Advances in wound care最新文献

{"title":"The Association Between Risk-Adjusted Wound Healing Rates and Long-Term Outcomes in a Network of U.S. Wound Care Clinics.","authors":"Grigory Franguridi, Andrew Becker, Soeren Mattke, Mary Sheridan, Jack Knott, William Ennis","doi":"10.1089/wound.2024.0263","DOIUrl":"10.1089/wound.2024.0263","url":null,"abstract":"<p><strong>Objective: </strong>Chronic wounds have a high prevalence and poor outcomes in a geriatric population. It is unknown whether higher rates of successful wound healing are associated with better long-term outcomes. We sought to determine the association of risk-adjusted healing rates in wound care clinics with postdischarge outcomes.</p><p><strong>Approach: </strong>This observational study compared outcomes of Medicare patients with chronic wounds who received care at clinics with the highest risk-adjusted wound healing rates (<i>n</i> = 91) to those with the lowest rates (<i>n</i> = 88) in a network of 510 specialized U.S. wound care clinics. All 12,703 patients with chronic wounds at the clinics that could be identified in Medicare data were included. The outcomes were incidences of wound recurrence, gangrene, sepsis, and amputation after discharge.</p><p><strong>Results: </strong>The study included 6,462 and 6,241 patients in top- and bottom-performing clinics, respectively. Being treated in a top-performing clinic was associated with a lower cumulative incidence of all four outcomes. The difference was statistically significantly lower for wound recurrence (adjusted hazard ratio [aHR] = 0.82, 95% confidence interval [CI] 0.76-0.87, <i>p</i> < 0.001) and gangrene (aHR = 0.62, 95% CI 0.52-0.76, <i>p</i> < 0.001) but not for sepsis (aHR = 0.88, 95% CI 0.76-1.001, <i>p</i> = 0.065) and amputation (aHR = 0.75, 95% CI 0.65-1.00, <i>p</i> = 0.055).</p><p><strong>Innovation: </strong>This study is the first to suggest that patients treated in clinics with better wound-healing outcomes also have better outcomes after discharge. This finding can inform analyses to understand differences in practice patterns that lead to better outcomes.</p><p><strong>Conclusion: </strong>Treatment of chronic wounds in wound care clinics with higher risk-adjusted healing rates is associated with a lower risk of wound-related adverse events during follow-up, particularly in the first year. More research is needed to understand the factors that contribute to this effect and to determine interventions to improve outcomes sustainably as well as assess the impact of changes in outcomes on resource utilization and patients' quality of life.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"671-680"},"PeriodicalIF":5.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144223995","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":"Cell-Free Regenerative Therapies for Wound Healing and Skin Repair: The Emerging Role of Adipose-Derived Stem Cell Extracellular Vesicles.","authors":"Yang Zhang, Xiaoxu Guo, Yu Chen, Yujie Peng, Sousan Cheong, Xuan Hu, Xiaorong Liu, Feng Lu, Yunfan He","doi":"10.1177/21621918261479710","DOIUrl":"https://doi.org/10.1177/21621918261479710","url":null,"abstract":"<p><strong>Significance: </strong>Chronic wounds, burns, radiation-injured wounds, and pathological scars remain major clinical challenges despite advances in wound care. Adipose-derived stem/stromal cell extracellular vesicles (ADSC-EVs) offer a cell-free strategy for delivering bioactive proteins, lipids, and nucleic acids across multiple phases of repair, but their clinical value depends on wound-focused product definition, delivery, and evidence standards.</p><p><strong>Recent advances: </strong>Preclinical studies consistently associate ADSC-EVs with improved inflammatory control, re-epithelialization, angiogenesis, extracellular matrix remodeling, and scar attenuation. Hydrogels, wound dressings, and microneedle platforms may improve local retention in burns and chronic ulcers. Early human studies in scars and skin aging provide preliminary feasibility and safety signals, whereas evidence in inflammatory dermatoses remains largely preclinical.</p><p><strong>Critical issues: </strong>Products remain heterogeneous in source cells, isolation, characterization, dose metrics, storage, potency testing, and reporting. Many studies use the term \"exosome\" despite incomplete biogenetic characterization, complicating interpretation and comparison. Outcomes also depend on delivery route and wound context. Human wound-care evidence is limited, and no exosome product has received U.S. Food and Drug Administration approval for routine wound or dermatologic use.</p><p><strong>Future directions: </strong>Translation requires standardized ADSC-EV products, mechanism-linked potency assays, scalable manufacturing compliant with good manufacturing practice, practical wound-specific delivery systems, and indication-specific trials. The greatest opportunities may lie in difficult-to-heal ulcers, burns, radiation-injured wounds, and scar modulation, where multifunctional biological therapies are most needed.[Figure: see text].</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"21621918261479710"},"PeriodicalIF":5.7,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148817170","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":"Reimagining VEGF Therapy: The Role of PLCγ2 in Pan-Organ Endothelial Networks.","authors":"Ahmed S Abouhashem, Sumit S Verma, Julie Faden-McCormack, Yomna A Moqidem, Partha Dutta, Chandan K Sen, Kanhaiya Singh","doi":"10.1177/21621918261474733","DOIUrl":"10.1177/21621918261474733","url":null,"abstract":"<p><strong>Objective: </strong>Ischemic tissue perfusion remains a major clinical challenge despite VEGF's central role in angiogenesis. Limited success of VEGF-based therapies underscores the need to understand endothelial heterogeneity, as distinct subsets exhibit differential responsiveness. This study explores conserved endothelial states that govern VEGF-driven angiogenesis across human organs and evaluates their functional significance.</p><p><strong>Approach: </strong>We performed single-cell and single-nucleus RNA-sequencing (scRNA-seq/snRNA-seq) analysis of endothelial cells (ECs) from eight human tissues using GTEx data, validated findings in independent skin and heart datasets, and conducted CRISPR-mediated PLCγ2 knockout in cultured ECs followed by scRNA-seq.</p><p><strong>Results: </strong>Analysis of 209,126 nuclei revealed a universal arterial-like endothelial subset (cluster 2) enriched across all organs, characterized by high expression of <i>PLCγ2</i>, a critical VEGF signaling effector. <i>PLCγ2</i>^high cells exhibited robust angiogenic and lymphangiogenic programs, including upregulation of <i>VEGFC</i>, <i>NOTCH4</i>, and <i>JAG1</i>, and enrichment of pathways for vasculature development and endothelial differentiation. Cell-cell communication analysis demonstrated exclusive BMP6, IGF2, and CXCL12 signaling from <i>PLCγ2</i>^high cells to fibroblasts, pericytes, and immune cells, positioning this subset as a central angiogenic hub. Functional validation showed that PLCγ2 knockout depleted <i>PLCγ2</i>^high clusters, suppressed VEGF signaling, and diminished BMP6 ligand secretion, confirming its role in maintaining proangiogenic endothelial states.</p><p><strong>Innovation: </strong>Ineffective targeting of the appropriate EC state may limit current therapeutic VEGF strategies, positioning <i>PLCγ2</i>^high ECs as a clinically relevant target.</p><p><strong>Conclusion: </strong>We identify <i>PLCγ2</i>^high arterial ECs as a conserved pan-organ population critical for VEGF responsiveness and vascular regeneration. These findings reimagine VEGF therapy by highlighting PLCγ2 as a critical regulator of a proangiogenic arterial-like endothelial state and a promising combinatorial target to overcome limitations of current angiogenic strategies.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"21621918261474733"},"PeriodicalIF":5.7,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148700478","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":"The Challenge of Healing Wounds in Radiation-Injured Skin.","authors":"Christopher V Lavin, Carter B Kendig, Danae Kawamoto, Jaden Tarter, Hanqi Yao, Palca Shibale, Parker S Sunwoo, David Perrault, Michael T Longaker, Derrick C Wan","doi":"10.1177/21621918251400347","DOIUrl":"10.1177/21621918251400347","url":null,"abstract":"<p><strong>Significance: </strong>Wound healing in irradiated skin remains a clinical challenge, with radiation therapy (XRT) resulting in excess collagen deposition and cell death resulting in poor tissue quality. This frequently results in chronic wounds that compromise patient outcomes and quality of life.</p><p><strong>Recent advances: </strong>Improved understanding of the pathophysiology behind radiation-induced soft tissue injury has led to the development of promising treatments. These include dermal substitutes, placental derivatives, fibronectin, injectable fat-derived and plasma-derived compounds, hyperbaric oxygen, and deferoxamine.</p><p><strong>Critical issues: </strong>Many traditional approaches to wound healing are often limited by poor tissue quality seen following XRT. A better understanding of mechanisms by which radiation induces these pathological changes may lead to the development of more effective therapeutics.</p><p><strong>Future directions: </strong>Treatments leveraging recent insights into collateral radiation injury may help to condition tissue to promote healing/regeneration of wounds. Although animal studies and human case reports have been promising, wide-scale clinical studies examining their efficacy are still needed before many of these novel strategies may be adopted to help the millions of patients worldwide suffering from radiation-related cutaneous wounds.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"613-638"},"PeriodicalIF":5.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145627414","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":"Wound Healing and Management Considerations in the Pediatric Surgical Patient.","authors":"Norah E Liang, Serena L Jing, Elijah J Suh, Helen H Wang, Benjamin P Pham, Bill Chiu, Jeong S Hyun, Michelle F Griffin, Michael T Longaker, Gillian L Fell","doi":"10.1177/21621918251387640","DOIUrl":"10.1177/21621918251387640","url":null,"abstract":"<p><strong>Significance: </strong>Wound healing in pediatric patients is affected by physiology, growth, and development considerations unique from those in adults. In the following report, we review the primary literature on aging and wound healing and highlight clinical wound healing applications for the pediatric patient across age ranges from neonates and infants in the first year of life to adolescents (aged 10-19 years by World Health Organization definition).</p><p><strong>Recent advances: </strong>We characterize the differences in wound healing biology between infants, adolescents, and adults and discuss wound care strategies for pediatric surgical patients, highlighting evidence-based guidelines for wound management. We discuss relevant animal models and review the multidisciplinary aspects of providing wound care for children.</p><p><strong>Critical issues: </strong>Pediatric surgical patients have specialized wound care needs. Optimizing wound care outcomes for infants, children, and adolescents relies on an understanding of their wound-healing biology and unique physiological, psychological, and social considerations.</p><p><strong>Future directions: </strong>Future directions in pediatric wound care will focus on validating and optimizing emerging technologies through pediatric-specific clinical trials, while also addressing key knowledge gaps in topical agent pharmacokinetics and advancing regenerative approaches like mesenchymal stem cell therapies tailored to the unique biology of infants and children.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"558-579"},"PeriodicalIF":5.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145450508","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 Features and Mechanisms of Differential Wound Healing and Scarring Across Anatomical Sites.","authors":"Hanqi Yao, Serena L Jing, Kelly X Huang, Michelle F Griffin, Michael T Longaker, Derrick C Wan, Dayan J Li","doi":"10.1177/21621918251387627","DOIUrl":"10.1177/21621918251387627","url":null,"abstract":"<p><strong>Significance: </strong>Fibrosis is associated with high rates of morbidity and mortality and poses a heavy burden on the health care system. Different regions of the body heal at different rates with varying degrees of fibrosis, with regions such as the extremities and trunk being more prone to scarring than the face and mucosa. Therapies that leverage the unique mechanisms underlying these anatomical differences in wound healing may be effective in mitigating fibrosis and scarring.</p><p><strong>Recent advances: </strong>Recent studies in mice have revealed fibroblast-intrinsic signaling pathways that contribute to scar formation in different areas of the body, such as engrailed-1-positive fibroblasts and paired-related homeobox-1-positive fibroblasts in dorsal, ventral, and dermal scars, respectively. Novel approaches that target specific molecular pathways within fibroblasts may pave the way for effective therapies in replicating features of scar-resistant skin and facilitating wound healing.</p><p><strong>Critical issues: </strong>Clinical practice and animal studies have shown some body regions to be more susceptible to fibrosis than others. However, our understanding on cellular and molecular mechanisms that contribute to this phenomenon remains limited.</p><p><strong>Future directions: </strong>Advances in antiscarring therapy will benefit from harnessing several aspects of wound healing in regions less prone to fibrosis, including reducing mechanical tension, controlling angiogenic response, and modulating fibroblast subtypes.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"580-595"},"PeriodicalIF":5.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145494551","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 Unique Roles of Adipose Tissue in Wound Healing.","authors":"Jennifer B Parker, Michelle Griffin, Deena Akras, Norah E Liang, Caleb Valencia, Annah G Morgan, Maxwell Kuhnert, Sarah E DiIorio, Michael T Longaker, Derrick C Wan","doi":"10.1177/21621918251383812","DOIUrl":"10.1177/21621918251383812","url":null,"abstract":"<p><strong>Significance: </strong>Recognized for its role in energy storage and thermal insulation, white adipose tissue (WAT) has garnered increasing attention given its functions beyond metabolism. In particular, dermal and subcutaneous WATs have been shown to play critical roles in wound healing and scarring. This review proposes that dermal and subcutaneous adipose tissues are not passive bystanders but active regulators of wound healing and fibrosis.</p><p><strong>Recent advances: </strong>Significant advances in wound healing biology have identified critical roles and signaling pathways that immune cells and fibroblasts are involved with in wound healing; however, fewer investigations have studied adipocytes in this context. This review focuses on the roles of WAT and specifically white adipocytes at different stages of wound healing: inflammation, proliferation, and remodeling. We also discuss applications of WAT and its derivatives as therapeutic strategies for improved wound healing.</p><p><strong>Critical issues and future directions: </strong>With multiple fibrotic conditions associated with decreased adipose tissue, understanding the different ways by which adipocyte subpopulations and WAT participate in repair and fibrotic processes will help shed light on how we can modulate cellular response for future therapeutic applications.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"596-612"},"PeriodicalIF":5.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197911","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":"Metabolic Effects on Wound Healing.","authors":"Hanqi Yao, Michelle F Griffin, Serena L Jing, Danae S Kawamoto-Duran, Jaden G Tarter, Norah E Liang, Michael T Longaker, Derrick C Wan","doi":"10.1177/21621918261438987","DOIUrl":"10.1177/21621918261438987","url":null,"abstract":"<p><strong>Significance: </strong>Wound healing is an energetically demanding process that is easily disturbed by metabolic dysregulation. Metabolic dysregulation, induced by diabetes, obesity, insulin resistance, and various hormone imbalances, can disrupt each phase of wound repair, increasing the risk of post-operative complications, infection, wound dehiscence, and pathological scarring. We review the current evidence on the role of metabolic regulation in wound healing and highlight clinically relevant considerations for patient care.</p><p><strong>Recent advances: </strong>Animal and human studies have advanced our understanding of how metabolic pathways influence inflammation, angiogenesis, fibroblast function, and extracellular matrix remodeling during wound healing. These insights have led to the development of novel therapies, including hormone-based topical agents and dressings that both sense and modulate metabolites during wound healing.</p><p><strong>Critical issues: </strong>Despite growing recognition of the role of metabolic syndromes and hormonal regulation in wound healing, these factors are insufficiently integrated into clinical wound management. Bridging this gap requires a clear understanding of how metabolic syndromes and hormonal derangements influence healing.</p><p><strong>Future directions: </strong>The continued development of treatments that modulate metabolic and hormonal pathways may enhance wound healing while minimizing systemic risk. Clinicians should also integrate local metabolic optimization with medical and lifestyle management to create the optimal wound healing environment for patients.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"539-557"},"PeriodicalIF":5.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147653423","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":"Benchmarking Zero-Shot Generative Pre-Trained Transformer-Based Multimodal Large Language Models for Pressure Injury Staging.","authors":"Toshiaki Takahashi, Kengo Miyo, Nao Tamai","doi":"10.1177/21621918261465916","DOIUrl":"https://doi.org/10.1177/21621918261465916","url":null,"abstract":"<p><strong>Objective: </strong>To benchmark zero-shot generative pre-trained transformer (GPT)-based multimodal large language models (MLLMs) for pressure injury (PI) staging from photographs and quantify the effects of prompt strategy, structured outputs, and clinically meaningful label granularity.</p><p><strong>Approach: </strong>We performed a retrospective observational benchmark using 1,091 public, de-identified PI photographs labeled Stage I-IV. In the standardized analysis, all 10 model/prompt conditions were evaluated using a standardized, resume-safe application programming interface pipeline with per-image logging. We evaluated exact four-class staging, three-class staging (I/II/III-IV), skin-break screening (I vs. II-IV), and an advanced-intervention threshold (I-II vs. III-IV). Reporting followed Strengthening the Reporting of Observational Studies in Epidemiology and artificial intelligence/machine learning guidance; metrics included accuracy, Wilson 95% confidence intervals, F1 scores, weighted kappa, and threshold sensitivity/specificity.</p><p><strong>Results: </strong>All conditions yielded parsed predictions for all 1,091 images. The best accuracy was 93.77% for skin-break screening (GPT-5.2 structured JavaScript Object Notation [JSON]), 90.28% for the advanced-intervention threshold (GPT-5.1 full prompt, low reasoning), 83.78% for three-class staging (GPT-5.1 full prompt, low reasoning), and 65.08% for exact four-class staging (GPT-5.2 structured JSON). The best advanced-intervention condition achieved sensitivity 96.72%, specificity 83.79%, and negative predictive value 96.19%. Stage IV undercalling remained safety-relevant; GPT-5.2-pro had Stage IV recall 8.79% and false-negative rate 91.21%.</p><p><strong>Innovation: </strong>This prompt-transparent benchmark shows how outcome granularity, prompting, and structured outputs affect GPT-based PI staging and adds ordinal, threshold-based, and safety metrics.</p><p><strong>Conclusion: </strong>GPT-based MLLMs may support clinician-supervised triage and prioritization, but image-only autonomous exact staging is not clinically ready.[Figure: see text].</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"21621918261465916"},"PeriodicalIF":5.7,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148381358","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":"Does Warmed Saline Irrigation Improve Comfort During Dressing Changes After Digit Replantation? A Randomized Controlled Trial.","authors":"Fengxia Lai, Feng Huang, Yunyi Sheng, Fanghui Guo, Hui Xia, Ye Dong, Suming Wei, Lan Mo, Leiyin Mao, Lijun Lu","doi":"10.1177/21621918261466878","DOIUrl":"https://doi.org/10.1177/21621918261466878","url":null,"abstract":"<p><strong>Objective: </strong>Dressing changes after digit replantation can trigger pain, anxiety, and local wound cooling, yet the clinical impact of cleansing solution temperature remains unclear. This study evaluated whether warmed saline irrigation improves patient experience and physiological stability during wound care after digit replantation.</p><p><strong>Approach: </strong>In this single-center, parallel-group randomized controlled trial, 149 patients undergoing digit replantation were randomized to receive warmed or room-temperature saline irrigation during postoperative dressing changes. Primary outcomes were pain and digit temperature assessed before, during, and after dressing changes. Secondary outcomes included anxiety, comfort, complications, and digit survival. Analyses followed the intention-to-treat principle using linear mixed-effects models. Reporting adhered to CONSORT guidelines.</p><p><strong>Results: </strong>Compared with room-temperature saline, warmed saline significantly reduced pain and anxiety and improved patient comfort over time (all <i>p</i> < 0.001). Warmed saline maintained peri-wound temperature during dressing changes, whereas room-temperature saline induced transient cooling. No between-group differences were observed in complication rates, C-reactive protein, or digit survival. Clinically meaningful improvements in pain, anxiety, and comfort were more frequent in the warmed-saline group. Exploratory analyses suggested greater benefit in younger patients and during colder seasons.</p><p><strong>Innovation: </strong>This trial provides preliminary randomized evidence in a microsurgical population demonstrating that warmed saline irrigation, a simple and low-cost modification, can improve patient-reported outcomes without compromising safety.</p><p><strong>Conclusion: </strong>Warmed saline irrigation offers a safe and practical strategy to enhance comfort and reduce distress during wound care after digit replantation. These findings highlight thermal management as an underutilized, patient-centered component of postoperative care and support its integration into routine practice.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"21621918261466878"},"PeriodicalIF":5.7,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148374203","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}