Advances in wound care最新文献

{"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}

{"title":"HMGB1 Accelerates Wound Healing by Promoting the Differentiation of Epidermal Stem Cells via the \"HMGB1-TLR4-Wnt/Notch\" Axis.","authors":"Miao Zhen, Yongkang Zhu, Peng Wang, Xiaogang Liu, Junyou Zhu, Hengdeng Liu, Jingting Li, Jingling Zhao, Bin Shu","doi":"10.1089/wound.2023.0130","DOIUrl":"10.1089/wound.2023.0130","url":null,"abstract":"<p><p><b>Objective:</b> Impairments in the differentiation and migratory capacity of epidermal stem cells (ESCs) are pivotal factors contributing to delayed wound healing. High mobility group box1 (HMGB1) has recently emerged as a potential target for tissue repair. Therefore, we aimed to investigate the role and molecular mechanisms of HMGB1 in ESCs during the wound-healing process. <b>Approach:</b> Initially, we examined the expression of HMGB1 and the differentiation of ESCs in normal skin, normal wounds and chronic wounds. Then, we assessed the ESC migration and differentiation, and the key markers in the Wnt/Notch signaling pathways, after treatment of HMGB1 and inhibitor, and the knockdown of toll-like receptor 4 (TLR4), using scratch assay, qPCR, western blotting, and immunofluorescence. Finally, we conducted mice models to analyze the healing rates and quality <i>in vivo</i>. <b>Results:</b> HMGB1 was decreased across all epidermal layers, and the differentiation of ESCs was hindered in diabetic foot ulcer. <i>In vitro</i>, HMGB1 enhanced both the migration and differentiation of ESCs while stimulating the expression of the Wnt/Notch pathway within ESCs. However, the downregulation of TLR4 negated these effects. Finally, our <i>in vivo</i> experiments provided evidence that HMGB1 facilitates wound healing and epidermis differentiation <i>via</i> TLR4 and Wnt/Notch signaling pathways. <b>Innovation:</b> This study innovatively introduces HMGB1 as a novel target for skin wound healing and elucidates its mechanisms of action. <b>Conclusions:</b> HMGB1 accelerated wound healing by promoting the differentiation of epidermal stem cells through the \"HMGB1-TLR4-Wnt/Notch\" axis, which reveals a new potential mechanism and target to expedite wound healing.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"365-380"},"PeriodicalIF":5.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142851593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multidisciplinary Management Improves Re-Admission, Major Amputation, and Mortality Rates in Patients with Diabetic Foot Ulcers.","authors":"Chi-Wei Chiu, Wen-Teng Yao, Chieh-Ming Yu, Yu-Fan Chen, Ya-Shu Chan, Hsuan-Yu Huang, An-Li Lee, Ying-Chun Liu, Shu-Tien Huang, Liong-Rung Liu, Yueh-Hung Lin, Kung-Chen Ho, Chia-Meng Yu, Wen-Chen Huang, Kwang-Yi Tung, Ming-Feng Tsai","doi":"10.1089/wound.2024.0182","DOIUrl":"10.1089/wound.2024.0182","url":null,"abstract":"<p><p><b>Objective:</b> The objective of this study was to evaluate the impact of a multidisciplinary team (MDT) approach in the management of diabetic foot ulcers (DFUs). <b>Approach:</b> A multidisciplinary diabetic foot care center (MDDFCC) was opened at our institution in August 2018. Outcomes of DFU treatment, including re-admission, amputation, and mortality rates, were compared before and after opening the MDDFCC. <b>Results:</b> Patients seen after the MDDFCC was opened had a lower risk of 1-year re-admission (hazard ratio [HR] = 0.697, 95% confidence interval [CI]: 0.387-0.988), 1-year major amputation (HR = 0.447, 95% CI: 0.091-0.984), and 1-year disease-specific mortality (HR = 0.277, 95% CI: 0.105-0.730). PEDIS score (HR = 2.343, 95% CI: 1.264-2.971), history of dialysis (HR = 1.858, 95% CI: 1.258-4.053), and consultation with a physiatrist (HR = 0.368, 95% CI: 0.172-0.788), orthopedist (HR = 0.105, 95% CI: 0.042-0.261), or social worker (HR = 0.370, 95% CI: 0.082-0.871) were associated with 1-year major amputation. One-year major amputation (HR = 2.636, 95% CI: 1.586-4.570), age (HR = 1.094, 95% CI: 1.051-1.140), and C-reactive protein level (HR = 1.052, 95% CI: 1.008-1.098) were associated with 1-year disease-specific mortality. <b>Innovation:</b> Plastic surgeons received patients at the MDDFCC, with active participation by all contributing members. This arrangement brought advantages, including more aggressive and timely surgical intervention, a more timely and higher rate of percutaneous transluminal angioplasty, and equally robust integrated medical care by all other members. <b>Conclusion:</b> The MDDFCC approach may be a potential organizational structure with for treating DFUs, resulting in significant improvements in outcomes of DFU including a lower re-admission, amputation, and mortality.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiological Trends of Pressure Injuries at the Global, Regional, and National Levels: A Trend Analysis Study from 1990 to 2021.","authors":"Hao Yang, Yuxi Zhou, Honglin Wu, Yongfei Chen, Xiaohui Li, Peng Wang, Jiayuan Zhu, Zhicheng Hu, Shuting Li","doi":"10.1089/wound.2025.0003","DOIUrl":"https://doi.org/10.1089/wound.2025.0003","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate global, regional, and national trends in the prevalence and disability-adjusted life years (DALYs) of pressure injuries (PIs) from 1990 to 2021 and project future trends to 2035, based on data from the Global Burden of Disease (GBD) study. <b>Approach:</b> This study used GBD 2021 data to analyze PIs prevalence and DALYs by age, sex, and Sociodemographic Index (SDI) region. The Bayesian age-period-cohort model was employed for temporal trend analysis and future projections. <b>Results:</b> From 1990 to 2021, the global prevalence slightly decreased from 8.246 to 7.920 per 100,000 (estimated annual percentage change -0.023%), whereas DALYs decreased by 9.7%. High-SDI regions presented significant DALY reductions (-39.3%), whereas middle- and low-middle-SDI regions presented increased prevalence rates (20.5% and 28.9%, respectively). The prevalence was highest in the ageing population, peaking in the 95+ year age group. Projections estimate that there will be 720,660 global cases by 2035, with the greatest burden expected among older adults in developing regions. <b>Innovation:</b> This study provides a comprehensive longitudinal analysis of PIs, revealing global disparities and emphasizing demographic-specific risks, especially in ageing populations and low-SDI regions. Bayesian modeling offered robust future projections. <b>Conclusion:</b> Despite modest improvements globally, significant disparities in the prevalence of PIs persist, particularly in developing regions and among older adults. Targeted interventions, preventive strategies, and health care policies are critical for addressing these challenges and mitigating future disease burdens.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144300956","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":"Pressure Injury Incidence and Quality of Care Index (1990-2021): An Analysis of Trends and Health Inequalities Based on the Study of Global Burden of Disease 2021.","authors":"Zhi-Qin Xie, Xue-Mei Tao, Ze-Quan Wang, Yun-Yu Du, Lin-Xia Yi, Chao Xie, Han-Xiao Yi, Min Zhang, Wan-Yin Xiong, Shi-Han Chen, Chao-Zhu He, Rui Liu, Li Zhou, Zhen Yang","doi":"10.1089/wound.2024.0241","DOIUrl":"https://doi.org/10.1089/wound.2024.0241","url":null,"abstract":"<p><p><b>Objectives:</b> To elucidate the global disease burden and care quality associated with pressure injury (PI). <b>Approach:</b> This study examined temporal trends in PI incidence over the past 32 years. Decomposition analysis attributed these trends to demographic and epidemiological shifts, and cross-national health inequities were quantified. The Quality of Care Index (QCI) was constructed using principal component analysis to assess spatiotemporal variations in global PI care quality. A log-linear age-period-cohort model was employed to forecast trends over the next 15 years. <b>Results:</b> In 2021, there were nearly 2.47 million PI cases globally, a 115.92% increase from 1.14 million in 1990. Decomposition analysis revealed that population aging and demographic growth were the primary drivers of increasing PI incidence. Lower QCI was concentrated in African countries and those with low sociodemographic index (SDI). Incidence rates increased gradually with improving SDI. Significant health inequalities existed among 204 countries and regions, with minimal changes in inequality slope indices over time. Projections indicate a gradual increase to 3.5 million PI cases globally by 2035. <b>Innovation:</b> This study developed a novel comprehensive indicator, the QCI, and for the first time, shed light on health inequalities in PI across 204 countries and territories. <b>Conclusion:</b> Over the past 32 years, the global disease burden of PI has been significant, accompanied by health inequalities across countries and regions. For nations with low SDI, there remains considerable room for improvement in the quality of care for PI, necessitating more effective strategies to address health care disparities.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245727","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 Practice Guidelines for the Prevention and Management of Pressure Injury in Critically Ill Patients Undergoing Prone Position Ventilation: A Systematic Review.","authors":"Ya-Bin Zhang, Chun-Yan Han, Dan Ma, Rui Li, Ai-Bing Si, Shui-Yu Wang","doi":"10.1089/wound.2024.0239","DOIUrl":"https://doi.org/10.1089/wound.2024.0239","url":null,"abstract":"<p><p><b>Significance:</b> This systematic review was conducted to assess the quality of clinical practice guidelines (CPGs) on prevention and management of pressure injury (PI) in patients undergoing prone position ventilation (PPV) and summarize the recommendations based on the analyses of the CPGs. <b>Recent Advances:</b> We searched the PubMed, Cochrane library, Embase databases, guideline websites, professional association, quality standards, and Wound-Related Research Journals from January 1, 2010 to August 31, 2024. Included guidelines were those with recommendations for prevention and management of PI in patients undergoing PPV published in English. Four researchers independently assessed the eligible studies and extracted the data. Appraisal of Guidelines Research & Evaluation (AGREE II) instrument and the Reporting Items for Practice Guidelines in Healthcare checklist were used to assess the quality of the CPGs. <b>Critical Issues:</b> A total of 13 CPGs were included in this review. AGREE II demonstrated that the highest mean score was based on the scope and purpose and was 73.65 ± 10.91, whereas the lowest mean score was based on the editorial independence and was 49.79 ± 19.49. The scores of inter-rater agreements for AGREE-II quality appraisal ranged from 0.86 to 0.96. Recommendations for prevention and management of PI in patients undergoing PPV were inconsistent. <b>Future Directions:</b> The included CPGs were limited due to methodological issues and exhibited discrepancies in the coverage of important topics. Therefore, existing evidence should be used to propose identifiable recommendations and strengthen the rigor and standardization of guideline development in future research.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144232933","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 Measurement of Transepidermal Water Loss.","authors":"Dibyasankha Kundu, Anant Jayaraman, Chandan K Sen","doi":"10.1089/wound.2024.0148","DOIUrl":"10.1089/wound.2024.0148","url":null,"abstract":"<p><p><b>Significance:</b> Recent reports recognize transepidermal water loss (TEWL) as a critical objective parameter measuring clinical wound healing endpoint. At the site of wound repair, TEWL measures functional wound closure as marked by re-establishment of barrier function at the wound site. This review article addresses recent developments in clinical TEWL measurement in the context of human skin health and wound care. To that end, emphasis is placed on the review of registered clinical studies reported in ClinicalTrials.gov for which TEWL results have been posted or published. <b>Recent Advances:</b> The U.S. Food and Drug Administration (FDA) defines complete wound closure as the achievement of 100% re-epithelialization of the wound surface, with no detectable exudate, drainage, or need for wound dressing, as verified during two sequential clinical assessments conducted at least 14 days apart. Clinically, wounds may meet this current FDA-recommended clinical criteria for wound closure, yet not achieve functional wound closure which requires the re-establishment of barrier function at the site of repair. Such wounds are likely to recur. High TEWL posthealing predicts wound recurrence. Thus, TEWL measurement at the site of repair posthealing is emerging as a significant measurement of wound healing endpoint. <b>Critical Issues:</b> Appropriate clinical measurement of TEWL requires a basic understanding of the related technologies and their appropriate use. Such understanding will help achieve the necessary rigor and reproducibility in clinical measurement. <b>Future Directions:</b> Recent reports on the critical significance of TEWL in wound care open new horizons wherein TEWL is likely to have broader applications involving altered skin barrier functions, such as during aging and other factors that determine skin health. Evidence to support revisiting the FDA definition of wound closure to include restoration of barrier function at the site of closure is strong. Widespread adoption of TEWL in wound care practices to determine functional wound closure is anticipated.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12359141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144232932","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}