70006

Lien-Chung Wei, Hsien-Jane Chiu

引用次数: 0

Clinically relevant evaluation of the antimicrobial and anti-inflammatory properties of nanocrystalline and nanomolecular silver. 纳米晶体和纳米分子银抗菌和抗炎特性的临床相关评价。

IF 3.8 3区医学

Wound Repair and Regeneration Pub Date : 2025-01-01 DOI: 10.1111/wrr.13249

Matthew W Pletts, Robert E Burrell

{"title":"Clinically relevant evaluation of the antimicrobial and anti-inflammatory properties of nanocrystalline and nanomolecular silver.","authors":"Matthew W Pletts, Robert E Burrell","doi":"10.1111/wrr.13249","DOIUrl":"10.1111/wrr.13249","url":null,"abstract":"Burns and chronic wounds present significant challenges in wound management due to risks of infection, excessive inflammation, and prolonged healing. Silver-based treatments have long been central to burn care, but limitations have prompted the exploration of nanocrystalline silver as an alternative, with its nanoscale properties offering distinct benefits. This paper reviews the structure, properties, mechanisms of action, and clinical applications of nanocrystalline silver in burn and general wound management, with particular emphasis on how wound healing processes inform the application of these dressings. Nanocrystalline silver's high surface area-to-volume ratio and crystal structure enhance its antimicrobial and anti-inflammatory efficacy. Nanocrystalline silver's mechanisms of action are disrupting cellular functions, inducing DNA damage, and inhibiting biofilms. Clinical studies demonstrate accelerated healing and reduced inflammation compared to traditional treatments. Whilst nanocrystalline silver dressings are costly, their effectiveness in lowering drug-resistant infections and minimising complications supports a financial case for their use, potentially reducing overall wound care expenses. Considerations of cytotoxicity, allergic reactions, and accessibility underscore the importance of individualised treatment selection based on wound and patient factors. In conclusion, nanocrystalline silver holds substantial promise in burn wound management, and further research is warranted to optimise its therapeutic potential and economic benefits in clinical practice.","PeriodicalId":23864,"journal":{"name":"Wound Repair and Regeneration","volume":"33 1","pages":"e13249"},"PeriodicalIF":3.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11662198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873017","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}

引用次数: 0

The infected diabetic foot: Incidence and risk factors for dehiscence after surgery for diabetic foot infections. 感染的糖尿病足：糖尿病足感染术后裂开的发生率和危险因素。

IF 3.8 3区医学

Wound Repair and Regeneration Pub Date : 2025-01-01 DOI: 10.1111/wrr.13235

Lawrence A Lavery, Mario C Reyes, Bijan Najafi, Tyler L Coye, Jayer Chung, Michael C Siah, Arthur N Tarricone

{"title":"The infected diabetic foot: Incidence and risk factors for dehiscence after surgery for diabetic foot infections.","authors":"Lawrence A Lavery, Mario C Reyes, Bijan Najafi, Tyler L Coye, Jayer Chung, Michael C Siah, Arthur N Tarricone","doi":"10.1111/wrr.13235","DOIUrl":"10.1111/wrr.13235","url":null,"abstract":"Our objective was to assess the incidence, risk factors and clinical outcomes of dehiscence after foot surgery in diabetic patients. We used pooled patient-level data from two randomised clinical trials with 240 diabetic patients who required foot surgery for infections. Most patients (n = 180, 75.0%) had surgical wound closure. We defined dehisced surgical wounds (DSW) when the surgical site was not completely epithelialized with no drainage after sutures/staples were removed with a 2-week validation of healing. We evaluated the time to heal, re-infection, re-ulceration, hospital admissions and amputations. Moderate and severe infection was based on criteria of the International Working Group on the Diabetic Foot. We used χ2 and t-test and Mann-Whitney U for comparison of clinical events, with α of <0.05. DSW occurred in 137 (76.1%) patients. DSW patients were more likely to have hypertension (62.8% vs. 81.8%, p = 0.01), high ESR (59.1 ± 37.9 vs. 75.9 ± 37.6, p = 0.01), low toe brachial indices (0.8 ± 0.2) (0.7 ± 0.2, p = 0.005), toe brachial indices <0.6 (16.7% vs. 40.9%, p = 0.008), and low skin perfusion pressure measurements (dorsal medial 71.0 ± 29.4 vs. 59.3 ± 23.3, p = 0.01, and plantar medial 81.8 ± 24.9 vs. 72.2 ± 20.4, p = 0.02). During 12-month follow-up, DSW patients were 12.9 times more likely to have re-infection (0% vs. 12.4%, p = 0.02) and 6.8 times more likely to require amputation (2.3% vs. 13.9%, p = 0.04). The median healing time (28, 22.5-35.0 vs. 114.0, 69.0; 365, p = 0.001), and median length of hospitalisation were longer in DSW patients (12.0, 9.01-9.0 vs. 15.0, 11.0-24.0, p = 0.04). There was a high incidence of DSW, associated with poor clinical outcomes.","PeriodicalId":23864,"journal":{"name":"Wound Repair and Regeneration","volume":"33 1","pages":"e13235"},"PeriodicalIF":3.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11647064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830073","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}

引用次数: 0

Pressure injuries and biofilms: Microbiome, model systems and therapies.

IF 3.8 3区医学

Wound Repair and Regeneration Pub Date : 2025-01-01 DOI: 10.1111/wrr.70005

Fahad Kabir, Deborah Bow Yue Yung, Waleska Stephanie da Cruz Nizer, Kira Noelle Allison, Sandra Zigic, Emily Russell, Katrina G DeZeeuw, Jonah E Marek, Edana Cassol, Daniel Pletzer, Joerg Overhage

{"title":"Pressure injuries and biofilms: Microbiome, model systems and therapies.","authors":"Fahad Kabir, Deborah Bow Yue Yung, Waleska Stephanie da Cruz Nizer, Kira Noelle Allison, Sandra Zigic, Emily Russell, Katrina G DeZeeuw, Jonah E Marek, Edana Cassol, Daniel Pletzer, Joerg Overhage","doi":"10.1111/wrr.70005","DOIUrl":"10.1111/wrr.70005","url":null,"abstract":"Chronic wounds have emerged as significant clinical problems owing to their increasing incidence and greater recognition of associated morbidity and socio-economic burden. They are defined as wounds that do not progress normally through the stages of healing in a timely and/or orderly manner. Pressure injuries, in particular, represent a serious problem for patients who are elderly or have limited mobility, such as wheelchair users or those who spend most of the day in bed. These injuries often result from prolonged pressure exerted on the skin over the bone. Treatment of pressure injuries is complex and costly. Emerging evidence suggests that the pressure injury microbiome plays a vital role in chronic wound formation and delaying wound healing. Additionally, antibiotics often fail due to the formation of resistant biofilms and the emergence of antimicrobial-resistant bacteria. In this review, we will summarise the current knowledge on: (a) biofilms and microbiomes in pressure injuries; (b) in vitro and in vivo model systems to study pressure injuries, and (c) current therapies and novel treatment approaches. Understanding the complex interactions between microbes and the host immune system in pressure injuries will provide valuable insights to improve patient outcomes.","PeriodicalId":23864,"journal":{"name":"Wound Repair and Regeneration","volume":"33 1","pages":"e70005"},"PeriodicalIF":3.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11826131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415067","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}

引用次数: 0

A structural equation model predicts chronic wound healing time using patient characteristics and wound microbiome composition.

IF 3.8 3区医学

Wound Repair and Regeneration Pub Date : 2025-01-01 DOI: 10.1111/wrr.70004

Jacob Ancira, Rebecca Gabrilska, Craig Tipton, Clint Miller, Zachary Stickley, Khalid Omeir, Catherine Wakeman, Todd Little, Joseph Wolcott, Caleb D Philips

{"title":"A structural equation model predicts chronic wound healing time using patient characteristics and wound microbiome composition.","authors":"Jacob Ancira, Rebecca Gabrilska, Craig Tipton, Clint Miller, Zachary Stickley, Khalid Omeir, Catherine Wakeman, Todd Little, Joseph Wolcott, Caleb D Philips","doi":"10.1111/wrr.70004","DOIUrl":"10.1111/wrr.70004","url":null,"abstract":"Wound aetiology, host characteristics and the wound microbiome contribute to chronic wound development. Yet, there is little accounting for the relative importance of these factors to predict wound healing. Here, a structural equation model was developed to provide such an explanatory and predictive framework. Chronic wounds from 565 patients treated at a clinic practicing biofilm-based wound care were included. Patient information included DNA sequencing-based wound microbiome clinical reports corresponding to the initial clinical visit. Wound microbiome data was integrated into the SEM as a latent variable using a pre-modelling parcel optimization routine presented herein for the first time (available as R library parcelR). A microbiome latent construct associated with improved healing was validated, and the final SEM included this latent construct plus three species associated with diminished healing (Anaerococcus vaginalis, Finegoldia magna and Pseudomonas aeruginosa), as well as smoking, wound volume, slough, exudate, edema, percent granulation and wound etiology. This model explained 46% of variations in healing time, with the microbiome contributing the largest proportion of variance explained. Model validity was confirmed with an independent cohort (n = 79) through which ~60% of the variation in healing time was predicted. This model can serve as a foundation for the development of a predictive tool that may have clinical utility.","PeriodicalId":23864,"journal":{"name":"Wound Repair and Regeneration","volume":"33 1","pages":"e70004"},"PeriodicalIF":3.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442218","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}

引用次数: 0

Exploring the gaps: A scoping review of burn injury research in skin of colour. 探索空白：有色皮肤烧伤研究的范围综述。

IF 3.8 3区医学

Wound Repair and Regeneration Pub Date : 2025-01-01 DOI: 10.1111/wrr.13252

Antoinette Nguyen, Emily Duckworth, Anmar Abu-Romman, Bradley Melnick, Brigid Coles, Robert D Galiano

{"title":"Exploring the gaps: A scoping review of burn injury research in skin of colour.","authors":"Antoinette Nguyen, Emily Duckworth, Anmar Abu-Romman, Bradley Melnick, Brigid Coles, Robert D Galiano","doi":"10.1111/wrr.13252","DOIUrl":"10.1111/wrr.13252","url":null,"abstract":"Burn injury management and outcomes reveal observed disparities in individuals with darker skin tones, likely influenced by limited representation in medical literature and clinical research. These gaps may contribute to variations in care quality and outcomes for these populations. A comprehensive literature search was conducted across PubMed, Scopus, and Embase databases, initially yielding 74 articles. Due to limited relevant studies directly addressing the research question, the approach shifted from a systematic review to a scoping review to allow for a broader exploration of potential disparities in burn injury outcomes. Following these criteria, 31 relevant articles were identified and analysed. The analysis suggests an underrepresentation of diverse skin tones in medical textbooks and clinical research, limitations in current burn assessment tools for darker skin, and a lack of tailored treatment protocols. Studies indicate that patients with darker skin tones may face higher risks of complications and varied outcomes, potentially influenced by systemic healthcare challenges and limited guidelines addressing diverse skin types. This scoping review highlights the importance of more inclusive research and clinical practices that consider the specific needs of individuals with darker skin tones. Addressing these observed gaps can support improvements in burn injury management, ultimately contributing to more equitable healthcare for all skin types.","PeriodicalId":23864,"journal":{"name":"Wound Repair and Regeneration","volume":"33 1","pages":"e13252"},"PeriodicalIF":3.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972356","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}

引用次数: 0

The infected diabetic foot: Risk factors for re-infection after treatment for diabetic foot osteomyelitis. 糖尿病足感染：糖尿病足骨髓炎治疗后再感染的危险因素

IF 3.8 3区医学

Wound Repair and Regeneration Pub Date : 2025-01-01 DOI: 10.1111/wrr.13246

Lawrence A Lavery, Mario C Reyes, Bijan Najafi, Tyler L Coye, Matthew Sideman, Michael C Siah, Arthur N Tarricone

{"title":"The infected diabetic foot: Risk factors for re-infection after treatment for diabetic foot osteomyelitis.","authors":"Lawrence A Lavery, Mario C Reyes, Bijan Najafi, Tyler L Coye, Matthew Sideman, Michael C Siah, Arthur N Tarricone","doi":"10.1111/wrr.13246","DOIUrl":"10.1111/wrr.13246","url":null,"abstract":"Our objective was to evaluate risk factors for re-infection in patients after treatment for diabetic foot osteomyelitis (OM). We used pooled patient level data from two RTCs that evaluated patients with diabetic foot infections. We evaluated 171 patients with OM. OM was confirmed with bone culture or histopathology. Data from the 12-month follow-up were used to determine clinical outcomes. Re-infection occurred in 47 (27.5%) patients. Risk factors for re-infection were Toe Brachial Index <0.40 (25.7% vs. 9.8%, p = 0.02), skin perfusion pressure <40 mmHg (6.3% vs. 5.9%, p = 0.04), wound healing (55.3% vs. 75.0%, p = 0.01), time to heal (156.0, 69.5-365 vs. 91.5, 38.8-365, p = 0.001), and history of MI (14.9% vs. 3.2%, p = 0.005). During 12-month follow-up, patients with re-infections were 198.8 times more likely to require a foot related hospitalisation (81.8% vs. 0.0%, p = 0.001), 10.4 times more likely have an all-cause hospitalisation (70.2% vs. 18.5%, p = 0.001) and 9.4 times more likely to need an amputation (36.2% vs. 5.6%, p = 0.001). Patients with re-infection had a significantly longer median length of hospitalisation (20.0, 13.5-34.5 vs. 14.0, 10.0-22.0, p = 0.003) and median length of antibiotic duration (55.0, 35.0-87.0 vs. 46.0, 22.8-68.0, p = 0.03). Patients with re-infection are less likely to heal and have more foot-related hospitalizations and amputations.","PeriodicalId":23864,"journal":{"name":"Wound Repair and Regeneration","volume":"33 1","pages":"e13246"},"PeriodicalIF":3.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012635","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}

引用次数: 0

More than a bag of tricks - Curriculum schema for chronic lower extremity wound healing.

IF 3.8 3区医学

Wound Repair and Regeneration Pub Date : 2025-01-01 DOI: 10.1111/wrr.70000

Enjae Jung, Bryanna De Lima, Alex G Ortega-Loayza, E Foy White-Chu

引用次数: 0