Advances in wound care最新文献

{"title":"Integration of Flow Cytometry and Single-Cell RNA Sequencing Analysis to Explore the Fibroblast Subpopulations in Keloid that Correlate with Recurrence.","authors":"Ruxin Xie, Chenyu Li, Tian Zhao, Shiwei Zhang, Ai Zhong, Nengbin Chen, Zhengyong Li, Junjie Chen","doi":"10.1089/wound.2024.0262","DOIUrl":"10.1089/wound.2024.0262","url":null,"abstract":"<p><strong>Objective: </strong>Fibroblasts (FBs) are the cytological basis of keloid (KD) formation. This study aimed to identify the key pathogenic target cell subpopulation involved in KD recurrence.</p><p><strong>Approach: </strong>Single-cell RNA sequencing data were retrieved from public databases, revealing distinct gene expression patterns in FB subpopulations. Flow cytometry (FCM) was used to identify the surface molecular phenotypes of FBs that affect KD recurrence. Simultaneously, logistic regression analysis was performed to assess the predictive value of changes in FB subpopulation percentages for clinical KD recurrence.</p><p><strong>Results: </strong>The percentage of keloid fibroblasts was significantly greater than that in normal tissues. Through further clustering analysis of the FB population, we obtained four subpopulations, FB1-FB4, in which the percentages of FB1 subpopulation were increased, and functional enrichment analysis suggested that the FB1 subpopulation may play a greater role in extracellular matrix collagen oversynthesis in KD. In addition, the gene expression of CD26 (DPP4), CD117 (c-KIT), and CD34 in the FB1 subpopulation was significantly higher than that in FB2-4 subpopulations. Moreover, the percentage of CD26+/CD117+/CD34+ cell subpopulations in the FCM data of patients with KD recurrence was significantly increased. Regression analysis confirmed that the CD26+/CD117+/CD34+ FB subpopulation was a risk factor for relapse.</p><p><strong>Innovation: </strong>We demonstrated that the molecular phenotypic and functional heterogeneity of FBs influences KD recurrence.</p><p><strong>Conclusion: </strong>We identified key pathogenic FB subpopulations that may affect KD development, which can be used as potential markers to predict recurrence and provide potential target cell populations for future clinical treatment.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"381-398"},"PeriodicalIF":5.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Adipose-Derived Stem Cell Exosome Sheet Promotes Oral Mucosal Wound Healing.","authors":"Dany Y Matar, Chung-Jan Kang, Adriana C Panayi, Dennis P Orgill, Huang-Kai Kao","doi":"10.1089/wound.2024.0216","DOIUrl":"10.1089/wound.2024.0216","url":null,"abstract":"<p><strong>Objective: </strong>Oral mucosal wound healing is not completely understood, and effective therapies are lacking. This study explores the potential of an adipose-derived stem cell (ADSC) exosome sheet in enhancing intraoral wound healing in rats.</p><p><strong>Approach: </strong>An ADSC exosome sheet derived from Tisseel and rat adipose tissue (ADSC-exo) was applied to 16 rats with 6 mm full-thickness mucosal hard palate wounds. Eight wounds received ADSC-exo with a superficial occlusive dressing (ADSC-exo group), and eight received only an occlusive dressing (control group). Wound closure was monitored on days 0, 2, 4, 7, and 10, with dressings changed every 2 days. On day 10, rats were sacrificed, and wounds (<i>n</i> = 8 per group) were collected for immunohistochemical analysis. <i>In vitro</i>, four ADSC-exosome concentrations (0, 4.5 × 10¹¹, 9 × 10¹¹, and 18 × 10¹¹ exosomes/mL; <i>n</i> = 4 per group) were applied to rat oral mucosal fibroblasts to assess migration speed.</p><p><strong>Results: </strong>ADSC-exo accelerated wound closure (18% ± 5% vs. 35% ± 9% of initial wound area; <i>p</i> = 0.002) and fibroblast migration (for 18 × 10¹¹ exosomes/mL at 24 h: 29.7% ± 3% vs. 62.2% ± 4% of initial gap area; <i>p</i> < 0.0001) compared with the control. ADSC-exo promoted reepithelialization (87% ± 14% vs. 21% ± 6%; <i>p</i> < 0.0001), proliferation (34 ± 12 vs. 18 ± 7 Ki67+/high-power field [HPF]; <i>p</i> = 0.004), and neovascularization (28 ± 9 vs. 11 ± 5 CD31+/HPF; <i>p</i> = 0.0002) while reducing inflammation (4 ± 1 vs. 13 ± 9 CD68+/HPF; <i>p</i> < 0.0001) and increasing M2 macrophages (9.2 ± 2 vs. 4.2 ± 3 CD163+/HPF; <i>p</i> = 0.0008). ADSC-exo increased Transforming Growth Factor beta 1 (TGF-β1) (1.3 ± 0.3 vs. 0.9 ± 0.2; <i>p</i> = 0.006), Smad3 (0.9 ± 0.02 vs. 0.7 ± 0.1; <i>p</i> = 0.006), and collagen I (1.5 ± 0.9 vs. 0.5 ± 0.3; <i>p</i> = 0.005) while downregulating caspase-3 (0.7 ± 0.3 vs. 1.1 ± 0.2; <i>p</i> = 0.003) and Bax (0.9 ± 0.2 vs. 1.4 ± 0.1; <i>p</i> < 0.0001).</p><p><strong>Innovation: </strong>This is the first study to demonstrate the pro-wound healing effects of an ADSC exosome sheet on intraoral wounds. This paves the way for future research and clinical applications of ADSC exosomes in mucosal wound healing.</p><p><strong>Conclusions: </strong>Application of an ADSC-exo to rat mucosal wounds significantly improved wound healing. Mechanistically, these effects may be linked to upregulated activity of the TGF-β/Smad pathway.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"355-369"},"PeriodicalIF":5.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electrically Conductive Hydrogels for Wound Healing.","authors":"Lulu Sun, Ruinan Hao, Kelly Van Van, Feng Tian, Jiajia Xue","doi":"10.1177/21621918251374285","DOIUrl":"10.1177/21621918251374285","url":null,"abstract":"<p><strong>Significance: </strong>Wound healing is a complex, tightly regulated process involving a range of enzymes, growth factors, and cytokines that coordinate cellular activities essential for tissue repair and wound closure. However, in cases of extensive or severe injury, the intrinsic repair mechanisms are often insufficient, underscoring the need for advanced therapeutic strategies to accelerate healing and minimize scar formation.</p><p><strong>Recent advances: </strong>Electrically conductive hydrogels (ECHs), combining the advantageous properties of hydrogels with the physiological and electrochemical characteristics of conductive materials, present a safer and more convenient alternative to traditional electrode-based electrical stimulation (ES) for treating chronic and nonhealing wounds. This review summarizes the various types of ECHs and their functional roles in facilitating wound healing.</p><p><strong>Critical issues: </strong>Understanding the mechanisms by which ECHs interact with electrical signals in the skin, along with precise control of the synergy between these signals and other functional properties, is critical for achieving optimal wound healing outcomes.</p><p><strong>Future directions: </strong>Future development of ECHs should focus on elucidating underlying mechanisms, standardizing ES parameters, validating efficacy in clinically relevant animal models, and integrating multifunctional systems. Additionally, material design must be optimized for biocompatibility, adaptability, and scalability to facilitate clinical translation in chronic and nonhealing wound treatment.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"399-413"},"PeriodicalIF":5.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global Burden of Pressure Ulcer and Contributing Factors from 1990 to 2021: A Systematic Analysis with Forecasts to 2035.","authors":"Hanyu Lei, Kaihuan Zhong, Zhizhao Chen, Ping Li, Jia Chen, Haihong Li, Biao Cheng, Jianda Zhou","doi":"10.1089/wound.2025.0021","DOIUrl":"10.1089/wound.2025.0021","url":null,"abstract":"<p><strong>Objective: </strong>To analyze global trends in pressure ulcer (PU) burden, focusing on microbial infections, antimicrobial resistance (AMR), and climate change from 1990 to 2021, and to forecast location-specific disease burdens through 2035.</p><p><strong>Approach: </strong>This is a cross-sectional study on PU globally from 1990 to 2021. This analysis assessed incidence and disability-adjusted life-years (DALYs) of PU by age, sex, and location, focusing on the relationship between PU burden and microbial infections, AMR, and climate factors.</p><p><strong>Results: </strong>Incidence and DALYs of PU increased from 1990 to 2021, while the corresponding age-standardized rate (ASR) declined or remained steady. ASR of incidence was highest in high sociodemographic index (SDI) areas and lowest in those with low SDI, while ASR of DALYs showed the opposite pattern. PU burden positively correlated with microbial infections and AMR in skin and subcutaneous infections (<i>p</i> < 0.05), and its increase was also associated with high temperature and humidity. Regardless of age, males bear a greater disease burden. However, with aging, females gradually surpass males in disease burden.</p><p><strong>Innovation: </strong>This study offers decision-makers insights into PU burden, contributing factors, and forecasts, supporting informed policies to mitigate its impact.</p><p><strong>Conclusion: </strong>PU poses a rising global challenge with persistent disease burden, especially in low-SDI and low-income regions. Microbial infections, AMR, and climate factors are associated with increased burden. Targeted policies and enhanced epidemiological understanding are crucial for effective prevention and control.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"370-380"},"PeriodicalIF":5.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetic Foot Ulcers as a Marker of Systemic Disease: Long-Term Survival, Limb Loss, and Economic Impact in a Large Real-World Cohort.","authors":"María Lourdes Del Río-Solá, Carlos García Padrón, Clara de la Torre Casaseca, Eva Álvarez García, Jose Antonio Brizuela Sanz","doi":"10.1177/21621918261450959","DOIUrl":"https://doi.org/10.1177/21621918261450959","url":null,"abstract":"<p><strong>Background: </strong>Diabetic foot ulcers (DFUs) represent one of the most severe complications of diabetes mellitus and are associated with limb loss, excess mortality, and substantial health care costs. Although DFUs are often approached as a localized wound condition, increasing evidence suggests that they reflect advanced systemic vascular and metabolic disease. However, large real-world longitudinal studies integrating wound outcomes, survival, and economic burden remain scarce.</p><p><strong>Objectives: </strong>The objective of this study is to evaluate long-term clinical outcomes, survival, and health care costs associated with DFUs in a large real-world cohort and to identify factors independently associated with mortality and limb loss.</p><p><strong>Methods: </strong>We conducted a retrospective longitudinal cohort study including 5,698 adult patients with diabetes treated for active DFUs at a tertiary referral hospital. Minor and major amputations, survival outcomes, health care utilization, and estimated direct hospital costs were analyzed. Time-to-event analyses included Kaplan-Meier estimation, competing-risk regression, and multivariable Cox proportional hazards models. Disease trajectories were further explored using multistate modeling.</p><p><strong>Results: </strong>During follow-up, 290 major amputations were recorded. Patients undergoing major amputation showed significantly worse survival compared with nonamputated patients or those with minor amputations (log-rank <i>p</i> < 0.001). Mean survival after major amputation was 35.3 months, compared with more than 47 months in patients without major limb loss. Five-year overall survival was 61.8%, decreasing to 32.1% among patients with major amputation. Increasing age, peripheral arterial disease, ischemic heart disease, end-stage renal failure, and prior major amputation were independently associated with mortality. Male sex emerged as the main independent predictor of major amputation in adjusted competing-risk models. DFU-related care was associated with high health care utilization and progressively escalating hospital costs.</p><p><strong>Conclusions: </strong>DFUs should be regarded as a marker of advanced systemic disease rather than an isolated wound condition, given their strong association with long-term mortality, limb loss, and economic burden. Early risk stratification and integrated multidisciplinary care strategies are essential to improve outcomes in this high-risk population.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"21621918261450959"},"PeriodicalIF":5.6,"publicationDate":"2026-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148136449","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":"Temporal <i>In Vitro</i> Models of Skin Wound Healing Components: A Cell-Specific Framework for Acute and Chronic Repair Mechanisms.","authors":"Dipti Kalshetti, Mahmud Amin, Ridham Varsani, Adhav Narayanan, Sara Ciurca, Isabella Grijalva, Alyssa Lickfeld, James Lukan, Steven Schwaitzberg, Praveen Arany","doi":"10.1177/21621918261450363","DOIUrl":"10.1177/21621918261450363","url":null,"abstract":"<p><strong>Significance: </strong>Wound healing is as much about opportunity (Gk. <i>Karios</i>) and sequence (Gk. <i>Chronos</i>). The sequential healing responses involve concerted responses of cells of various lineages along with both soluble (cytokines and growth factors) and insoluble (matrix composition and topology) that are precisely coordinated for ultimate healing. This motivated the current scoping review to examine the biological relevance and utility of current <i>in vitro</i> models of wound healing, focusing on specific cellular responses.</p><p><strong>Recent advances: </strong>We examined PubMed, Web of Science, and EBSCO of Science for the years 2020-2025, using keywords <i>in vitro</i> wound healing and individual cell type, namely epithelial cells, keratinocytes, fibroblasts, macrophages, platelets, and endothelial cells. This identified 126 relevant studies were selected and categorized by healing stage, cell types, and prototypical biological responses such as proliferation, migration, and lineage-specific functions.</p><p><strong>Critical issues: </strong>This analysis outlined the utility of a temporal framework to organize current <i>in vitro</i> models as acute-initial, early and late, and chronic-delayed. Existing two-dimensional and three-dimensional models focus on platelet function (hemostasis), neutrophil or macrophage chemotaxis and phagocytosis (inflammation), epithelium (closure), fibroblast (matrix synthesis, contraction), and endothelial (angiogenesis). While these models provide key insights into specific phases, cell functions, and molecular mechanisms, they do not fully replicate the integrated, multiorgan processes of wound healing observed <i>in vivo</i>.</p><p><strong>Future directions: </strong>Sequential combinations of these models lend themselves to the advances in artificial intelligence, machine learning, and robotic automation that are integral to developing prognostic and therapeutic wound care agents.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"21621918261450363"},"PeriodicalIF":5.6,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147986244","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":"Alpha-1-Antitrypsin Enhances Fat Graft Survival in a Murine Model.","authors":"Dor Halpern, Idan Farber, Yuval Anav, Alexandra Tsitrina, Eli C Lewis, Eldad Silberstein","doi":"10.1089/wound.2024.0176","DOIUrl":"10.1089/wound.2024.0176","url":null,"abstract":"<p><strong>Objective: </strong>Fat grafting is widely applied for various purposes, including volume restoration, improving tissue quality, and promoting wound healing, but it has poor long-term graft survival predictability. Alpha-1-antitrypsin (AAT) administration is hypothesized to improve fat graft outcomes by expediting inflammatory resolution and graft vascularity and reducing necrosis.</p><p><strong>Approach: </strong>Mice heterozygote to human AAT was grafted fat under the scalp alongside 400 µg/graft AAT or albumin (ALB) on days 0 and 3. Graft volume was determined by micro-magnetic resonance imaging, and explants were assessed for viability, histology, immunohistochemistry, and expression of selected genes. AAT expression was examined in hypoxia-exposed adipose-derived stem cells (ADSCs).</p><p><strong>Results: </strong>After 90 days, AAT-treated grafts maintained higher volumes (70.06% vs. 34.54%, <i>n</i> = 8, <i>p</i> = 0.02) and displayed improved tissue quality. On day 10 after grafting, grafts exhibited more blood vessels (mean 1.94/mm² vs. 0.33/mm²) and 6.25-fold more adiponectin transcript levels (<i>n</i> = 12, <i>p</i> = 0.02). Although day-3 interleukin (IL)-1β expression was 5-fold greater in AAT-treated grafts (<i>n</i> = 6, <i>p</i> = 0.4), day-10 IL-1β expression was 2-fold lower compared to ALB-treated grafts (<i>n</i> = 22, <i>p</i> = 0.01). In the Methoxynitrosulfophenyl-tetrazolium carboxanilide (XTT) assay, day-3 AAT-treated grafts were 1.56-fold more metabolically functional (<i>n</i> = 6, <i>p</i> = 0.04) and exhibited greater perilipin-positive regions (18.5% versus 3.1%). Hypoxia-exposed ADSC expressed 9-fold higher AAT transcript levels (<i>p</i> = 0.04).</p><p><strong>Innovation: </strong>Fat grafting outcomes improved by early AAT treatment, probably by accelerating inflammatory resolution. Due to its marked safety profile, the study's findings are for adjunct clinical-grade AAT therapy.</p><p><strong>Conclusion: </strong>AAT has a promising potential to be utilized as a fat graft outcome enhancer in terms of volume retention predictability and tissue quality.[Figure: see text].</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"299-309"},"PeriodicalIF":5.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143661905","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":"Evidence Mapping of Clinical Practice Guideline Recommendations for Self-Management Strategies of Diabetic Foot Ulcers.","authors":"Shupeng Shi, Piaoyu Yang, Xingzhou Liu, Yongjie Li, Chuan Yang","doi":"10.1089/wound.2024.0276","DOIUrl":"10.1089/wound.2024.0276","url":null,"abstract":"<p><strong>Significance: </strong>Diabetic foot ulcer (DFU) is a common complication of diabetes, characterized by chronic, hard-to-heal wounds that can lead to serious infections and amputations. Effective self-management is crucial for treatment and prevention.</p><p><strong>Recent advances: </strong>A comprehensive literature search was conducted across academic databases, clinical practice guideline (CPG) databases, and the websites of diabetes societies. The characteristics, recommendations, and evaluation criteria of the CPGs were extracted and organized using Excel. Four researchers independently assessed the methodological and reporting quality of the CPGs using the Appraisal of Guidelines Research and Evaluation II instrument and the Reporting Items for practice Guidelines in HealThcare checklist. Data were synthesized and visualized through evidence mapping to provide an overview of current guideline coverage and key recommendations.</p><p><strong>Critical issues: </strong>This study included 13 CPGs and synthesized 46 recommendations. Self-management strategies for patients with DFU mainly involve health education, foot self-care, lifestyle change, comorbidity/symptom management, as well as follow-up and medical help-seeking. The identified CPGs were of mixed quality, with four classified as high quality. With respect to methodology, the CPGs performed well in scope and purpose (82.6%±10.9%) and clarity (80.77%±9.19%), but showed deficiencies in stakeholder involvement (52.8%; interquartile range [IQR]: 17.3%) and editorial independence (58.3%; IQR: 82.3%). For reporting quality, limitations were noted in transparency regarding review and quality assurance (18.75%; IQR: 100%), as well as funding and declaration of interests (12.5%; IQR: 32.82%).</p><p><strong>Future directions: </strong>The evidence provided by CPGs for DFU self-management varied in strength, and some recommendations were inconsistent. The results adds to our knowledge and promotes the development of trustworthy CPGs on DFU. Further research is necessary to propose more evidence-based and high-quality recommendations.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"310-324"},"PeriodicalIF":5.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143661907","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":"AI-Powered Image-Based Assessment of Pressure Injuries Using You Only Look Once Version 8 (YOLOv8) Models.","authors":"Mehedi Hasan Tusar, Fateme Fayyazbakhsh, Niloofar Zendehdel, Eduard Mochalin, Igor Melnychuk, Lisa Gould, Ming C Leu","doi":"10.1089/wound.2024.0245","DOIUrl":"10.1089/wound.2024.0245","url":null,"abstract":"<p><strong>Objective: </strong>The primary objective of this study is to enhance the detection and staging of pressure injuries using machine learning capabilities for precise image analysis. This study explores the application of the You Only Look Once version 8 (YOLOv8) deep learning model for pressure injury staging.</p><p><strong>Approach: </strong>We prepared a high-quality, publicly available dataset to evaluate different variants of YOLOv8 (YOLOv8n, YOLOv8s, YOLOv8m, YOLOv8l, and YOLOv8x) and five optimizers (Adam, AdamW, NAdam, RAdam, and stochastic gradient descent) to determine the most effective configuration. We followed a simulation-based research approach, which is an extension of the Consolidated Standards of Reporting Trials (CONSORT) and Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines for dataset preparation and algorithm evaluation.</p><p><strong>Results: </strong>YOLOv8s, with the AdamW optimizer and hyperparameter tuning, achieved the best performance metrics, including a mean average precision at intersection over union ≥0.5 of 84.16% and a recall of 82.31%, surpassing previous YOLO-based models in accuracy. The ensemble model incorporating all YOLOv8 variants showed strong performance when applied to unseen images.</p><p><strong>Innovation: </strong>Notably, the YOLOv8s model significantly improved detection for challenging stages such as Stage 2 and achieved accuracy rates of 0.90 for deep tissue injury, 0.91 for Unstageable, and 0.74, 0.76, 0.70, and 0.77 for Stages 1, 2, 3, and 4, respectively.</p><p><strong>Conclusion: </strong>These results demonstrate the effectiveness of YOLOv8s and ensemble models in improving the accuracy and robustness of pressure injury staging, offering a reliable tool for clinical decision-making.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"271-288"},"PeriodicalIF":5.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623193","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":"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":"10.1089/wound.2025.0074","url":null,"abstract":"<p><strong>Significance: </strong>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).</p><p><strong>Recent advances: </strong>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.</p><p><strong>Critical issues: </strong>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.</p><p><strong>Future directions: </strong>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":"325-347"},"PeriodicalIF":5.6,"publicationDate":"2026-05-01","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}