International Journal of Burns and Trauma最新文献

{"title":"Diagnostic accuracy of ultrasound compared to magnetic resonance imaging for rotator cuff tears: a systematic review.","authors":"Farzaneh Hekmatnia, Ghazaleh Jamalipour Soufi, Andrew Parviz Zarei, Shamim Shafieioun, Ali Hekmatnia, Nazanin Sadraei, Farshad Riahi","doi":"10.62347/VJLM3737","DOIUrl":"10.62347/VJLM3737","url":null,"abstract":"<p><strong>Objective: </strong>This systematic review aimed to conduct a comprehensive comparative analysis of the diagnostic performance of magnetic resonance imaging (MRI) and ultrasound (US) in detecting rotator cuff tears (RCTs).</p><p><strong>Methods: </strong>A systematic literature search was conducted in the PubMed, Scopus, and Embase databases from January 2021 to March 2025 for original studies on adults (≥18 years) with suspected RCTs undergoing both US and MRI. Thirteen studies involving 792 participants met the inclusion criteria.</p><p><strong>Results: </strong>US was better than MRI for full-thickness tears, with a sensitivity of 100% (especially for supraspinatus), a specificity of 81-100%, and a kappa of up to 1.0. For partial-thickness tears, the results varied (sensitivity 72-94%, accuracy 76-94%). Non-supraspinatus tendons were less reliable, and the results were affected by the operator's skill, the patient's sex (worse in females), and the side of the body. MRI was better for partial tears, complicated cases, and planning surgery.</p><p><strong>Conclusion: </strong>The findings demonstrate that US can serve as a valuable auxiliary imaging modality for rotator cuff evaluation, particularly excelling in detecting full-thickness tears when MRI is contraindicated, unavailable, or in resource-limited settings. While US shows excellent diagnostic performance for full-thickness supraspinatus tears, MRI remains the primary diagnostic standard in clinical practice for comprehensive rotator cuff assessment, particularly for partial tears, complex pathologies, and detailed pre-operative planning.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":"16 2","pages":"33-44"},"PeriodicalIF":1.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13195288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148018091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing evacuation delay: the critical role of the core region of combat trauma concept in future warfare.","authors":"Qilin Huang, Yanan Zhou, Ning Luo, Juxiang Chen","doi":"10.62347/DXAN7688","DOIUrl":"10.62347/DXAN7688","url":null,"abstract":"<p><p>With the transition to large-scale combat operations (LSCOs) and distributed warfare in theatre, medical evacuation times could be a lot longer, which challenges the \"golden hour\". In response to this challenge, the paper presents the \"Core Region of Combat Trauma (CRCT)\" as a novel framework for directing care in the Prolonged Casualty Care (PCC) phase when evacuation is prolonged. The CRCT is the site of injuries which are among the leading causes of potentially preventable deaths following Tactical Combat Casualty Care (TCCC). The care of CRCT located in the transitional phase between TCCC and damage control surgery. The guiding principle of CRCT management is damage control and physiological maintenance. This methodology facilitates the transition of casualties from a state where evacuation is not feasible to one where evacuation is tolerable.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":"16 2","pages":"72-75"},"PeriodicalIF":1.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13195289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148018131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myocutaneous latissimus dorsi split pedicle flap for simultaneous reconstruction of elbow and breast: a case report.","authors":"Roman K Romansky, Tsvetelina S Spiridonova","doi":"10.62347/EMTY5889","DOIUrl":"10.62347/EMTY5889","url":null,"abstract":"<p><p>In this article we present a case of a large anterior elbow defect and an ipsilateral post-mastectomy defect reconstructed simultaneously using a single latissimus dorsi pedicle flap, split into two separate skin islands based on its independent vascular branches. To the best of our knowledge, no previous cases utilizing this approach for simultaneous treatment of mastectomy and distal arm tissue defects have been reported. Therefore, it was deemed relevant to share the technical aspects of the surgical procedure. The case involves a 61-year-old woman of Caucasian origin, diagnosed with breast cancer of the left breast. She underwent a modified radical mastectomy. Postoperative radiotherapy and chemotherapy were administered. During a chemotherapy infusion, extravasation of the chemotherapeutic agent led to necrosis in the left elbow and distal upper arm regions. The patient was primarily treated at another facility with skin grafting. We performed a reconstruction with a pre-expanded latissimus dorsi pedicle flap divided into two independent myocutaneous flaps for the upper extremity and mastectomy defects. The left breast underwent delayed combined reconstruction with the myocutaneous flap and a silicone implant. The upper extremity defect was simultaneously reconstructed with the other part of the same flap. The whole reconstruction included three operative stages. The blood supply to the transferred tissues was excellent and no complications occurred. The constant vascular anatomy of the thoracodorsal vessels and their intramuscular distribution pattern provides a robust amount of healthy tissue, which can be successfully used for treating a variety of defects within the flaps rotational arc. This allows for the reconstruction of different anatomical regions. Based on this case we demonstrate that coverage of a large elbow defect and simultaneous breast reconstruction is possible by splitting a pre-expanded pedicle latissimus dorsi flap into two independent flaps.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":"16 2","pages":"51-54"},"PeriodicalIF":1.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13195293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148018152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical observation of Wound Care Ointment on split-thickness skin graft donor site healing.","authors":"Fang Zhang, Hongyang Meng, Xinlei Yang, Zhijun Chen, Lei Lei, Xiaolu Xu, Zhiying Wang, Zhangyuzhe Liang, Xinhe Zhang, Xiaoying Gao","doi":"10.62347/KLLY6516","DOIUrl":"10.62347/KLLY6516","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the clinical application of Wound Care Ointment combined with Vaseline gauze for the repair of split-thickness skin graft donor sites.</p><p><strong>Methods: </strong>A total of 64 patients who met the inclusion criteria were included. The study group (32 patients) used Vaseline gauze lined with Wound Care Ointment to close the split - thickness skin graft donor sites, while Vaseline gauze was applied directly to the donor sites in the control group (32 patients). Demographic data, wound infection conditions, epithelialization time, the time of the first postoperative outer gauze replacement, Visual analogue scale (VAS) during the first postoperative outer gauze change and the number of layers of bleeding gauze were recorded for the selected patients.</p><p><strong>Results: </strong>The epithelialization time of the donor site wound in the study group was significantly shorter than that in the control group [(10.09±0.93) days vs. (10.78±0.94) days, P<0.05]; VAS for the first postoperative change of the outer gauze in the study group was lower than that in the control group (2.47±0.84 vs. 3.53±1.14, P<0.05); the time for the first postoperative change of the outer gauze in the study group was later than that in the control group [(6.38±0.91) days vs. (5.78±1.26) days, P<0.05]; and the number of layers of bleeding gauze during the first postoperative change of the outer dressing in the study group was less than that in the control group (6.72±1.02 vs. 7.50±1.08, P<0.05).</p><p><strong>Conclusion: </strong>Wound Care Ointment is beneficial for the wound healing of split-thickness skin graft donor sites, which prolongs the first postoperative dressing change, reduces pain during the removal of the inner layer dressing, provides excellent wound protection and shortens the healing time. Therefore, Wound Care Ointment can be recommended for the repair of split-thickness skin graft donor sites.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":"16 2","pages":"45-50"},"PeriodicalIF":1.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13195291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148018162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rethinking intraoperative blood loss monitoring: a decision-oriented framework for clinically integrated assessment.","authors":"Jiangtao Bai, Yutong Lu, Guilin Wang, Qihui Zheng, Haitao Jia, Zhilong Dong, Yunxin Zhang, Zhiping Wang","doi":"10.62347/RYZE7872","DOIUrl":"10.62347/RYZE7872","url":null,"abstract":"<p><p>Intraoperative blood loss (IBL) monitoring is an important factor in decision-making of anesthesia, and real-time and reliable IBL is vital in the safety of the patient during the perioperative period. But even now after decades of technological development in medicine, this basic clinical issue has not been addressed. The current strategies of monitoring do not usually achieve all the needs of accuracy, timeliness, and procedural flexibility in regular clinical care. This article re-examines this critical issue of intraoperative blood loss monitoring from the perspective of actual clinical surgery and anesthesiology. We analyzed the structural reasons for the long-term unreliability of IBL clinical measurements and proposed some core principles for future surveillance strategies. Traditional methods for assessing intraoperative blood loss include visual estimation, gravimetric methods, volumetric methods, and laboratory or spectrophotometric methods. These methods all have inherent limitations. We believe these shortcomings are not isolated technical problems, but rather stem from a design philosophy that did not address the needs of clinical decision-making from the outset. To better explain the clinical challenges faced by IBL monitoring, we propose the \"Irreconcilable Triangle of IBL Monitoring\" model. This model consists of three conflicting requirements: accuracy, timeliness, and workflow compatibility. Optimizing one dimension of technology inevitably compromises other dimensions. Therefore, we redefine accuracy as \"functional accuracy\". That is, the accuracy of intraoperative bleeding monitoring should reach the level necessary to support intraoperative clinical decision-making, without pursuing absolute accuracy. Simultaneously, it should be made as time-relevant and clinically feasible as possible to meet clinical needs. This paper envisions future strategies for intraoperative blood loss monitoring. Future clinical practice requires automated equipment capable of continuously quantifying free blood, absorbed blood, and blood clots, shifting from inferential estimation to direct automated measurement. Furthermore, this equipment must be seamlessly integrated into the anesthesia workflow. The paper discusses the availability of artificial intelligence (AI) in surgical blood loss monitoring. We believe that while AI has limitations in interpretability, it can serve as a complication prediction and backend computational tool for the entire monitoring system. In the future, we hope to develop IBL monitoring into an integrated system centered on clinical usability and decision relevance through new technology development and system integration.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":"16 2","pages":"59-71"},"PeriodicalIF":1.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13195292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148018085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One-stage transplantation of artificial dermis and autologous split-thickness skin graft for the repair of severe foot trauma: a case report.","authors":"Yibin Guo, Yang Yang, Guoqing Wu, Hongwei Bai, Liping Chen","doi":"10.62347/ZQRY9327","DOIUrl":"10.62347/ZQRY9327","url":null,"abstract":"<p><p>For the repair of complex wounds involving bone and joint infections resulting from severe trauma, the conventional approach typically involves a two-stage procedure: initial implantation of an artificial dermis (AD), followed by autologous split-thickness skin grafting (STSG) after 2-3 weeks. This report presents an innovative one-stage technique in which AD and autologous STSG were transplanted simultaneously onto a wound bed prepared with antibiotic-loaded bone cement (ALBC). The patient had sustained multiple open fractures, dislocations, bone defects, and bone and joint infections following a traffic accident. After two initial surgical procedures that included thorough debridement, fracture fixation, and ALBC placement for infection control, a one-stage skin graft was performed to co-implant AD and autologous STSG (0.15-0.25 mm thick) for wound closure. At the 18-month follow-up, the graft flap exhibits no contraction, and its color, texture, softness, and elasticity closely resemble those of the surrounding normal skin. This ALBC-assisted one-stage transplantation of AD combined with autologous STSG offers a feasible and efficient method for repairing complex wounds involving bone and joint injuries with concomitant skin and soft tissue defects. Moreover, it may reduce treatment duration and simplify the clinical pathway compared with traditional two-stage skin grafting protocols.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":"16 2","pages":"55-58"},"PeriodicalIF":1.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13195290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148018100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A randomized open-label study comparing the safety and efficacy of a natural antimicrobial dressing with silver sulfadiazine in the management of second-degree burn wounds.","authors":"Soumya Gayen, Shivalingappa B Javalli, Siddharth Pandey","doi":"10.62347/AXSO3940","DOIUrl":"10.62347/AXSO3940","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluates the efficacy of VELVERT, a novel antimicrobial dressing, compared to the standard Silver Sulfadiazine dressing in treating second-degree burns.</p><p><strong>Method: </strong>Conducted at a tertiary burn care center, 63 patients were enrolled and randomized into two groups: VELVERT (n = 31) and Silver Sulfadiazine (n = 30). The primary outcomes measured were wound closure percentage and time to complete healing within 24 days, while secondary outcomes included infection control, pain relief, and adverse events. The study was registered with CTRI with the registration number CTRI/2020/12/029698 (https://ctri.nic.in/Clinicaltrials/pmaindet2.php?EncHid=NDY5MDc=&Enc=&userName=).</p><p><strong>Result: </strong>Among 61 patients who completed the study, 87% (27/31) in the VELVERT group achieved complete wound healing compared to 63% (19/30) in the Silver Sulfadiazine group. The BWAT score, assessing wound healing, showed a decline from 31.66 ± 3.15 to 15.55 ± 4.42 in the VELVERT group and from 31.55 ± 3.35 to 16.18 ± 5.37 in the Silver Sulfadiazine group (P = 0.176). Both treatments were well tolerated, but VELVERT exhibited superior wound healing outcomes.</p><p><strong>Conclusion: </strong>These findings suggest that VELVERT may serve as a more effective alternative for second-degree burn treatment, offering improved healing rates. Further research with larger sample sizes is recommended to validate its clinical benefits over standard treatments.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":"16 1","pages":"14-24"},"PeriodicalIF":1.0,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13012882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147521909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiographic and functional outcomes of dorsal-assisted volar plate fixation in comminuted intra-articular distal radius fractures: a prospective study.","authors":"Akshay A Shreegan, Deepak Kumar, Anil Kumar Kotteda, Arjit Bansal, Tharun Teja Aduri, Vijay Goni","doi":"10.62347/GFNB2009","DOIUrl":"10.62347/GFNB2009","url":null,"abstract":"<p><strong>Objective: </strong>Comminuted intra-articular distal radius fractures (DRFs) present significant treatment challenges due to their complex morphology and tendency for post-traumatic arthritis. Volar plating alone may be insufficient to achieve and maintain reduction in dorsally displaced fractures. This prospective study evaluated the radiological and functional outcomes of dorsal-assisted volar plate fixation in dorsally displaced comminuted intra-articular DRFs.</p><p><strong>Methods: </strong>A total of 21 patients treated at a tertiary care trauma centre were enrolled. All underwent dorsal-assisted reduction followed by volar plating without dorsal instrumentation and were followed for a minimum of one year (mean follow-up: 19.6 ± 4.7 months). Radiological outcomes were assessed using radial height, radial inclination, volar tilt, and intra-articular step-off, while functional outcomes were measured using the QuickDASH and modified Mayo Wrist scores. The study was prospectively registered in the Department review board in department of Orthopaedic Surgery, PGIMER, under registration number DRB/Ortho/2023/49.</p><p><strong>Results: </strong>The mean patient age was 38 years, with a male predominance (17/21; 80.9%). Most fractures (15/21; 71.4%) were AO type 2R3C3. Postoperative evaluation demonstrated restoration of wrist alignment with a mean radial inclination of 23.35°, radial height of 11.29 mm, and volar tilt of 6.70°, closely approximating the uninjured wrist. Functional outcomes improved significantly from two months postoperatively to the final follow-up (P < 0.001), achieving a mean QuickDASH score of 4.95 and a modified Mayo Wrist Score of 90. Only two patients experienced minor complications related to implant prominence.</p><p><strong>Conclusions: </strong>Dorsal-assisted volar plating is a safe and effective technique for managing dorsally displaced comminuted intra-articular distal radius fractures, providing excellent anatomical restoration and functional recovery with minimal complications. It offers a valuable surgical option where volar plating alone may be inadequate.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":"16 1","pages":"25-32"},"PeriodicalIF":1.0,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13012884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147521887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of the nutritional approach and recovery in children with flame burns: case report and review of the literature.","authors":"Carolina Bonilla-González, Juanita Uribe-Londoño, Arianna Martínez, Karen Andrea Lancheros Molano, Yessica León Avendaño, María Margarita-Rodriguez","doi":"10.62347/SLPK7207","DOIUrl":"10.62347/SLPK7207","url":null,"abstract":"<p><p>Pediatric burn injuries present unique challenges due to children's physiological vulnerabilities. This article provides a detailed analysis of the nutritional management of an 11-year-old patient with extensive burns affecting 60% of total body surface area. The patient received intensive care in a specialized pediatric burn unit, highlighting the fundamental role of nutrition in counteracting catabolic states and muscle loss frequently observed in these cases. Nutritional strategies-including gastrostomy infusion, albumin supplementation, and protein-enriched diets-were carefully implemented to optimize energy intake and promote wound healing. The article also reviews the metabolic and immunological responses of burn patients, emphasizing the importance of early nutritional support to mitigate hypermetabolism and enhance immune defense. Key elements of nutritional assessment, such as energy requirement estimation and macronutrient composition, are explored. Furthermore, the role of micronutrient supplementation in accelerating wound healing and reducing infectious complications is underscored. The article concludes by highlighting the evolving landscape of pediatric burn care, stressing the importance of interdisciplinary collaboration and the integration of advanced technologies to achieve precise nutritional interventions. This case study provides valuable insights into optimizing nutritional strategies for pediatric burn patients and contributes to the advancement of pediatric critical care.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":"16 1","pages":"1-13"},"PeriodicalIF":1.0,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13012883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147521821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of holistic assessment, multidisciplinary diagnosis and treatment, and negative-pressure wound therapy with instillation in managing complex diabetic foot ulcers: a case-based discussion.","authors":"Shaobin Yu, Weiqiang Zhang, Xiaoyuan Wu, Yuhuan Zhao, Zhifeng Yang, Junyi He, Ronghua Yang","doi":"10.62347/UJRA7230","DOIUrl":"10.62347/UJRA7230","url":null,"abstract":"<p><p>The etiology of diabetic foot ulcers (DFU) is multifactorial, encompassing neuropathy, peripheral arterial disease, and susceptibility to infection. The management of DFU remains challenging due to high recurrence rates and amputation risks. While various treatments exist, a standardized, effective approach integrating holistic care is essential. This paper presents a detailed analysis of two representative cases of complex DFU managed within our institution. Both patients underwent a structured process involving immediate holistic assessment, formation of an MDT to devise personalized treatment strategies, surgery, application of NPWTi, and structured post-discharge planning including health education. Eventually, both patients achieved successful wound closure without major amputation. The successful management of complex DFU necessitates a paradigm shift from isolated interventions to a comprehensive strategy. This strategy should encompass 1) early holistic patient assessment, 2) centralized coordination via an MDT for personalized care plans, 3) meticulous surgical debridement, 4) judicious use of advanced adjunctive therapies like NPWTi, and 5) robust post-discharge follow-up and patient education to prevent recurrence. This framework serves as a practical guide until further robust evidence emerges to refine these recommendations.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":"15 6","pages":"238-247"},"PeriodicalIF":1.0,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12816875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}