Advances in wound care最新文献

{"title":"Renal Foot in Diabetes: Implications for Wound Healing and Solutions.","authors":"Ashu Rastogi, Rahul Gupta, Jayaditya Ghosh, Edward B Jude","doi":"10.1089/wound.2025.0074","DOIUrl":"https://doi.org/10.1089/wound.2025.0074","url":null,"abstract":"<p><p><b>Significance:</b> The prevalence of diabetes is increasing and so is diabetic foot disease (DFD). DFD encompasses diabetic foot ulcer (DFU), which is a major global health problem. DFD contributes to increased morbidity (reduced quality of life and lower limb amputation), a high rate of recurrence, and increased mortality. Patients with renal disease are at the highest risk of diabetes-related foot disease (renal foot). <b>Recent Advances:</b> Research has been undertaken in the last decade to understand the underlying causes leading to DFD in chronic kidney disease (CKD). The mechanisms, pathophysiology, biochemical, and immunological changes that occur in renal foot are being investigated and have given some insights into renal foot disease. <b>Critical Issues:</b> Patients with renal foot have multiple comorbidities, both systemic and local, that are peculiar to renal disease. Identification and treatment of existing comorbidities of anemia, hypoalbuminemia, immune dysfunction, vascular calcification, and limited life span are crucial to optimize outcomes in renal foot. Attention needs to be paid to nutrition deficiencies that can also adversely affect foot outcomes. Anticipated challenges in the management of infected DFU and endovascular interventions for peripheral arterial disease need to be studied. Compromised bone health in CKD complicates the management of Charcot foot in DFD. A better understanding of preulcer interventions that could be performed in patients with renal disease is lacking. <b>Future Directions:</b> Research focus on renal foot is required for delineating treatments that can be instituted to prevent DFD and disease progression in CKD. Intervention studies specifically targeting comorbidities in renal foot, such as peripheral vascular disease and cardiovascular disease, are required. Educating physicians and surgeons about the heightened risk of adverse consequences in renal foot is paramount. Multidisciplinary teams and one-stop foot/renal clinics shall ensure comprehensive care to improve outcomes in patients with renal foot.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658121","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}

{"title":"Human Wound and Its Burden: Updated 2025 Compendium of Estimates.","authors":"Chandan K Sen","doi":"10.1177/21621918251359554","DOIUrl":"https://doi.org/10.1177/21621918251359554","url":null,"abstract":"<p><p>Chronic wounds are a silent epidemic in the United States, affecting one in six Medicare beneficiaries-about 10.5 million people-and costing Medicare an estimated $22.5 billion annually. While outpatient wound care costs dropped from $10.5 billion in 2014 to $2.5 billion in 2019, physician office costs rose to $4.1 billion, reflecting a shift in care delivery. Globally, wound care expenditure reached a staggering $148.65 billion in 2022. Despite this burden, federal research funding remains disproportionately low. Chronic wounds often recur due to incomplete healing. Many wounds close by resurfacing without discharge but fail to restore the skin's barrier function-measured by transepidermal water loss at the site of closure-making them prone to reopening. Outcomes of recent patient-based studies advocate redefining wound closure endpoint to include full barrier restoration. The 2023 Wound Balance Framework promotes holistic, patient-centered care, while cutting-edge technologies are reshaping the field. Bioengineered skin therapies can reduce healing time. Machine learning tools, such as scanning electron microscopy-based trainable Weka (Waikato Environment for Knowledge Analysis) intelligent segmentation technology, detect biofilms, while other tools predict healing outcomes and amputation risks. Multiomics technologies identify biomarkers such as Fos-related antigen 1 (FOSL1), enabling precision therapies tailored to wound phase and patient biology. Telehealth is proving to be transformative for wound care. A 2023 meta-analysis of 2,397 patients showed it significantly reduced healing time, pain, and amputation rates. Policy is catching up: Centers for Medicare & Medicaid Services doubled allowable skin substitute applications (from four to eight) and extended treatment windows to 16 weeks. The Better Wound Care at Home Act established national payment for disposable negative pressure wound therapy, and the Lymphedema Treatment Act mandated Medicare coverage for compression garments, projected to save $1.3-$1.5 billion over 10 years. Together, these advances signal a shift toward proactive, personalized, and equitable wound care-driven by science, guided by ethics, supported by policy, and centered on patients. [Figure: see text].</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144635963","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}

{"title":"Application of Perioperative Real-Time Fluorescence Imaging to Achieve High-Quality Debridement: A Randomized Control Trial.","authors":"Jui-Chen Hsu, Yi-Hung Chu, Yi-Chun Wu, Jung-Hsuan Chang, Ching-Uen Huang, Xin-Yi Lin, Yu-Fen Chiu, Fu-Yu Wang, Ka-Wai Tam, Shun-Cheng Chang","doi":"10.1177/21621918251359558","DOIUrl":"https://doi.org/10.1177/21621918251359558","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the effectiveness of real-time fluorescence imaging (RTFI)-assisted debridement in managing chronic wounds compared with standard surgical debridement. <b>Approach:</b> This study was a patient-blinded, randomized clinical trial conducted from February 17, 2021, to July 30, 2021, on patients with chronic wounds. Patients were randomized to an RTFI group (M group) or conventional group (C group). The primary outcomes were as follows: percentage of residual bacterial area (preoperative and postoperative), number of debridements, high-quality debridement ratio, operation duration, and wound healing duration. <b>Results:</b> A total of 100 patients were enrolled in both groups. No significant difference in the percentage of preoperative residual bacterial area or high-quality debridement ratio was seen. The M group underwent debridement an average of 2.6 times and had a significantly longer duration of operation (33.5 ± 12.7 min) than the C group (29.9 ± 10.4 min; <i>p</i> = 0.031). The postoperative residual bacterial area was significantly lower in the M than in the C group (6.83% ± 1.39% vs. 30.0% ± 12.37%, respectively; <i>p</i> < 0.001). The M group required significantly fewer wound healing days (49.2 ± 25.3 vs. 63.0 ± 27.9, <i>p</i> < 0.001). Secondary outcomes also demonstrated statistically significant differences in total hospitalized days (17.5 ± 9.3 vs. 21.5 ± 12.5, <i>p</i> < 0.01), days of antibiotic use (15.5 ± 8.7 vs. 18.7 ± 6.7, <i>p</i> < 0.01), and reinfection rates (4 of 100 vs. 22 of 100, <i>p</i> < 0.001). <b>Innovation:</b> RTFI can detect signals from normal skin components and bacterial metabolites. Therefore, interpretation of RTFI results should be correlated with the clinical condition. RTFI is associated with high-quality debridement. This technique can also be applied in targeted biopsy and in training young staff to mature debridement procedures. <b>Conclusion:</b> RTFI in debridement is associated with favorable clinical outcomes and may have a positive influence on chronic wound healing.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625270","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}

{"title":"Patterns of Co-Occurring Pressure Injuries: A Data-Driven Study Using Real-World Clinical Records.","authors":"Veysel Karani Baris, Wenyu Song, Min-Jeoung Kang, Luwei Liu, Graham Lowenthal, Luciana Schleder Goncalves, Tanya Martel, Sandy Cho, Diane L Carroll, Debra Furlong, Wadia Gilles-Fowler, Lisa Herlihy, Beth Melanson, Jacqueline Massaro, Lori D Morrow, Paula Wolski, Patricia C Dykes","doi":"10.1089/wound.2025.0019","DOIUrl":"https://doi.org/10.1089/wound.2025.0019","url":null,"abstract":"<p><p><b>Objective:</b> This study aimed to investigate patterns and risk factors associated with co-occurring pressure injuries (PrIs) using real-world clinical data. <b>Approach:</b> This retrospective cohort study analyzed electronic health records (EHRs) of adult patients with PrIs from 2015 to 2023 across five hospitals within a large U.S. health care system. An EHR-based phenotype-a set of algorithmic rules using structured clinical data-was developed and validated to identify patients with co-occurring PrIs, enabling classification of all patients in the study cohort into either single-occurring or co-occurring PrI groups. The accuracy of the co-occurring PrI phenotype was assessed through chart review. Univariate analyses and binary logistic regression were employed to identify risk factors associated with co-occurring PrIs. All findings are reported in accordance with the STROBE checklist. <b>Results:</b> Among 18,195 patients with at least one PrI record, 4,415 (24.3%) had co-occurring PrIs. The phenotype demonstrated high accuracy (accuracy = 0.96). Pattern analysis showed a direct association between the number of PrIs and severe-stage injuries. Logistic regression revealed that severe PrIs (odds ratio [OR] 3.47; 95% confidence interval [CI]: 3.23-3.74) were most strongly associated with co-occurring PrIs, followed by Black or African American race (OR: 1.45; 95% CI: 1.14-1.84) and spinal cord injury (OR: 1.32; 95% CI: 1.14-1.52). <b>Innovation:</b> This study introduces a validated EHR-based phenotype for identifying co-occurring PrIs. It reveals a direct link between co-occurring PrIs and injury severity, as well as unique risk factors associated with co-occurring PrIs. <b>Conclusions:</b> Co-occurring PrIs are prevalent and strongly associated with severe PrIs. This study also revealed distinct occurrence patterns, with injury severity increasing as the number of co-occurring PrIs rises. The findings from this study emphasize the need for targeted risk assessment and prevention efforts for co-occurring PrIs.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144635964","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}

{"title":"A Framework for Writing and Critically Evaluating Guideline Articles.","authors":"Chandan K Sen","doi":"10.1089/wound.2025.0083","DOIUrl":"10.1089/wound.2025.0083","url":null,"abstract":"<p><p>Credible guideline articles are essential for advancing evidence-based medicine, yet their development demands rigorous methodology to ensure transparency, reliability, and applicability. This editorial outlines a framework for writing and critically evaluating guideline articles, emphasizing standardized approaches such as GRADE (Grading of Recommendations Assessment, Development, and Evaluation), IOM (Institute of Medicine) standards, and GIN (Guidelines International Network) criteria. Key steps include: (1) transparent and credible author panel selection: incorporating diverse stakeholders with established expertise (objective benchmark requirements that are publicly disclosed), including clinician scientists, translational scientists, methodologists, and patients (where applicable), to mitigate bias and enhance relevance; (2) Transparency and conflict-of-interest management: adhering to IOM principles for panel selection and publicly available documentation to uphold trustworthiness; (3) Systematic evidence synthesis: using structured methods such as GRADE to assess the quality of evidence and strength of recommendations while relying on the expertise of an appropriately chosen panel to address limitations such as sparse data in emerging fields; and (4) Implementation planning: leveraging structured tools (employ GIN as applicable) to ensure real-world feasibility and adaptability. The article contrasts these frameworks with <i>ad hoc</i> expert opinion articles, which are vulnerable to bias. Hybrid approaches, as applicable to specific needs, are strongly encouraged. For example, combining GRADE for evidence assessment, IOM for procedural credibility, and GIN for practical rollout should be considered for optimal rigor. Niche systems such as USPSTF (US Preventive Services Task Force) for preventive services and NICE (National Institute for Health and Care Excellence) for cost-effectiveness integration are discussed. By adhering to these principles, as applicable to the specific case, guideline authors can produce actionable, ethically sound recommendations that bridge research and practice, ultimately improving healthcare quality and reducing variability in clinical decision-making.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"323-326"},"PeriodicalIF":5.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144179617","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}

{"title":"Lineage Mapping of Extracellular Vesicles: What Cells Do They Come from and Where Do They Go?","authors":"Dong Jun Park, Wooil Choi, Hanan Zhang, Brian P Eliceiri","doi":"10.1089/wound.2024.0068","DOIUrl":"10.1089/wound.2024.0068","url":null,"abstract":"<p><p><b>Significance:</b> Release of extracellular vesicles (EVs) by various cell types has been shown to mediate the delivery of biologically active payloads from donor cells to recipient cells; however, it remains unclear what cell types these EVs come from. With a focus on fluorescent reporters to monitor the release of EVs, especially those under the control of cell type-specific promoters, we address the translational relevance of genetic tools in cultured cells, normal tissues, and in models of development, injury, cancer, and wound healing. <b>Recent Advances:</b> It is well established that EVs are released by many cell types in the body via fusion and release processes at the plasma membrane. Since there remains debate about what fraction of EVs are released through regulated endosomal trafficking pathways versus nonspecific mechanisms, the development and validation of novel molecular tools are important to address the cellular source of EVs. <b>Critical Issues:</b> There is a need to develop and characterize new cell type-specific reporter mouse models that build upon the examples detailed here to identify the cellular source of EVs with genetic approaches being useful in addressing these critical limitations. <b>Future Directions:</b> Advances in reporter systems will drive a better understanding of EV subsets to identify compartment-specific EV localization to guide the development of more translationally relevant models for the wound healing field.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"355-364"},"PeriodicalIF":5.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141888187","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}

{"title":"Skin Grafting.","authors":"Jyrki Vuola, Andrew Lindford","doi":"10.1089/wound.2023.0166","DOIUrl":"10.1089/wound.2023.0166","url":null,"abstract":"<p><p><b>Significance:</b> Although skin grafting is a basic surgical procedure, there are many sophisticated innovations that are used only by experienced surgeons. In-depth knowledge of new and old methods gives the opportunity to select the most appropriate technique in each case. <b>Recent Advances:</b> Most methods have been invented long ago, but some of them have been rediscovered and further refined. An improved understanding of wound healing and basic skin grafting techniques enable the development of new solutions. <b>Critical Issues:</b> Clinical randomized controlled trials in wound research are time consuming, expensive, and difficult to perform. This has given rise to many techniques that are not well proven. Recent strict regulations concerning all forms of cell therapy have further hindered the development of promising new ideas. <b>Future Directions:</b> Cell therapies to enhance epithelialization and promote wound healing are already available but far from everyday practice. Very strict regulations have halted many promising projects. An alternative approach to circumvent some of these regulatory hurdles is the grafting of uncultured, autologous cells or very small pieces of skin, which also offer very large expansion of the graft. The development and adoption of new bilayered skin substitutes are expected to be the most significant development in the near future, although they face similar regulatory challenges as cell therapies.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"344-354"},"PeriodicalIF":5.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143031760","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}

{"title":"Lower Extremity Traumatic Wound Management: Relative Significance of Negative Pressure Wound Therapy in the Orthopedic Setting.","authors":"Evania Lok, Timothy Oe, Sally Ng","doi":"10.1089/wound.2023.0133","DOIUrl":"10.1089/wound.2023.0133","url":null,"abstract":"<p><p><b>Significance:</b> Lower extremity traumatic wounds are associated with numerous perioperative challenges. Their etiologies determine the characteristics and extent of the injury. The timing of subsequent surgical intervention and wound healing optimization after lower extremity trauma are integral to successful perioperative lower extremity wound management. <b>Recent Advances:</b> Managing trauma to the lower extremities uses a multidisciplinary surgical approach. The objective of this review is to summarize lower limb trauma assessment, advancements in lower extremity trauma management, and the clinical applications of advanced wound care in lower limb traumatic wounds. The advent of lower limb reconstruction and the development of advanced wound care modalities have helped to improve the management of these complex injuries. <b>Critical Issues:</b> The extensive involvement of bone, soft tissues, nerves, and blood vessels of severe lower extremity trauma wounds presents a challenge for clinicians in both the acute care setting and during patient rehabilitation. If not properly managed, these injuries may be subject to a decline in limb function and may possibly result in limb loss. To reveal developing limb-threatening conditions, serial examinations should be performed. <b>Future Directions:</b> The majority of lower limb traumatic wound will benefit from the perioperative administration of an appropriate negative pressure wound therapy (NPWT)-based system, which can help to promote granulation tissue and remove wound exudate before definitive closure and/or reconstruction. NPWT should be included as an important adjunct in the surgical management of lower limb traumatic wounds.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"327-343"},"PeriodicalIF":5.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141603147","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}

{"title":"HMGB1 Accelerates Wound Healing by Promoting the Differentiation of Epidermal Stem Cells via the \"HMGB1-TLR4-Wnt/Notch\" Axis.","authors":"Miao Zhen, Yongkang Zhu, Peng Wang, Xiaogang Liu, Junyou Zhu, Hengdeng Liu, Jingting Li, Jingling Zhao, Bin Shu","doi":"10.1089/wound.2023.0130","DOIUrl":"10.1089/wound.2023.0130","url":null,"abstract":"<p><p><b>Objective:</b> Impairments in the differentiation and migratory capacity of epidermal stem cells (ESCs) are pivotal factors contributing to delayed wound healing. High mobility group box1 (HMGB1) has recently emerged as a potential target for tissue repair. Therefore, we aimed to investigate the role and molecular mechanisms of HMGB1 in ESCs during the wound-healing process. <b>Approach:</b> Initially, we examined the expression of HMGB1 and the differentiation of ESCs in normal skin, normal wounds and chronic wounds. Then, we assessed the ESC migration and differentiation, and the key markers in the Wnt/Notch signaling pathways, after treatment of HMGB1 and inhibitor, and the knockdown of toll-like receptor 4 (TLR4), using scratch assay, qPCR, western blotting, and immunofluorescence. Finally, we conducted mice models to analyze the healing rates and quality <i>in vivo</i>. <b>Results:</b> HMGB1 was decreased across all epidermal layers, and the differentiation of ESCs was hindered in diabetic foot ulcer. <i>In vitro</i>, HMGB1 enhanced both the migration and differentiation of ESCs while stimulating the expression of the Wnt/Notch pathway within ESCs. However, the downregulation of TLR4 negated these effects. Finally, our <i>in vivo</i> experiments provided evidence that HMGB1 facilitates wound healing and epidermis differentiation <i>via</i> TLR4 and Wnt/Notch signaling pathways. <b>Innovation:</b> This study innovatively introduces HMGB1 as a novel target for skin wound healing and elucidates its mechanisms of action. <b>Conclusions:</b> HMGB1 accelerated wound healing by promoting the differentiation of epidermal stem cells through the \"HMGB1-TLR4-Wnt/Notch\" axis, which reveals a new potential mechanism and target to expedite wound healing.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"365-380"},"PeriodicalIF":5.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142851593","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}

{"title":"Multidisciplinary Management Improves Re-Admission, Major Amputation, and Mortality Rates in Patients with Diabetic Foot Ulcers.","authors":"Chi-Wei Chiu, Wen-Teng Yao, Chieh-Ming Yu, Yu-Fan Chen, Ya-Shu Chan, Hsuan-Yu Huang, An-Li Lee, Ying-Chun Liu, Shu-Tien Huang, Liong-Rung Liu, Yueh-Hung Lin, Kung-Chen Ho, Chia-Meng Yu, Wen-Chen Huang, Kwang-Yi Tung, Ming-Feng Tsai","doi":"10.1089/wound.2024.0182","DOIUrl":"10.1089/wound.2024.0182","url":null,"abstract":"<p><p><b>Objective:</b> The objective of this study was to evaluate the impact of a multidisciplinary team (MDT) approach in the management of diabetic foot ulcers (DFUs). <b>Approach:</b> A multidisciplinary diabetic foot care center (MDDFCC) was opened at our institution in August 2018. Outcomes of DFU treatment, including re-admission, amputation, and mortality rates, were compared before and after opening the MDDFCC. <b>Results:</b> Patients seen after the MDDFCC was opened had a lower risk of 1-year re-admission (hazard ratio [HR] = 0.697, 95% confidence interval [CI]: 0.387-0.988), 1-year major amputation (HR = 0.447, 95% CI: 0.091-0.984), and 1-year disease-specific mortality (HR = 0.277, 95% CI: 0.105-0.730). PEDIS score (HR = 2.343, 95% CI: 1.264-2.971), history of dialysis (HR = 1.858, 95% CI: 1.258-4.053), and consultation with a physiatrist (HR = 0.368, 95% CI: 0.172-0.788), orthopedist (HR = 0.105, 95% CI: 0.042-0.261), or social worker (HR = 0.370, 95% CI: 0.082-0.871) were associated with 1-year major amputation. One-year major amputation (HR = 2.636, 95% CI: 1.586-4.570), age (HR = 1.094, 95% CI: 1.051-1.140), and C-reactive protein level (HR = 1.052, 95% CI: 1.008-1.098) were associated with 1-year disease-specific mortality. <b>Innovation:</b> Plastic surgeons received patients at the MDDFCC, with active participation by all contributing members. This arrangement brought advantages, including more aggressive and timely surgical intervention, a more timely and higher rate of percutaneous transluminal angioplasty, and equally robust integrated medical care by all other members. <b>Conclusion:</b> The MDDFCC approach may be a potential organizational structure with for treating DFUs, resulting in significant improvements in outcomes of DFU including a lower re-admission, amputation, and mortality.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332281","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}