Advances in wound care最新文献

{"title":"The Shizuoka Study of a Population-Based Retrospective Cohort for the Evaluation of Risk of Pressure Injury in the Elderly.","authors":"Hideo Hashizume, Ammi Matsuura, Yoshiki Miyachi","doi":"10.1089/wound.2024.0256","DOIUrl":"10.1089/wound.2024.0256","url":null,"abstract":"<p><strong>Objective: </strong>The risk of pressure injuries (PIs) is increasing in Japan, where an aging population imposes substantial health care burdens.</p><p><strong>Approach: </strong>This retrospective cohort study utilizing the Shizuoka Kokuho Database evaluated factors associated with PI development in hospitalized patients.</p><p><strong>Results: </strong>An analysis of over 546,000 patients aged ≥65 years from 2012 to 2022 identified 6,372 PI cases. Cox regression analyses revealed that male sex (hazard ratio [HR] 1.32, 95% confidence interval [CI]: 1.25-1.39), advanced age (HR 8.54, 95% CI: 7.40-9.87 for ≥95 years vs. 65-69 years) and comorbidities such as neurological disorders (HR 1.87, 95% CI: 1.72-2.04), dementia (HR 1.69, 95% CI: 1.59-1.80), and congestive heart failure (HR 1.19, 95% CI: 1.12-1.27) were associated with increased PI risks. Conversely, antihyperlipidemic drugs may be associated with a lower PI risk (HR 0.69, 95% CI: 0.65-0.74). Due to data limitations, factors such as nutritional status, mobility, and caregiver support could not be evaluated.</p><p><strong>Innovation: </strong>This study is the first in Japan to leverage big data to identify high-risk groups for PIs, particularly among elderly individuals with specific comorbidities. This approach offers actionable insights into PI management, potentially enhancing care strategies and preventive guidelines.</p><p><strong>Conclusion: </strong>Male sex, advanced age, and comorbidities, including neurological disorders, dementia, psychosis, and congestive heart failure, were identified as primary PI risk factors. Conversely, antihyperlipidemic drug use may be associated with a lower PI risk. These findings highlight the need for comprehensive, targeted prevention strategies to reduce the risk of PI in elderly hospitalized patients.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"289-298"},"PeriodicalIF":5.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646804","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":"Moisturizers, Emollients, or Barrier Preparations for the Prevention of Pressure Injury: A Systematic Review and Meta-Analysis.","authors":"Hayley Ryan, Brett G Mitchell, Oya Gumuskaya, Alison Hutton, Peta Tehan","doi":"10.1089/wound.2023.0002","DOIUrl":"10.1089/wound.2023.0002","url":null,"abstract":"<p><strong>Significance: </strong>Pressure injuries are prevalent, yet preventable global health care problem estimated to affect 14% of hospital patients and up to 46% of aged care residents. One common prevention strategy is improving skin integrity through emollient therapy to optimize hydration and avoid skin breakdown. Therefore, this study aimed to review the literature and determine effectiveness of inert emollients, moisturizers, and barrier preparations compared with standard care, to prevent pressure injury in aged care or hospital settings.</p><p><strong>Recent advances: </strong>Search terms were derived with database searches, including ProQuest, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Medline, Science Direct, Scopus, and the Cochrane library. The Robins1 and Risk of Bias 2 (Rob2) quality appraisal tools were used. A meta-analysis of the effects of interventions was conducted (random effects). Four studies met the inclusion criteria, with heterogeneous quality. Pooling of nonrandomized studies found that the application of emollients, moisturizers or barrier preparations did not significantly reduce incidence of pressure injury compared with standard care (relative risk 0.50, 95% confidence interval: 0.15-1.63, <i>Z</i> = 1.15, <i>p</i> = 0.25).</p><p><strong>Critical issues: </strong>This review suggests that the use of inert moisturizers, emollients, or barrier preparations for preventing pressure injuries was not effective to prevent pressure injury in aged care or hospital settings. However, there was a distinct lack of randomized controlled trials (RCTs), with only one meeting the inclusion criteria. Furthermore, most of the included studies did not report on the frequency of application of the product, making it difficult to determine if application was in line with current international guidelines. One included study, which utilized a combination of neutral body wash and emollient demonstrated a significant reduction in the development of stage one and two pressure injuries. This combination of care may further support skin integrity and should be further examined in future trials.</p><p><strong>Future directions: </strong>Future studies should ideally be RCTs, which control for skin cleansing, and implement an inert moisturizer emollient or barrier preparation as part of a pressure injury reduction bundle of care. Standardization of the application of the product, the volume of product applied at each application, and the quality of the product should also be considered.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"wound20230002"},"PeriodicalIF":5.6,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9777781","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 Functionality of High-Density Lipoproteins Is Impaired in People with Diabetes Who Require Minor Amputations.","authors":"Zahra Lotfollahi, Emma L Solly, Joanne T M Tan, Victoria A Nankivell, Lauren Sandeman, Liam Stretton, Mohsen Dorraki, Guilherme Pena, Johan Verjans, Zygmunt Szpak, Joseph Dawson, Neil McMillan, Peter J Psaltis, Robert Fitridge, Christina A Bursill","doi":"10.1177/21621918261441530","DOIUrl":"https://doi.org/10.1177/21621918261441530","url":null,"abstract":"<p><strong>Objective: </strong>High-density lipoprotein (HDL) functionality is emerging as a novel predictor of disease outcomes. The role of HDL functionality in patients with diabetes-related amputations is unexplored. We aimed to assess changes in HDL functionality in people with diabetes who had minor amputations and to determine the relationship between HDL functionality and wound closure (WC).</p><p><strong>Approach: </strong>Thirty patients with diabetes mellitus (DM) and 11 without (non-DM) undergoing minor amputations were recruited. Blood was collected at baseline (DM, <i>n</i> = 30; non-DM, <i>n</i> = 11), 1 month (DM, <i>n</i> = 22; non-DM, <i>n</i> = 5), and 6 months (DM, <i>n</i> = 14; non-DM, <i>n</i> = 3) postamputation and from 20 healthy gender- and age-matched control participants. HDL was isolated from plasma and functionality markers of macrophage cholesterol efflux, and anti-inflammatory and proangiogenic capacities in endothelial cells were assessed. The study adhered to Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.</p><p><strong>Results: </strong>HDL-cholesterol (HDL-c) levels positively correlated with WC (<i>r</i> = 0.44, <i>p</i> < 0.05). Cholesterol efflux capacity of DM HDL was reduced 1-month postamputation (-44% vs. non-DM HDL, <i>d</i> = -1.5, <i>p</i> < 0.05). Following inflammatory stimulation, DM HDL-treated cells had elevated levels of <i>C-X3-C motif chemokine ligand 1</i> (+92%, <i>d</i> = 0.9), <i>C-C motif chemokine ligand 2</i> (+49%, <i>d</i> = 0.8), <i>vascular cell adhesion molecule 1</i> (+67%, <i>d</i> = 0.9), and <i>intracellular adhesion molecule 1</i> (+58%, <i>d</i> = 0.9) (vs. non-DM HDL, <i>p</i> < 0.05). The capacity of endothelial cells to form tubules reduced linearly with time following DM HDL treatment (<i>p</i> < 0.05), concomitant with reduced <i>vascular endothelial growth factor A</i> (-47% vs. non-DM HDL, <i>d</i> = -1.2, <i>p</i> < 0.05). Endothelial cells treated with HDL from participants with delayed WC (<50%, 1-month postamputation) exhibited increased v-rel avian reticuloendotheliosis viral oncogene homolog A (<i>RELA)</i> expression (+52%, <i>d</i> = 1.2, <i>p</i> < 0.05). The impairment of HDL functionality in DM was concomitant with reduced apolipoprotein AI (-34%, <i>d</i> = 1.2) and paraoxonase 1 (-32%, <i>d</i> = -1.3, vs. non-DM, <i>p</i> < 0.05) protein in HDL 1-month postamputation.</p><p><strong>Innovation: </strong>An HDL panel, including HDL-c and HDL functionality and composition, could be used in early screening to identify patients who may benefit from early therapeutic intervention, guiding wound care management.</p><p><strong>Conclusion: </strong>Impaired HDL functionality, mediated through changes in HDL composition, may contribute to delayed wound healing.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"21621918261441530"},"PeriodicalIF":5.6,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759480","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":"Protein-Based Nutrition for Chronic Wounds: A Clinician's Guide to Patient Selection, Dosing, Monitoring, and Outcomes.","authors":"Zilong Tan, Yi Ru, Caiyun Zhang, Xinxin Wu, Qingkai Liu, Bin Li, Qilong Chen","doi":"10.1177/21621918261444178","DOIUrl":"https://doi.org/10.1177/21621918261444178","url":null,"abstract":"<p><strong>Significance: </strong>Chronic wounds remain a major global health burden and often stall despite guideline-based care because of persistent inflammation, oxidative stress, impaired perfusion, and dysregulated extracellular matrix remodeling. Protein-based nutrition is best positioned as an adjunct to, rather than a substitute for, standard wound care.</p><p><strong>Recent advances: </strong>Human studies, supported by mechanistic rationale, suggest that optimizing total protein intake (commonly ∼1.25 to 1.5 g/kg/day in appropriate patients) and, in selected settings, adding functional components such as arginine, glutamine, and β-hydroxy-β-methylbutyrate (HMB) may improve wound-area reduction and healing trajectories when integrated with standard care. Reported signals vary by etiology, including improved wound-area reduction and Pressure Ulcer Scale for Healing outcomes in pressure injuries, possible benefit in selected high-risk diabetic foot ulcer subgroups, and reduced venous ulcer area when supplementation is paired with consistent compression.</p><p><strong>Critical issues: </strong>Evidence remains heterogeneous across wound types and study designs, with inconsistent dosing, duration, endpoints, and patient-selection criteria that limit standardized implementation. Safety and feasibility are especially important in renal risk and diabetes, where renal function and glycemic control require monitoring. Clinical evidence was interpreted with attention to study design and reporting standards, including CONSORT, STROBE, or STARD, as applicable.</p><p><strong>Future directions: </strong>This review translates current evidence into a clinician-oriented framework for patient selection, prescribing, monitoring, and treatment adjustment, emphasizing initiation triggers in stalled wounds and trajectory-based reassessment every 2-4 weeks. Future work should prioritize pragmatic, well-controlled trials comparing formulations and dosing windows by wound etiology, together with biomarker-informed stratification to improve personalization, safety, and real-world uptake.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"21621918261444178"},"PeriodicalIF":5.6,"publicationDate":"2026-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147715728","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":"Overcoming Challenges in Wound Infection: Biofilm and Antimicrobial Resistance.","authors":"Markus Rothmaier, Matthew J Hardman, Bithi Chatterjee, Holly N Wilkinson, Michelle Rudden, Ran Frenkel","doi":"10.1177/21621918261440437","DOIUrl":"10.1177/21621918261440437","url":null,"abstract":"<p><strong>Significance: </strong>Chronic wounds represent a growing clinical and economic burden, affecting 1-2% of the global population, with prevalence expected to rise due to aging and increasing rates of diabetes, obesity, and vascular diseases. Wound persistence is often driven by infection and compounded by antimicrobial resistance (AMR), resulting in poor patient outcomes. High prevalence of microbial biofilms, which shield pathogens from immune clearance and promote AMR, further promotes the chronicity of infected wounds.</p><p><strong>Recent advances: </strong>Adoption of antimicrobial stewardship in wound care is increasing, emphasizing timely diagnosis of infection and pathogen identification to guide treatment and limit unnecessary AMR-driving antibiotic use. However, current diagnostic and therapeutic approaches remain only partially effective, particularly for biofilm-containing wounds. While many antimicrobials exist, their use is constrained by negative impacts on wound healing, limited antibiofilm activity, and insufficient evidence of improved clinical outcome. To address these gaps, recent advances in diagnostics and therapeutics aim to disrupt microbial communities, reduce AMR risk, and accelerate wound healing.</p><p><strong>Critical issues: </strong>The treatment of chronic wounds is challenged by AMR, biofilms, and the limited effectiveness of current therapies. Contemporary antimicrobials (<i>e.g.,</i> broad-spectrum antibiotics and silver) are linked to AMR development, compounded by biofilms that shield pathogens, limit antimicrobial efficacy, and sustain infection. While alternative treatments with lower AMR risk and greater antibiofilm activity are under investigation, the lack of robust clinical data limits their adoption.</p><p><strong>Future directions: </strong>Broader adoption of antimicrobial stewardship and biofilm-targeting sustainable wound care practices are key for combatting AMR and improving patient outcomes.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"21621918261440437"},"PeriodicalIF":5.7,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147697337","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":"Senescence Programs Shape the Chronic Wound Microenvironment.","authors":"Maria Shvedova, Minsung Cho, Jeroen Eyckmans, Daniel S Roh","doi":"10.1177/21621918261441046","DOIUrl":"https://doi.org/10.1177/21621918261441046","url":null,"abstract":"<p><strong>Significance: </strong>Chronic wounds such as diabetic foot ulcers, venous leg ulcers, and pressure ulcers are characterized by impaired healing and persistent inflammation. Cellular senescence, defined as irreversible growth arrest with a pro-inflammatory secretory phenotype (senescence-associated secretory phenotype), has emerged as a potential driver of these nonhealing states. While transient induction of senescence may aid acute repair, chronic accumulation of senescent cells is thought to disrupt tissue regeneration, promote extracellular matrix degradation, and sustain inflammation.</p><p><strong>Recent advances: </strong>Single-cell RNA sequencing and spatial transcriptomics have revealed diverse cell states in chronic wounds, including senescent subsets. Studies in diabetic, venous, and pressure ulcers implicate senescent fibroblasts and immune cells in impaired remodeling, often triggered by oxidative stress, hyperglycemia, or ischemia-reperfusion injury. Therapeutic strategies targeting senescent cells in delayed wound healing have demonstrated promise in preclinical models; however, interventions must be timed and targeted precisely.</p><p><strong>Critical issues: </strong>Despite emerging evidence, the identity, abundance, and location of senescent cells in chronic wounds remain poorly defined. Reliance on nonspecific markers such as p21 or SA-β-gal complicates interpretation. Senescence appears to play context-dependent roles, with beneficial effects during acute healing but harmful persistence in chronic wounds, presenting challenges for therapeutic targeting.</p><p><strong>Future directions: </strong>More studies using single-cell RNA sequencing, spatial transcriptomics, and longitudinal profiling are needed to define senescent subpopulations, map their spatial distribution, and track dynamics during wound progression. These approaches will help distinguish transient from persistent senescence. A deeper understanding of interactions with immune, epithelial, and stromal components will guide precisely timed, cell type-specific interventions to improve outcomes.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"21621918261441046"},"PeriodicalIF":5.6,"publicationDate":"2026-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147669844","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":"Engineered Mesenchymal Stem Cells with Endogenous Trehalose Expression Activate the NRF2-HMOX1 Pathway to Enhance Antioxidant Stress and Wound Healing Capacity.","authors":"Zhen Wang, Xin Liu, Xin Chen, Jie Jing, Qiuyang Chen, Feiyang Zhou, Zian Chen, Wei Fang, Li Wang, Yuanyuan Wang, Zian Li, Qiang Wang, Jing Gao, Jing Zhao, Guangchao Xu, Rongqing Pang","doi":"10.1177/21621918261438590","DOIUrl":"https://doi.org/10.1177/21621918261438590","url":null,"abstract":"<p><strong>Objective: </strong>Oxidative stress limits mesenchymal stem cell (MSC) efficacy in tissue repair by reducing retention and survival at injury sites. Endogenous production of trehalose may enhance MSC resilience and promote skin wound healing.</p><p><strong>Approach: </strong>Trehalose-6-phosphate synthase 1-expressing MSCs (TPS1-MSCs) were engineered via adenoviral transduction. Trehalose content and synthase activity were assessed. Oxidative stress models (H₂O₂, 0% fetal bovine serum, CoCl₂) were used to evaluate reactive oxygen species (ROS), apoptosis, and cell damage. TPS1-MSCs were transplanted into mouse wounds to track retention rate via <i>in vivo</i> imaging. Histology and immunofluorescence were used to assess wound healing, collagen deposition, and angiogenesis. Conditioned medium (CM) was used to evaluate paracrine functions. RNA-seq identified differentially expressed genes, and mechanisms were validated using the NRF2 inhibitor ML385.</p><p><strong>Results: </strong>TPS1-MSCs exhibited TPS1 activity and synthesized trehalose. Under oxidative stress, these cells showed reduced ROS, enhanced viability, and decreased apoptosis. <i>In vivo</i>, TPS1-MSCs displayed higher retention, accelerated healing, and neovascularization. CM from TPS1-MSCs promoted keratinocyte migration, fibroblast collagen secretion, and enhanced the tube-forming capacity of endothelial cells. Transcriptome analysis revealed enrichment in the NRF2-HMOX1 pathway. TPS1-MSCs showed elevated levels of p62, nuclear NRF2, and HMOX1. ML385 treatment impaired the observed antioxidant capacity.</p><p><strong>Innovation: </strong>Engineering MSCs for endogenous trehalose synthesis enhanced oxidative stress resistance and retention through NRF2-HMOX1 activation, suggesting a potential novel MSC-based wound repair strategy.</p><p><strong>Conclusion: </strong>TPS1-MSCs improved antioxidant capacity and wound healing, potentially through the NRF2-HMOX1 pathway, and may represent a promising therapy for skin wounds. [Figure: see text] [Figure: see text].</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"21621918261438590"},"PeriodicalIF":5.6,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147637721","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 Invisible Wound: Silent Focal Breach of Skin Integrity that Cascades into Systemic Dysfunction and Chronic Morbidity.","authors":"Chandan K Sen, Sashwati Roy","doi":"10.1177/21621918261438591","DOIUrl":"https://doi.org/10.1177/21621918261438591","url":null,"abstract":"<p><p>Barrier function of human skin maintains hydration by preventing excessive transepidermal water loss (TEWL), blocks the entry of pathogens and allergens, regulates thermal and chemical exchange with the environment, and sustains immune equilibrium. A wound arises when this barrier is breached, resulting in a loss of structural integrity and barrier function. An invisible wound represents a focal loss of human skin barrier function without any visible cut, ulcer, or defect. Despite appearing intact, the skin in these regions is functionally compromised. Current U.S. Food and Drug Administration (FDA) criteria define complete wound closure as full re-epithelialization without drainage or dressing needs, confirmed during two assessments at least 14 days apart. Wounds may satisfy this structural requirement for wound closure yet fail to restore barrier function. Recent studies demonstrate that wounds closed meeting FDA closure criteria but exhibiting elevated TEWL at the wound site (<i>i.e.,</i> invisible wound) are more likely to recur, highlighting the clinical importance of achieving functional wound closure. Invisible wounds occur across the lifespan and arise from a wide range of everyday and high-risk exposures. They can result from age-related skin thinning, sunburn, and the routine use of cosmetic chemicals on vulnerable or sensitized skin. They may also develop after minor trauma that leaves no laceration, from mechanical stress imposed by prosthetic use, and from barotrauma or other subclinical mechanical forces commonly encountered by warfighters. Although outwardly undetectable, these silent disruptions weaken the skin's protective barrier, undermine systemic health, and contribute to chronic morbidity.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"21621918261438591"},"PeriodicalIF":5.6,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147632134","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":"Prediction Models for Intraoperative Acquired Pressure Injury of Adults: A Systematic Review and Critical Appraisal.","authors":"Yihong Xu, Han Zhao, Shuang Wu, Jianan Wang, Jinyan Zhou, Shanni Ding, Wen Li, Wenjin Wu, Zhichao Yang, Hongxia Xu, Hongying Pan","doi":"10.1089/wound.2024.0238","DOIUrl":"10.1089/wound.2024.0238","url":null,"abstract":"<p><strong>Significance: </strong>Postoperative Pressure Injuries (PIs) present unique risks, requiring dedicated research for accurate assessment. Despite the increasing number of Intraoperative Acquired Pressure Injury (IAPI) prediction models, their risk of bias and clinical applicability remains unclear.</p><p><strong>Recent advances: </strong>Adhered to the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement requirements, IAPI prediction models of adult inpatients (≥18 years) were systematically retrieved from eight databases. Bias risk and applicability were evaluated using the Prediction model Risk Of Bias Assessment Tool (PROBAST), followed by narrative synthesis.</p><p><strong>Critical issues: </strong>From 837 studies, 25 were included, covering 32 prediction models. Most studies (88%) were single-center and conducted in China, Korea, the United States, or Singapore, spanning various surgical specialties. Among 26,142 participants, IAPI incidence ranged from 4.1% to 41.75%. Common predictors included surgery duration, age, and diabetes. Areas Under the Curve (AUC) values varied from 0.702 to 0.984, but calibration was underreported. All studies had high bias risk, with 22 models exhibiting applicability concerns. [Figure: see text] Future Directions:The development of IAPI models requires a clear definition of the timing and personnel responsible for assessing PIs, with a preference for prospective data collection and thorough internal and external validation. Adherence to the critical appraisal and data extraction for systematic reviews of prediction modeling studies checklist and PROBAST guidelines can improve reporting quality. Models should be user-friendly, clinically applicable, and rigorously validated. Precisely defining and rigorously selecting predictors is critical to reducing variability. Future research should adopt more stringent designs to develop high-quality models capable of effectively guiding clinical practice.PROSPERO registration number: CRD42024502726.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"228-245"},"PeriodicalIF":5.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490365","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":"Systematic Review of Relevant Biomarkers for Human Connective Tissue Repair and Healing Outcome: Implications for Understanding Healing Processes and Design of Healing Interventions.","authors":"Junyu Chen, Xiaoxue Fu, Aisha S Ahmed, David A Hart, Zongke Zhou, Paul W Ackermann","doi":"10.1089/wound.2024.0233","DOIUrl":"10.1089/wound.2024.0233","url":null,"abstract":"<p><strong>Objective: </strong>The healing process following connective tissue (CT) injuries is complex, resulting in variable and often suboptimal outcomes. Patients undergoing CT repair frequently experience healing failures, compromised function, and chronic degenerative diseases. The identification of biomarkers to guide improved clinical outcomes after CT injuries remains an emerging but promising field. [Figure: see text] [Figure: see text] Design:Systematic review.</p><p><strong>Data sources: </strong>Databases, including PubMed, MEDLINE Ovid, Web of Science, and Google Scholar, were searched up to August 2024.</p><p><strong>Eligibility criteria: </strong>To achieve the research objective, randomized control trials, cohort studies, and case-control studies on biomarkers associated with CT repair and healing outcomes were selected. The present analysis was confined to clinical and preclinical models, excluding imaging studies. The entire process of this systematic review adhered strictly to the guidelines outlined in the Preferred Reporting Items for Systematic Review and Meta-Analyses protocol checklist.</p><p><strong>Results: </strong>A total of 1,815 studies on biomarkers of CT repair were initially identified, with 75 studies meeting eligibility criteria and 55 passing quality assessments. For biomarkers associated with CT healing outcomes, 281 studies were considered, with 30 studies meeting eligibility criteria and 24 passing quality assessments. Twenty-one overlapping studies investigated the effects of biomarkers on both CT repair and healing outcomes. Specific biomarkers identified, and ranked from highest to lowest quality, include complement factor D, eukaryotic elongation factor-2, procollagen type I N-terminal propetide, procollagen type III N-terminal propetide, lactate, pyruvate, platelet-derived growth factor-BB, tissue inhibitor of metalloproteinase-3 (TIMP-3), cysteine-rich protein-1, plastin-3, periostin, protein S100-A11, vimentin, matrix metalloproteinases (MMP-2, MMP-7, and MMP-9), hepatocyte growth factor, interferon-γ, interleukins (IL-6, IL-8, and IL-10), MMP-1, MMP-3, tumor necrosis factor-α, fibroblast growth factor-2, IL-1α, chondroitin-6-sulfate, inter-alpha-trypsin inhibitor heavy chain-4, transforming growth factor-beta 1, vascular endothelial growth factor, C-C chemokine receptor 7, C-C chemokine ligand 19, IL-1β, IL-1Ra, IL-12p40, granulocyte-macrophage colony-stimulating factor (GM-CSF), and TIMP-1.</p><p><strong>Conclusions: </strong>All of the 37 identified potential biomarkers demonstrated regulatory effects on CT repair and mediated healing outcomes. Notably, the identified biomarkers from human studies can potentially play an essential role in the development of targeted treatment protocols to counteract compromised healing and can also serve as predictors for detecting CT healing processes and long-term outcomes.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"246-263"},"PeriodicalIF":5.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970791","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}