International Journal of Lower Extremity Wounds最新文献

{"title":"Mean Platelet Volume-to-Lymphocyte Ratio Is a Biomarker of 1-Year Mortality in Patients With Diabetic Foot Infections.","authors":"Javier Aragón-Sánchez, Gerardo Víquez-Molina, María Eugenia López-Valverde, Cristina Aragón-Hernández, Javier Aragón-Hernández, José María Rojas-Bonilla","doi":"10.1177/15347346231165668","DOIUrl":"10.1177/15347346231165668","url":null,"abstract":"<p><p>We aimed to evaluate the value of 2 peripheral blood cell ratios, the mean platelet volume-to-lymphocyte ratio (MPVLR) and the neutrophil-to-lymphocyte ratio (NLR) as prognostic biomarkers of mortality in patients with diabetic foot infections (DFIs). We conducted a prospective observational study consisting of a cohort of 200 patients with moderate to severe DFIs consecutively recruited from our Diabetic Foot Unit, Hospital San Juan de Dios, San José de Costa Rica, Costa Rica from October 15, 2020, to December 15, 2021. We studied the variables associated with one-year all-cause mortality using a multivariate backward Cox's regression model. Nonparametric Spearman Rho was used to study the linear correlation between NLR and MPVLR and other inflammatory markers. The variables associated with all-cause mortality were retinopathy (hazard ratio [HR]: 2.55, 95% confidence interval [CI]: 1.22-5.33, <i>P </i>= .01), estimated glomerular filtration rate (HR: 0.979, 95% CI: 0.969-0.990, <i>P </i>< .001), HbA1c (HR: 0.825, 95% CI: 0.702-0.969, <i>P </i>= .01), and MPVLR (HR: 1.093, 95% CI: 1.020-1.172, <i>P </i>= .01). NLR showed a strong correlation with white blood cell count (<i>r</i> = 0.60 [<0.001]) and c-reactive protein (<i>r</i> = 0.63 [<0.001]), and a weak correlation with erythrocyte sedimentation rate (<i>r</i> = 0.33 [<0.001]), though it was not associated with mortality. In conclusion, apart from other risk factors of mortality, we have for the first time demonstrated that the increasing value of MPVLR is a factor associated with one-year mortality in patients with DFIs.</p>","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"1159-1164"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9246978","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":"Fractional Epidermal Skin Grafts in Hard-to-Heal Wounds: Case Series.","authors":"Agata Janowska, Cristian Fidanzi, Marco Romanelli, Michela Iannone, Teresa Oranges, Francesca Montaquila, Valentina Dini","doi":"10.1177/15347346231163637","DOIUrl":"10.1177/15347346231163637","url":null,"abstract":"<p><p>Cellutome^™ is a minimally invasive, automated system for harvesting fractional epidermal micrografts. This therapy is indicated for granulating, small size, poor exuding acute wounds. We enrolled 15 patients with 9 venous leg ulcers and 6 atypical ulcers. The micrografts were applied with a nonadherent dressing and covered with a polyurethane foam and multilayer bandage. We scheduled 3 weekly visits for the change of the secondary dressings and multilayer bandage and clinical assessment (Wound Bed Score [WBS], pain assessment, and healing rate). The lesions were measured with the Silhouette Star^™ system, a software that allows measurement of perimeter and area from a digital image. The only symptom during the procedure was a sensation of warmth. The donor area healed in 2 weeks in all patients (<i>n</i> = 15). We reported an area reduction of 24.30% in typical ulcers and 38.82% in atypical ulcers after 3 weeks. The average WBS improved in all ulcers from 13.06 to 14.93. The average healing rate was 0.19 mm/day both in typical and atypical ulcers. Consequently, in our small case series fractionated epidermal graft treatment significantly promoted the healing rate in all chronic ulcers regardless of etiology. Future studies with larger case series will be needed.</p>","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"1148-1151"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9116618","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":"Effectiveness of Negative Pressure Wound Therapy of Diabetic Foot Ulcers Using Periplaneta Americana (Kangfuxin Liquid) Irrigation.","authors":"Haojie Sun, Chengxin Yang, Xuekui Liu, Jun Liang, Houfa Geng","doi":"10.1177/15347346231176917","DOIUrl":"10.1177/15347346231176917","url":null,"abstract":"<p><p>This study was to evaluate the efficacy of <i>Periplaneta Americana</i> (Kangfuxin Liquid) relative to normal saline when applied in negative-pressure wound therapy (NPWT) with instillation for facilitating diabetic foot ulcers (DFUs) healing. Eighty patients with Wagner grades 3 or 4 DFUs were enrolled in this retrospective study. Based on the treatment type, patients were equally assigned to either (i) an NPWT with Kangfuxin liquid instillation group (NPWT-K) or (ii) an NPWT with normal saline instillation group (NPWT-I). The primary study outcome was the wound healing rate and Kaplan-Meier survival estimate was used to examine the cumulative wound healing rate, while the secondary outcomes were the amputation rate, inpatient days, duration of antibiotic treatments, reinfection rate, new ulcer formation rate, readmission rate, and changes in the inflammatory markers (such as ESR, CRP, and PCT) and serum growth factors (including VEGF, EGF, and bFGF). The 12-week wound healing rate (31 of 40[77.5%] vs 22 of 40[55.0%], <i>P</i> = .033) and the cumulative wound healing rate was higher in the NPWT-K group than in the NPWT-I group (<i>P</i> = .004). The wound healing time was shorter in the NPWT-K group (55 days [95% CI 50-60]) than in the NPWT-K group (64 days [95% CI 59-69], <i>P</i> = .016). Patients who received NPWT-K had fewer inpatient days and duration of antibiotic treatment and faced lower reinfection and readmission rates (<i>P</i> < .05). After 1 week of treatment, the ESR, CRP, and PCT levels in the blood were lower in the NPWT-K group than in the NPWT-I group (<i>P</i> < .05), while the VEGF, EGF, and bFGF levels in the NPWT-K group were higher than those in the NPWT-I group (<i>P</i> < .001). The present study showed that NPWT with Kangfuxin liquid instillation was effective and showed significantly accelerated DFUs healing. Thus, Kangfuxin liquid is an effective instillation solution for use in the treatment of DFUs with NPWT.</p>","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"1165-1172"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9480652","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":"Letter to Editor Regarding \"Mean Platelet Volume-to-Lymphocyte Ratio is a Biomarker of 1-Year Mortality in Patients With Diabetic Foot Infections\".","authors":"Cengiz Beyan, Esin Beyan","doi":"10.1177/15347346231179047","DOIUrl":"10.1177/15347346231179047","url":null,"abstract":"<p><p>We read with great interest the prospective observational study of Aragón-Sánchez et al. They reported that the increase in the mean platelet volume (MPV) to lymphocyte ratio (MPVLR) value is a biomarker accompanying 1-year mortality in patients with a diabetic foot infection. We explained why the MPV value and associated MPVLR value may not be a prognostic biomarker of mortality in patients with diabetic foot infections.</p>","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"1276-1277"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9586533","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 Bridging Effect of Artificial Dermis on Reconstruction of Skin Avulsion Injury.","authors":"Yun-Nan Lin, Yu-Chi Wang, Su-Shin Lee, Meng-Chien Willie Hsieh, Sin-Daw Lin, Shu-Hung Huang, Tsai-Ming Lin, Yur-Ren Kuo","doi":"10.1177/15347346231158175","DOIUrl":"10.1177/15347346231158175","url":null,"abstract":"<p><p>Skin avulsion wounds are expected to be swollen and tense after trauma, and skin perfusion can be compromised after primary closure, resulting in wound dehiscence and poor healing. The artificial dermis (AD) serves as a dermal regeneration template that is used to heal skin defects with secondary intention. Therefore, the aim of this study is to evaluate the effect of AD application on traumatic skin avulsion injuries compared to conventional primary closure. A retrospective cohort of 20 patients with skin avulsion injuries were included the study: ten patients were treated with AD and ten patients were managed with primary closure. When compared to the primary closure group, AD group had a shorter average healing time (58.40 ± 26.94 days V 65.50 ± 46.45 days) and significantly higher flap viability (92.00 ± 13.17% V 78.00 ± 13.98%; <i>p</i> = .03). In conclusion, AD is a promising material for the treatment of skin avulsion injury and produces better clinical results.</p>","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"1140-1147"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9307325","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":"Superbugs and Bacterial Epidemiology from Wound Infection at Health Institutions in Northeast Ethiopia.","authors":"Zekarias Kebede, Wondmagegn Demsiss, Mihret Tilahun, Alemu Gedefie, Agumas Shibabaw","doi":"10.1177/15347346231171447","DOIUrl":"10.1177/15347346231171447","url":null,"abstract":"<p><p>Wound infection plays an important role in the development of chronicity by delaying wound healing, prolonging hospital stay, increasing treatment cost and is responsible for significant morbidity. The aim of this study was to investigate the bacterial epidemiology, multi-drug resistance, and associated risk factors for wound infection at health institutions in Northeast Ethiopia. A facility-based cross-sectional study was conducted from February to April 2021. Demographic, clinical, and risk factor variables were collected using a structured questionnaire. Swabs/pus from wound were collected using sterile applicator swab. Specimens were inoculated on culture media and bacterial isolates were identified using microbiological techniques. Antimicrobial susceptibility test was performed using Kirby-Bauer disc diffusion method. Statistical analysis was done using SPSS software. A total of 229 participants were included in this study. A total of 170 bacterial isolates (74.2%) were isolated. The predominant isolates were <i>S. aureus</i> 80 (47.05%), followed by <i>P. aeruginosa</i> 29 (17.05%), <i>E. coli</i> 22 (12.94%), and <i>Klebsiella spp</i>. 16 (9.41%). Tetracycline (71.7%), clindamycin (15.2%), erythromycin (30.4%), penicillin (80.4%), and co-trimoxazole (80.4%) resistance rates were observed among Gram positive bacterial isolates. The overall prevalence of multi-drug resistance was 71%. Hence, improving the laboratory setup for culture and drug susceptibility testing is recommended for effective treatment of wound infection and to improve infection prevention and control practices in healthcare settings.</p>","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"1206-1216"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9507092","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":"Diabetic Amputations in 2023 are Still More Frightening Than Death-Act Now Before it is Too Late.","authors":"Cynthia Formosa, Nachiappan Chockalingam, Alfred Gatt, Nikolaos Papanas","doi":"10.1177/15347346231171439","DOIUrl":"10.1177/15347346231171439","url":null,"abstract":"<p><p>Despite huge medical and technological advances to date for the diagnosis, monitoring, and management of diabetic foot complications, their prevalence is still alarmingly high. Patients' quality of life may be severely compromised. Patients may fear amputations more than death. An effort to minimize the impact of these complications and to ensure prompt access to care for everyone is still required. Urgent therapeutic measures should become possible when needed. Improved physician training in and management of peripheral arterial disease are also vital. We need to act now before it is too late. This will definitely be one of the greatest challenges for 2023 and the years to come.</p>","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"1271-1273"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9739074","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":"Analysis of Energy and Density in Treating Hypertrophic Scar After Burn in Children with CO₂ Dot Matrix Laser.","authors":"Zhi-Bo Zhang, Zhu-Liang Zhou, Fu-Xi Xing, Yong Li, Xing-Chen Sun, Yu-Ting Zhao, Xiang-Zhou Zhang, Ji-Song Liu","doi":"10.1177/15347346221144152","DOIUrl":"10.1177/15347346221144152","url":null,"abstract":"<p><p><b>Objective:</b> To analyze and compare the effect of the combination of energy and density parameters of CO₂ dot matrix laser in the hyperplastic stage of pediatric burn. <b>Materials and Methods:</b> A total of 160 pediatric patients with hypertrophic scar after limb burn from 2017 to 2020 were randomly divided into four parameter groups (n = 40). The patients were treated with ablative fraction carbon dioxide laser, once every 10 weeks. During the interval of laser treatment, Compound Heparin Sodium and Allantoin Gel (Contractubex) was applied externally, tid, and elastic cover or elastic bandage is attached to the affected limb. Scoring based on the Vancouver Scar Scale is performed before each laser treatment, The score before the first treatment was the initial score, which was scored by two people separately, and the average score was calculated. Subsequently, the patients were treated four times and scored. The differences between each treatment and the first score of each parameter group were compared. Under the same energy and different treatment density, the scores after each treatment were compared. Under the same density and different energy, the scores after each treatment were compared. The bleeding and pigmentation of each parameter group were compared. <b>Results:</b> The increase of density can show the therapeutic effect earlier than the increase of energy, and 25mj energy and 10% density have better intervention effect. With the course of disease and the progress of treatment, the correlation between intervention effect and parameters tends to weaken. Comparing the number of cases with different scores between each treatment and the first time, the score in the 5% density group was lower than that in the 10% density group, but there was no significant difference between the 25mj and 17.5mj energy levels in the same density group. The intervention effect of the increase of density on scar was better than that of energy, and the increase of energy and density could aggravate the pain. <b>Conclusion:</b> In pediatric burn hypertrophic scars treated by CO₂ dot matrix laser in exfoliation mode, the intervention effect of increasing density is better than that of energy. When setting laser treatment parameters, we should give priority to increasing density and adjust energy according to the effect of treatment and the condition of pain, bleeding and color precipitation. In this study, the best combination of parameters is 17.5mj/10%.</p>","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"1068-1074"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10390594","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":"Mycetoma (Madura foot): A Case Report of a Rare Tropical Disease in Turkey.","authors":"Elif Kuzucular, Abdulkadir Eren, Eray Isik, Ferhat Ozden","doi":"10.1177/15347346231156642","DOIUrl":"10.1177/15347346231156642","url":null,"abstract":"<p><p>Mycetoma is a chronic discharging infection involving the skin, subcutaneous tissue, fascia, and bone, which is endemic in tropical and subtropical countries. We report a rare case of mycetoma localized on the foot of a patient living in a country with a temperate climate. A 32-year-old male patient presented with painless swelling in the right foot. He had undergone surgery 3 years ago with the same complaints. Magnetic resonance imaging revealed a 90 × 65 × 37 mm cystic soft tissue lesion in the posterior of the right ankle. Histological analysis identified the fungus. Extensive resection was performed. Mycetoma is characterized by chronic granulomatous inflammatory response, often associated with sinus tract formations due to fungal (eumycetoma) or bacterial (actinomycetoma) organisms. Here we provide a literature review and highlight the importance of increasing awareness toward mycetoma, particularly in non-endemic regions.</p>","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"1261-1265"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10816825","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":"Systemic Immune-Inflammation Index in Diabetic Foot Infections and Osteomyelitis.","authors":"Javier Aragón-Sánchez, Gerardo Víquez-Molina, María Eugenia López-Valverde, José María Rojas-Bonilla","doi":"10.1177/15347346231179280","DOIUrl":"10.1177/15347346231179280","url":null,"abstract":"<p><p>The systemic immune-inflammation index (SII) was significantly higher in patients with severe infections, those with necrosis, and in those requiring admission, postoperative antibiotics, and any amputation. However, SII was significantly lower in patients with osteomyelitis compared to those with soft tissue infections. The correlation coefficients (rho) between SII and other inflammatory markers were as follows: WBC (Moderate correlation, 0.64, <i>P</i> < .001), ESR (Weak correlation, 0.34, <i>P</i> < .001), and CRP (Moderate correlation, 0.56, <i>P</i> < .001). The correlation coefficient (rho) between SII and the number of days admitted was moderate, 0.42 (<i>P</i> < .001). Based on a previous experience, SII may be an additional marker to diagnose osteomyelitis in the feet of patients with diabetes. Now, we need further research including SII, a low-cost and easy-to-measure index, in well-designed controlled studies to definitively clarify its role.</p>","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"1278-1280"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9615704","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}