Advances in wound care最新文献

{"title":"The Correlation Between Wound Bed Preparation and Wound Closure in Venous Leg Ulcers: A <i>Post Hoc</i> Analysis of the ChronEx Multicenter Randomized Controlled Trial.","authors":"Marissa J Carter, Robert J Snyder, Keren David Zarbiv, Yael Katz-Levy, Asi Haviv, Ety Klinger, Ofra Barnett-Griness, Chaviva Peretz-Rozenblum, Yaron Shoham, John C Lantis","doi":"10.1177/21621918251366644","DOIUrl":"https://doi.org/10.1177/21621918251366644","url":null,"abstract":"<p><p><b>Objective:</b> This <i>post hoc</i> analysis determined the correlation between wound bed preparation (WBP), defined as complete debridement of nonviable tissue and complete granulation tissue coverage, and wound closure, using data from a published, Consolidated Standards of Reporting Trials (CONSORT)-compliant randomized controlled trial that evaluated bromelain-based enzymatic debridement (BBD) compared with a placebo gel vehicle (GV) or nonsurgical standard of care (NSSOC) in patients with chronic venous leg ulcers (VLUs). <b>Approach:</b> Patients with chronic VLUs were randomized (3:3:2 ratio) to daily treatment with BBD, GV, or NSSOC for up to 2 weeks and followed up weekly with NSSOC for 12 weeks. Wound closure incidence was compared between those who did and did not achieve WBP by 14 days or anytime during the study. <b>Results:</b> Data were analyzed from 119 VLUs. Among 80 wounds that achieved WBP anytime during the study, 42% healed; among 39 wounds without WBP, only 10.3% healed (relative risk [RR] = 4.1, <i>p</i> = 0.0004, negative predictive value [NPV] = 90%). Among 37 wounds that achieved WBP by 14 days, 54% healed; among 78 wounds that did not achieve WBP by 14 days, only 22% healed (NPV = 78%). Wounds were 2.4 times more likely to achieve closure anytime during the study, if they achieved WBP by 14 days (RR = 2.4, <i>p =</i> 0.0005). <b>Innovation:</b> This landmark analysis confirms that WBP status is an early predictive variable of wound closure. <b>Conclusion:</b> WBP of chronic VLUs significantly increased the likelihood of wound closure and is a critical, though not sufficient, condition for healing.</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":"144833615","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 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":"Current and Future Directions in Fluorescence Imaging-Guided Debridement.","authors":"Rachael Orkin, Arjun Sharma, Johnson V John, David G Armstrong","doi":"10.1089/wound.2024.0067","DOIUrl":"10.1089/wound.2024.0067","url":null,"abstract":"<p><p><b>Significance:</b> Sterility and reduction of the bioburden are crucial for healing in chronic wounds such as diabetic foot ulcers. Although there are methods for measuring bioburdens, such as semiquantitative analysis of swab/biopsy samples, microbiological sampling, and molecular diagnostics, these tools are less accessible owing to costs or not being as quick as other methods. These methods are also dependent on clinical assessment by the clinician, and high bacterial burden may appear asymptomatic. <b>Recent Advances:</b> Autofluorescence (AF) imaging is a novel technology for identifying and quantifying chronic inhibitory bacterial load in chronic wounds. Eighty-seven percent of bacteria that frequent chronic wounds have fluorophores that fluoresce under violet light as red or cyan, depending on the type of fluorophore. Therefore, AF image-guided treatment is becoming increasingly effective for physicians to implement wound dressing changes and debridement because bacterial burdens are difficult to locate clinically. <b>Critical Issue:</b> Products such as the commercially available MolecuLight i:X and MolecuLight DX function as handheld cameras for physicians to use as a reference but require additional work to ensure that the photograph will be taken with adequate lighting. <b>Future Directions:</b> Designs for Vision Inc. introduced a device called REVEAL, an AF imaging form factor that allows the device to be worn on top of a pair of glasses, which the physician would wear intraoperatively. The benefits of this form factor include not requiring certain lighting conditions and not having to interpret the results using a handheld camera, allowing the device to be used during active surgical debridement.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"409-417"},"PeriodicalIF":5.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141544340","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":"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":"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}