Advances in wound care最新文献

{"title":"SEMTWIST Quantification of Biofilm Infection in Human Chronic Wound Using Scanning Electron Microscopy and Machine Learning.","authors":"Surabhi Singh, Fabio Muniz De Oliveira, Cong Wang, Manoj Kumar, Yi Xuan, Deeptankar DeMazumder, Chandan K Sen, Sashwati Roy","doi":"10.1089/wound.2024.0291","DOIUrl":"10.1089/wound.2024.0291","url":null,"abstract":"<p><p><b>Objective:</b> To develop scanning electron microscopy-based Trainable Weka (Waikato Environment for Knowledge Analysis) Intelligent Segmentation Technology (SEMTWIST), an open-source software tool, for structural detection and rigorous quantification of wound biofilm aggregates in complex human wound tissue matrix. <b>Approach:</b> SEMTWIST model was standardized to quantify biofilm infection (BFI) abundance in 240 distinct SEM images from 60 human chronic wound-edge biospecimens (four technical replicates of each specimen). Results from SEMTWIST were compared against human expert assessments and the gold standard for molecular BFI detection, that is, peptide nucleic acid fluorescence <i>in situ</i> hybridization (PNA-FISH). <b>Results:</b> Correlation and Bland-Altman plot demonstrated a robust correlation (<i>r</i> = 0.82, <i>p</i> < 0.01), with a mean bias of 1.25, and 95% limit of agreement ranging from -43.40 to 47.11, between SEMTWIST result and the average scores assigned by trained human experts. While interexpert variability highlighted potential bias in manual assessments, SEMTWIST provided consistent results. Bacterial culture detected infection but not biofilm aggregates. Whereas the wheat germ agglutinin staining exhibited nonspecific staining of host tissue components and failed to provide a specific identification of BFI. The molecular identification of biofilm aggregates using PNA-FISH was comparable with SEMTWIST, highlighting the robustness of the developed approach. <b>Innovation:</b> This study introduces a novel approach \"SEMTWIST\" for in-depth analysis and precise differentiation of biofilm aggregates from host tissue elements, enabling accurate quantification of BFI in chronic wound SEM images. <b>Conclusion:</b> Open-source SEMTWIST offers a reliable and robust framework for standardized quantification of BFI burden in human chronic wound-edge tissues, supporting clinical diagnosis and guiding treatment.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959104","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":"Acellular Scaffolds for Muscle Regeneration: Advances and Challenges.","authors":"Jessica Mroueh, Luisa Weber, Yori Endo, Vanessa Mroueh, Indranil Sinha","doi":"10.1089/wound.2024.0049","DOIUrl":"https://doi.org/10.1089/wound.2024.0049","url":null,"abstract":"<p><p><b>Significance:</b> Volumetric muscle loss is defined as composite loss of muscle mass. Severe injuries result in permanent functional impairment. Treatment options are limited. Tissue engineering techniques utilizing scaffolds offer promise as a potential therapy. <b>Recent Advances:</b> Emerging strategies, including bioactive molecules and growth factors in biocompatible scaffolds, may promote muscle regeneration following severe injury. In this context, scaffolds can act as a drug-delivery device, provide guidance to cells as a supporting matrix, and slowly release growth factors to promote healing. <b>Critical Issues:</b> Scaffolds engraftment and ability to promote tissue regeneration in injured beds remain limited. Tuning and optimizing scaffold fiber diameter, alignment, cellular cues, growth factor delivery, and porosity will be important in reconstituting functional skeletal muscle following loss. <b>Future Directions:</b> Our mechanistic understanding of interactions between biomimetic scaffolds and host tissue is still evolving, and future research can identify factors to promote tissue regeneration.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958034","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":"Noninferiority of Copper Dressings Than Negative Pressure Wound Therapy in Healing Diabetic Wounds: A Randomized Clinical Trial.","authors":"Eyal Melamed, Jihad Dabbah, Talia Israel, Ilana Kan, Michael S Pinzur, Tohar Roth, Gadi Borkow","doi":"10.1089/wound.2024.0273","DOIUrl":"https://doi.org/10.1089/wound.2024.0273","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate if treatment of diabetic wounds by copper oxide impregnated dressings (COD) is noninferior to negative pressure wound therapy (NPWT). <b>Approach:</b> Following the CONSORT guidelines, patients with diabetes mellitus (type 1 or type 2) and noninfected wounds eligible for treatment with NPWT were randomized into two groups. One group received NPWT followed by standard wound care dressings, whereas the other was treated exclusively with COD. The primary outcome was wound size reduction, measured blindly using a 3D wound-imaging system. Secondary outcomes included patient and caregiver convenience (assessed <i>via</i> visual analog scores), cost, and additional wound parameters. <b>Results:</b> COD showed statistically significant noninferiority to NPWT in wound size reduction throughout the study (<i>p</i> < 0.01). The percentage of wounds that closed was 47.83% (11/23) and 34.78% (8/23) in the COD and NPWT arms, respectively (<i>p</i> > 0.05). The average time to wound closure, adjusted to potential confounders, such as gender, age, body mass index, diabetes, and smokers, was similar in both arms (<i>p</i> > 0.05). COD were found to be more convenient than NPWT for both patients (<i>p</i> < 0.001) and caregivers (<i>p</i> = 0.003), with a significantly shorter application time (<i>p</i> < 0.001). The COD cost was 14% of NPWT cost ($470 compared with $3,360). <b>Innovation:</b> COD may be considered as the first line of treatment for diabetic foot wounds when NPWT seems indicated. <b>Conclusions:</b> Using copper dressings as a first line of treatment of diabetic wounds, when NPWT is indicated, is expected to reduce health costs, improve convenience, and increase compliance without compromising the final outcome.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963906","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":"An Adipose-Derived Stem Cell Exosome Sheet Promotes Oral Mucosal Wound Healing.","authors":"Dany Y Matar, Chung-Jan Kang, Adriana C Panayi, Dennis P Orgill, Huang-Kai Kao","doi":"10.1089/wound.2024.0216","DOIUrl":"https://doi.org/10.1089/wound.2024.0216","url":null,"abstract":"<p><p><b>Objective:</b> Oral mucosal wound healing is not completely understood, and effective therapies are lacking. This study explores the potential of an adipose-derived stem cell (ADSC) exosome sheet in enhancing intraoral wound healing in rats. <b>Approach:</b> An ADSC exosome sheet derived from Tisseel and rat adipose tissue (ADSC-exo) was applied to 16 rats with 6 mm full-thickness mucosal hard palate wounds. Eight wounds received ADSC-exo with a superficial occlusive dressing (ADSC-exo group), and eight received only an occlusive dressing (control group). Wound closure was monitored on days 0, 2, 4, 7, and 10, with dressings changed every 2 days. On day 10, rats were sacrificed, and wounds (<i>n</i> = 8 per group) were collected for immunohistochemical analysis. <i>In vitro</i>, four ADSC-exosome concentrations (0, 4.5 × 10¹¹, 9 × 10¹¹, and 18 × 10¹¹ exosomes/mL; <i>n</i> = 4 per group) were applied to rat oral mucosal fibroblasts to assess migration speed. <b>Results:</b> ADSC-exo accelerated wound closure (18% ± 5% vs. 35% ± 9% of initial wound area; <i>p</i> = 0.002) and fibroblast migration (for 18 × 10¹¹ exosomes/mL at 24 h: 29.7% ± 3% vs. 62.2% ± 4% of initial gap area; <i>p</i> < 0.0001) compared with the control. ADSC-exo promoted reepithelialization (87% ± 14% vs. 21% ± 6%; <i>p</i> < 0.0001), proliferation (34 ± 12 vs. 18 ± 7 Ki67+/high-power field [HPF]; <i>p</i> = 0.004), and neovascularization (28 ± 9 vs. 11 ± 5 CD31+/HPF; <i>p</i> = 0.0002) while reducing inflammation (4 ± 1 vs. 13 ± 9 CD68+/HPF; <i>p</i> < 0.0001) and increasing M2 macrophages (9.2 ± 2 vs. 4.2 ± 3 CD163+/HPF; <i>p</i> = 0.0008). ADSC-exo increased Transforming Growth Factor beta 1 (TGF-β1) (1.3 ± 0.3 vs. 0.9 ± 0.2; <i>p</i> = 0.006), Smad3 (0.9 ± 0.02 vs. 0.7 ± 0.1; <i>p</i> = 0.006), and collagen I (1.5 ± 0.9 vs. 0.5 ± 0.3; <i>p</i> = 0.005) while downregulating caspase-3 (0.7 ± 0.3 vs. 1.1 ± 0.2; <i>p</i> = 0.003) and Bax (0.9 ± 0.2 vs. 1.4 ± 0.1; <i>p</i> < 0.0001). <b>Innovation:</b> This is the first study to demonstrate the pro-wound healing effects of an ADSC exosome sheet on intraoral wounds. This paves the way for future research and clinical applications of ADSC exosomes in mucosal wound healing. <b>Conclusions:</b> Application of an ADSC-exo to rat mucosal wounds significantly improved wound healing. Mechanistically, these effects may be linked to upregulated activity of the TGF-β/Smad pathway.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961947","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":"Exploring the Efficacy of Selected Allografts in Chronic Wound Healing: Evidence from Murine Models and Clinical Data for a Proposed Treatment Algorithm.","authors":"Charlotte R Reed, Tokoya Williams, Iulianna Taritsa, Kevin Wu, Evangelia Chnari, Madeline J O'Connor, Bradley A Melnick, Kelly C Ho, Marc Long, Kristin N Huffman, Robert D Galiano","doi":"10.1089/wound.2023.0139","DOIUrl":"10.1089/wound.2023.0139","url":null,"abstract":"<p><p><b>Significance:</b> Chronic wounds can lead to poor outcomes for patients, with risks, including amputation and death. In the United States, chronic wounds affect 2.5% of the population and cost up to $28 billion per year in primary health care costs. <b>Recent Advances:</b> Allograft tissues (dermal, amnion, and amnion/chorion) have shown efficacy in improving healing of chronic, recalcitrant wounds in human patients, as evidenced by multiple clinical trials. Their mechanisms of actions have been relatively understudied, until recently. Research in murine models has shown that dermal allografts promote reepithelialization, amnion allografts promote granulation tissue formation and angiogenesis, and amnion/chorion allografts support all stages of wound healing. These findings confirm their effectiveness and illuminate their therapeutic mechanisms. <b>Critical Issues:</b> Despite the promise of allografts in chronic wound care, a gap exists in understanding which allografts are most effective during each wound healing stage. The variable efficacy among each type of allograft suggests a mechanistic approach toward a proposed clinical treatment algorithm, based on wound characteristics and patient's needs, may be beneficial. <b>Future Directions:</b> Recent advances in allografts provide a framework for further investigations into patient-specific allograft selection. This requires additional research to identify which allografts support the best outcomes during each stage of wound healing and in which wound types. Longitudinal human studies investigating the long-term impacts of allografts, particularly in the remodeling phase, are also essential to developing a deeper understanding of their role in sustained wound repair and recovery.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"260-272"},"PeriodicalIF":5.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140955715","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":"The WOUND-Q Function and Symptoms Scales for Chronic Lower Extremity Wounds: A Validation Study.","authors":"Nina Vestergaard Simonsen, Anne F Klassen, Charlene Rae, Lily R Mundy, Lotte Poulsen, Andrea L Pusic, Kenneth L Fan, Jens Ahm Sørensen","doi":"10.1089/wound.2024.0035","DOIUrl":"10.1089/wound.2024.0035","url":null,"abstract":"<p><p><b>Objective:</b> Determine the validity and reliability of the LIMB-Q scales, Function, and Symptoms in patients with chronic lower extremity wounds. <b>Approach:</b> Cognitive debriefing interviews with people with current or previous wounds were conducted to examine content validity. Scales were field-tested in an international sample of people with chronic lower extremity wounds sourced from an online platform (<i>i.e.,</i> Prolific). Psychometric properties were examined using the Rasch Measurement Theory analysis. A test-retest reproducibility study was performed, and construct validity was examined. <b>Results:</b> Content validity was established after 10 cognitive interviews. A total of 233 people with lower extremity wounds (age 19-80 years, mean 39.3) participated in the field test. All 25 items tested demonstrated good fit to the Rasch model with ordered thresholds. One item had a fit residual outside ±2.5, but no items had significant <i>χ</i>² values after Bonferroni adjustment. Reliability was high with the person separation index, Cronbach alpha, and intraclass correlation coefficient values >0.8. Strong correlations were found between the Function and Symptoms scales and EQ-5D dimensions measuring similar constructs as well as the EQ-5D global score. All hypotheses for construct validity were confirmed. <b>Innovation:</b> Patient-reported outcome measures are an important component of patient-centered care, as they capture the patient's perspective in a rigorous and reproducible way. Adding these two scales to the WOUND-Q provides a means to measure function and symptoms associated with lower extremity wounds. <b>Conclusion:</b> These new WOUND-Q scales can be used to measure outcomes important to patients with lower extremity wounds in clinical settings and research studies.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"238-250"},"PeriodicalIF":5.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141074905","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":"Identifying the Pattern Characteristics of Anoikis-Related Genes in Keloid.","authors":"Ruxin Xie, Chenyu Li, Jiao Yun, Shiwei Zhang, Ai Zhong, Ying Cen, Zhengyong Li, Junjie Chen","doi":"10.1089/wound.2024.0027","DOIUrl":"10.1089/wound.2024.0027","url":null,"abstract":"<p><p><b>Objective:</b> Anoikis is a kind of programmed cell death that is triggered when cells lose contact with each other or with the matrix. However, the potential value of anoikis-related genes (ARGs) in keloid (KD) has not been investigated. <b>Approach:</b> We downloaded three keloid fibroblast (KF) RNA sequencing (RNA-seq) datasets from the Gene Expression Omnibus (GEO) and obtained 338 ARGs from a search of the GeneCards database and PubMed articles. Weighted correlation network analysis was used to construct the coexpression network and obtain the KF-related ARGs. The LASSO-Cox method was used to screen the hub ARGs and construct the best prediction model. Then, GEO single-cell sequencing datasets were used to verify the expression of hub genes. We used whole RNA-seq for gene-level validation and the correlation between KD immune infiltration and anoikis. <b>Results:</b> Our study comprehensively analyzed the role of ARGs in KD for the first time. The least absolute shrinkage and selection operator (LASSO) regression analysis identified six hub ARGs (<i>HIF1A</i><b>,</b> <i>SEMA7A</i>, <i>SESN1</i>, <i>CASP3</i>, <i>LAMA3</i>, <i>and SIK2</i>). A large number of miRNAs participate in the regulation of hub ARGs. In addition, correlation analysis revealed that ARGs were significantly correlated with the infiltration levels of multiple immune cells in patients with KD. <b>Innovation:</b> We explored the expression characteristics of ARGs in KD, which is extremely important for determining the molecular pathways and mechanisms underlying KD. <b>Conclusions:</b> This study provides a useful reference for revealing the characteristics of ARGs in the pathogenesis of KD. The identified hub genes may provide potential therapeutic targets for patients. This study provides new ideas for individualized therapy and immunotherapy.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"223-237"},"PeriodicalIF":5.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141074852","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":"Clinical Efficacy of a Contralateral Shoe Lift in Patients with Diabetic Foot Ulcers and Induced Limb-Length Discrepancies: A Randomized Controlled Trial.","authors":"Mateo López-Moral, Marta García-Madrid, Raúl J Molines-Barroso, Irene Sanz-Corbalán, Aroa Tardáguila-García, José Luis Lázaro-Martínez","doi":"10.1089/wound.2024.0151","DOIUrl":"10.1089/wound.2024.0151","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate the clinical efficacy of combining an offloading device with a contralateral shoe lift to compensate for induced limb-length discrepancies in participants with plantar diabetes-related foot ulcers. <b>Approach:</b> Between March 2021 and December 2023, 42 consecutive patients with active plantar diabetic foot ulcers (DFUs) were randomly assigned (1:1) to the treatment group (limb-length discrepancy compensation with a shoe lift in the therapeutic footwear of the contralateral limb) or a control group that did not receive limb-length discrepancy compensation. Primary outcomes included the 20-week wound-healing rate and wound area reduction. Secondary outcomes included minor amputation, new ulcers in the contralateral limb, perceived comfort, and hip pain. <b>Results:</b> On an intention-to-treat basis, 15 participants in the control and 19 in the treatment group showed ulcer healing (<i>p</i> = 0.0023). In those with >80% adherence to the offloading device, multivariate analysis showed that the shoe lifts improved ulcer healing time. The use of a shoe lift reduced the number of minor amputations and the occurrence of new ulcers in the contralateral limb (<i>p</i> = 0.035; <i>p</i> = 0.033 respectively). Hip pain and perceived comfort improved with the use of shoe lifts (<i>p</i> < 0.001). <b>Innovation:</b> It validates the use of shoe lifts for patients with DFUs, as it is the first largest study of its kind to establish a clear reference standard to guide clinician decision-making. <b>Conclusion:</b> The use of shoe lifts reduced healing time in participants with diabetes and active plantar foot ulcers. Shoe lifts reduce late complications, including new ulcers in the contralateral limb and minor amputations.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"251-259"},"PeriodicalIF":5.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142492821","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":"Advances in Designer Materials for Chronic Wound Healing.","authors":"Anish Vasan, Suntae Kim, Emily Davis, Daniel S Roh, Jeroen Eyckmans","doi":"10.1089/wound.2024.0108","DOIUrl":"https://doi.org/10.1089/wound.2024.0108","url":null,"abstract":"<p><p><b>Significance:</b> Nonhealing or chronic wounds represent a significant and growing global health concern, imposing substantial burdens on individuals, health care systems, and economies worldwide. Although the standard-of-care treatment involves the application of wound dressings, most dressing materials are not specifically designed to address the pathological processes underlying chronic wounds. This review highlights recent advances in biomaterial design tailored to chronic wound healing. <b>Recent Advances:</b> Chronic wounds are characterized by persistent inflammation, impaired granulation tissue formation, and delayed re-epithelialization. Newly developed designer materials aim to manage reactive oxygen species and extracellular matrix degradation to suppress inflammation while promoting vascularization, cell proliferation, and epithelial migration to accelerate tissue repair. <b>Critical Issues:</b> Designing optimal materials for chronic wounds remains challenging due to the diverse etiology and a multitude of pathological mechanisms underlying chronic wound healing. While designer materials can target specific aberrations, designing a materials approach that restores all aberrant wound-healing processes remains the Holy Grail. Addressing these issues requires a deep understanding of how cells interact with the materials and the complex etiology of chronic wounds. <b>Future Directions:</b> New material approaches that target wound mechanics and senescence to improve chronic wound closure are under development. Layered materials combining the best properties of the approaches discussed in this review will pave the way for designer materials optimized for chronic wound healing.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958946","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":"Global Burden of Pressure Ulcer and Contributing Factors from 1990 to 2021: A Systematic Analysis with Forecasts to 2035.","authors":"Hanyu Lei, Kaihuan Zhong, Zhizhao Chen, Ping Li, Jia Chen, Haihong Li, Biao Cheng, Jianda Zhou","doi":"10.1089/wound.2025.0021","DOIUrl":"https://doi.org/10.1089/wound.2025.0021","url":null,"abstract":"<p><p><b>Objective:</b> To analyze global trends in pressure ulcer (PU) burden, focusing on microbial infections, antimicrobial resistance (AMR), and climate change from 1990 to 2021, and to forecast location-specific disease burdens through 2035. <b>Approach</b>: This is a cross-sectional study on PU globally from 1990 to 2021. This analysis assessed incidence and disability-adjusted life-years (DALYs) of PU by age, sex, and location, focusing on the relationship between PU burden and microbial infections, AMR, and climate factors. <b>Results:</b> Incidence and DALYs of PU increased from 1990 to 2021, while the corresponding age-standardized rate (ASR) declined or remained steady. ASR of incidence was highest in high sociodemographic index (SDI) areas and lowest in those with low SDI, while ASR of DALYs showed the opposite pattern. PU burden positively correlated with microbial infections and AMR in skin and subcutaneous infections (<i>p</i> < 0.05), and its increase was also associated with high temperature and humidity. Regardless of age, males bear a greater disease burden. However, with aging, females gradually surpass males in disease burden. <b>Innovation:</b> This study offers decision-makers insights into PU burden, contributing factors, and forecasts, supporting informed policies to mitigate its impact. <b>Conclusion:</b> PU poses a rising global challenge with persistent disease burden, especially in low-SDI and low-income regions. Microbial infections, AMR, and climate factors are associated with increased burden. Targeted policies and enhanced epidemiological understanding are crucial for effective prevention and control.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955475","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}