Advances in wound care最新文献

{"title":"The Efficacy of Negative Pressure Wound Therapy Combined with Topical Oxygen Therapy in Treating Chronic Refractory Wounds: A Systematic Review and Meta-Analysis.","authors":"Junwei Su, Dong Zhang, Jincheng Du, Ruozu Xiao, Zhe Liu, Yuqian Li, Haowei Zhou, Jing Li","doi":"10.1177/21621918251366606","DOIUrl":"https://doi.org/10.1177/21621918251366606","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate the clinical efficacy of negative pressure wound therapy (NPWT) combined with topical oxygen therapy (TOT) for chronic refractory wounds (CRWs), addressing potential hypoxia limitation of NPWT through oxygen supplementation, thereby offering an innovative therapeutic approach for CRWs. <b>Approach:</b> The study was performed according to the 2015 Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols statement. A comprehensive search was conducted in PubMed, Cochrane, Embase, Web of Science, CNKI, VIP, and Wanfang databases for randomized controlled trials (RCTs) on the treatment of CRWs with NPWT combined with TOT (inception to October 2024). Studies were screened based on predefined criteria, and data were extracted and assessed using RevMan 5.4. Meta-analysis, sensitivity analysis, and publication bias assessment were performed using Stata 15.0. <b>Results:</b> Eleven RCTs (844 patients) were included. Compared with NPWT, the combination therapy was associated with the following outcomes: increased healing rate (risk ratio [RR] = 1.51, 95% confidence interval [CI]: 1.36-1.69, <i>I</i>² = 18.1%), reduced time from debridement to skin grafting (mean difference [MD] = -2.82 days, 95% CI: -3.15 to -2.50, <i>I</i>² = 4%), shortened healing time (MD = -9.09 days, 95% CI: -11.98 to -6.20, <i>I</i>² = 91.2%), enhanced granulation coverage (MD = 7.56%, 95% CI: 6.09-9.03, <i>I</i>² = 0.0%), and decreased bacterial positivity (RR = 0.27, 95% CI: 0.18-0.41, <i>I</i>² = 0.0%). <b>Innovation:</b> This study provides evidence-based medical research supporting NPWT plus TOT as a synergistic strategy for CRWs. <b>Conclusion:</b> Combined therapy may offer benefits over NPWT alone in CRW treatment, suggesting a promising approach to improve healing outcomes.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144833616","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":"Effects of ON101 for Hard-to-Heal Diabetic Foot Ulcers in a Randomized Phase III Trial: A <i>Post Hoc</i> Analysis.","authors":"Shun-Cheng Chang, Ching-Wen Lin, Jui-Ching Chen, Yi-Hsin Wu, Shyi-Gen Chen, Yu-Yao Huang, Nai-Chen Cheng, Shawn M Cazzell, Hsin-Han Chen, Kuo-Feng Huang, Kwang-Yi Tung, Hsuan-Li Huang, Cherng-Kang Perng, Bimin Shi, Chang Liu, Yujin Ma, Yemin Cao, Yanbing Li, Yaoming Xue, Fang Gao, Ying Cao, Li Yan, Qiu Li, David G Armstrong, Guang Ning","doi":"10.1089/wound.2023.0167","DOIUrl":"10.1089/wound.2023.0167","url":null,"abstract":"<p><p><b>Objective:</b> Hard-to-heal diabetic foot ulcers (DFUs) are associated with higher mortality rates and an increased medical burden for patients. ON101, a new topical cream, exhibited better healing efficacy than the control dressing in a Phase III trial. In this <i>post hoc</i> analysis, we further identify whether ON101 can improve the healing of ulcers with hard-to-heal risk factors in this cohort of DFU patients. <b>Approach:</b> To compare the efficacy of ON101 with absorbent dressing among various hard-to-heal wounds in patients with DFU, a <i>post hoc</i> analysis of a randomized Phase III trial that included 276 DFU patients was performed by subgrouping those patients based on ulcer depth, location, size, duration, and patients' glycated hemoglobin (HbA1c) levels and body mass index (BMI). <b>Results:</b> In the full analysis set, the proportion of patients achieving healing was 61.7% in the ON101 group and 37.0% in the comparator (<i>p</i> = 0.0001). In subgroup analysis according to risk factors, ON101 demonstrated superior healing capacity on Wagner grade 2 ulcers (<i>p</i> < 0.0001); plantar ulcers (<i>p</i> = 0.0016), ulcer size ≥5 cm² (<i>p</i> = 0.0122), ulcer duration ≥3 months (<i>p</i> = 0.0043); for patients with HbA1c ≥9% (<i>p</i> = 0.0285); and patients with BMI ≥25 (<i>p</i> = 0.0005). <b>Innovation:</b> ON101, a novel therapeutic drug, can modulate the functions of macrophages and demonstrate superior healing rates to conventional absorbent dressing in patients with hard-to-heal DFUs. <b>Conclusions:</b> The results of this <i>post hoc</i> study suggest that ON101 is a better therapeutic option than conventional dressing used in treatment for DFU patients with higher HbA1c, BMI, or ulcers with complex conditions such as longer duration, deeper wounds, larger size, and plantar location.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"381-392"},"PeriodicalIF":5.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141080311","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":"New Opportunities for Electric Fields in Promoting Wound Healing: Collective Electrotaxis.","authors":"Yan Zhang, Shiwen Huang, Yifei Cao, Li Li, Jun Yang, Min Zhao","doi":"10.1089/wound.2024.0003","DOIUrl":"10.1089/wound.2024.0003","url":null,"abstract":"<p><p><b>Significance:</b> It has long been hypothesized that naturally occurring electric fields (EFs) aid wound healing by guiding cell migration. Consequently, the application of EFs has significant potential for promoting wound healing. However, the mechanisms underlying the cellular response to EFs remain unclear. <b>Recent Advances:</b> Although the directed migration of isolated single cells under EFs has been studied for decades, only recently has experimental evidence demonstrated the distinct collective migration of large sheets of keratinocytes and corneal epithelial cells in response to applied EFs. Accumulating evidence suggests that the emergent properties of cell groups in response to EF guidance offer new opportunities for EF-assisted directional migration. <b>Critical Issues:</b> In this review, we provide an overview of the field of collective electrotaxis, highlighting key advances made in recent years. We also discuss advanced engineering strategies utilized to manipulate collective electrotaxis. <b>Future Directions:</b> We outline a series of unanswered questions in this field and propose potential applications of collective electrotaxis in developing electrical stimulation technologies for wound healing.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"418-428"},"PeriodicalIF":5.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141080314","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":"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":"393-408"},"PeriodicalIF":5.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12359142/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Collagen-Based Products in Wound, Skin, and Health Care.","authors":"Chandan K Sen, Andrew Friday, Savita Khanna, Sashwati Roy","doi":"10.1177/21621918251361118","DOIUrl":"10.1177/21621918251361118","url":null,"abstract":"<p><p>Collagen, the most abundant structural protein in the human body, plays a vital role in wound healing, tissue repair, and skin integrity. Collagen-based products-ranging from wound dressings, skin substitutes, dental and orthopedic scaffolds, to topical cosmetics and oral supplements-have proliferated rapidly across healthcare and consumer markets. Medical applications leverage collagen's biocompatibility, biodegradability, and scaffold-forming properties to manage chronic wounds, burns, and bone defects, while emerging technologies such as recombinant collagen and phage-integrated dressings target future innovations. Topical collagen improves skin hydration but is unlikely to replace endogenous collagen; injectable fillers offer temporary cosmetic enhancement with some potential risks. Oral collagen supplements, although marketed for skin, joint, and hair health, primarily serve as incomplete proteins and require cautious interpretation, as rigorous clinical evidence supporting transformative outcomes remains limited. Specific formulations such as undenatured type II collagen show promise for inflammatory joint conditions by promoting immune tolerance. In wound care, collagen-based scaffolds enhance healing by supporting fibroblast proliferation, reducing inflammation, and modulating moisture balance, while novel crosslinked matrices and living skin equivalents push regenerative medicine boundaries. Not all collagen-based products are the same. As the global collagen market surges toward $18.7 billion by 2030, users must distinguish between marketing claims and evidence-based benefits of specific preparations. Proper product selection should be guided by clinical context, molecular source (animal, marine, recombinant), and intended use with awareness of underlying scientific evidence critical to therapeutic success. Continued innovation, rigorous validation, mechanism of action studies and rigorous clinical testing are essential to fully realize collagen's therapeutic potential across medicine and wellness.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12359144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144726456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"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":"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":5.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12344125/pdf/","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":"OA","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":"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}