Advances in wound care最新文献

{"title":"Hypoxia-Inducible Factor Prolyl Hydroxylase Inhibitor Roxadustat Accelerates Wound Healing in a Mouse Hind limb Lymphedema Model.","authors":"Kosuke Ishikawa, Yoshitada Hoshino, Masayuki Osawa, Emi Funayama, Takahiro Miura, Masahiro Hojo, Yuki Sasaki, Satoru Sasaki, Yuhei Yamamoto, Taku Maeda","doi":"10.1089/wound.2024.0237","DOIUrl":"10.1089/wound.2024.0237","url":null,"abstract":"<p><strong>Objective: </strong>Drugs regulating hypoxia-inducible factor (HIF)-1α have not been investigated for wound healing in lymphedema. Therefore, we examined the effects of drug modulation of HIF-1α activity for wound healing in our previously developed mouse model of nonirradiated hind limb lymphedema.</p><p><strong>Approach: </strong>Mouse hind limb lymphedema models (<i>n</i> = 17) and a sham group (<i>n</i> = 6) were created using 8- to 10-week-old male C57BL/6N mice. Mice with hind limb lymphedema were randomized into experimental groups receiving roxadustat, 3-(5'-hydroxymethyl-2'-furyl)-1-benzylindazole (YC-1), or dimethyl sulfoxide and were given intraperitoneal injections every 2 days for up to 2 weeks. Four days after the surgery, an 8-mm diameter full-thickness skin wound was created in the hind limb. The number of days required for wound closure and the percentage of wounds closed were measured. Skin samples taken at wound creation were evaluated by histological and molecular analysis.</p><p><strong>Results: </strong>Administration of roxadustat accelerated wound healing, whereas YC-1 delayed it, with a significant decrease and increase in skin thickness, respectively. The relative mRNA expression of <i>Hif1α</i>, <i>matrix metalloproteinase-3</i>, and <i>interleukin-6</i> was significantly higher in the roxadustat group and that of <i>metalloproteinase-9</i> was significantly lower in the roxadustat group compared with the control group.</p><p><strong>Innovation: </strong>This study is the first to demonstrate delayed wound healing in a mouse model of hind limb lymphedema and the first to demonstrate the promotion of significant wound healing through the use of roxadustat.</p><p><strong>Conclusion: </strong>Roxadustat exerts wound-healing effects and may promote the regulation of extracellular matrix remodeling <i>via</i> gene expression in hind limb lymphedema wound models.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"218-227"},"PeriodicalIF":5.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143031756","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":"Treatment of Surgical Scars with Fractional Carbon Dioxide (CO₂) Laser: A Randomized Controlled Trial.","authors":"Liang Chen, Han Xu, Qiu Yu Wang, Peng Chen, Lin Qi Wang, Xiao Ming Qin","doi":"10.1089/wound.2024.0213","DOIUrl":"10.1089/wound.2024.0213","url":null,"abstract":"<p><strong>Object: </strong>The aim of this study was to compare the long-term effects of fractional carbon dioxide (CO₂) laser treatment with traditional therapy on surgical scars by analyzing and comparing observational indicators.</p><p><strong>Approach: </strong>A randomized controlled trial was conducted on 116 patients who received scar treatment in our hospital, of which 58 patients received fractional CO₂ laser treatment, and 58 patients received injection treatment. The outcome measures comprised the Vancouver Scar Scale (VSS) and the Patient and Observer Scar Assessment Scale (POSAS). The observation intervals occur at specific times. Evaluated at 6 months of follow-up, the outcome was blinded, on-site evaluation using the dermatological appearance scale (DAS) and visual analog scale (VAS).</p><p><strong>Results: </strong>Patients in the fractional carbon-dioxide laser (CO₂FL) group rated better than those in the injection group in the POSAS, VSS, DAS, and VAS scores (<i>p</i> < 0.05). The therapeutic efficacy and patients' satisfaction of the research group were superior to those in the control group.</p><p><strong>Innovation: </strong>Scars following surgical procedures can be treated in a variety of methods, but there is no consensus on the best method. CO₂FL has exhibited safety and is more effective than traditional injection treatments for surgical scars. It is a worthwhile approach to consider in clinical treatment.</p><p><strong>Conclusions: </strong>This study demonstrates that CO₂FL achieves more significant long-term results in surgical scars, including improved scar appearance, safety, and patient satisfaction.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"208-217"},"PeriodicalIF":5.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045008","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":"Flexible Pressure Sensors for Optimizing Pressure Garment Therapy in Periarticular Scar Treatment: Preclinical and Clinical Applications.","authors":"Jia Xu, Yaxin Xue, Wei Xu, Xin Li, Weijie Su, Jiajun Fan, Yanhong Ma, Dong Han","doi":"10.1089/wound.2024.0139","DOIUrl":"10.1089/wound.2024.0139","url":null,"abstract":"<p><strong>Objective: </strong>Pressure garment therapy is a common strategy for controlling hypertrophic scars; however, insufficient pressure due to reduced elasticity or joint movement limits its effectiveness around joints. The FlexiForce B201 pressure sensor offers precise pressure measurements, thereby demonstrating a promising solution.</p><p><strong>Approach: </strong>This study used a Bama pig scar model with an untreated group, a pressure garment group, and a pressure monitoring group that was treated with FlexiForce B201 sensors and pressure garments. The therapeutic effects were recorded over 1 month. The clinical research followed the Consolidated Standards of Reporting Trials and was registered as ChiCTR2200064173. Eighty-two patients with peri-joint hypertrophic scars were enrolled. Forty-one patients were randomly assigned to the control group and received conventional pressure garment therapy, whereas the remaining 41 patients were included in the monitoring group. Treatment outcomes were tracked at 3 months and 6 months.</p><p><strong>Results: </strong>The Bama pig scar model demonstrated reduced scar hypertrophy in the monitoring group. In the clinical study, the scar thickness in the monitoring group was 47.76% of the initial thickness after 6 months, thereby representing an additional 11.33% reduction compared to the control group. The Vancouver Scar Scale score of the monitoring group (6.44 ± 1.62) was significantly better than that of the control group (7.33 ± 1.53).</p><p><strong>Innovation: </strong>The FlexiForce B201 pressure sensor is soft and flexible. It provides accurate pressure measurements within the pressure garment and guides physicians in adjusting the pressure distribution.</p><p><strong>Conclusion: </strong>This study revealed that pressure monitoring technology enhances the effectiveness of pressure garments.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"195-207"},"PeriodicalIF":5.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603392","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":"Prognostic Models for Mortality in Patients with Diabetic Foot Ulcers: A Systematic Review.","authors":"Huiren Zhuang, Yihao Gu, Jingjing Guo, Jinyi Zhu, Xiaojing Li, Weiying Zhang","doi":"10.1177/21621918261429115","DOIUrl":"10.1177/21621918261429115","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to systematically review and summarize existing prognostic models for all-cause mortality in patients with diabetic foot ulcers (DFUs). It further evaluates their characteristics, performance, and methodological quality to inform future model development and clinical application.</p><p><strong>Approach: </strong>We searched eight databases from their inception to February 24, 2025. Extracted data included general study characteristics and model-specific information. The prognostic models were classified using the transparent reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis guidelines and evaluated using the Prediction Model Risk of Bias Assessment Tool (PROBAST) to assess the risk of bias (ROB) and applicability.</p><p><strong>Results: </strong>Of the 1,580 retrieved studies, 19 were included, reporting a total of 22 prognostic models. Reported mortality rates among DFU patients ranged from 4.2% to 48.5%, with follow-up durations varying from 12 weeks to 22 years. All studies exhibited a high ROB due to issues with data sources, small sample sizes, inadequate data handling, and model validation flaws. Across the included prognostic models, the most frequently reported predictors were age, cardiovascular disease, renal disease, ulcer severity, ischemia, and serum albumin.</p><p><strong>Innovation: </strong>Prognostic assessment of mortality risk in patients with DFUs is critical for effective clinical management. This study systematically evaluated 22 published prognostic models using the PROBAST, identifying key methodological limitations and commonly used predictors. The findings provide a scientific basis for the future development of higher quality, clinically applicable prognostic models. In addition, this work offers valuable insights to inform clinical risk stratification and decision-making for DFU patients.</p><p><strong>Conclusions: </strong>All included prognostic models demonstrated a high ROB according to the PROBAST assessment. Future research should focus on using larger sample sizes, rigorous study designs, and multicenter external validation to develop more reliable prognostic models. Given the multifactorial nature of mortality risk in DFU patients, multidisciplinary collaboration is essential to improve clinical outcomes.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"21621918261429115"},"PeriodicalIF":5.6,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147525334","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":"Can Electrical Stimulation Prevent Recurrence of Keloid Scars? A Scoping Review.","authors":"Robert E George, Caroline C Bay, Sarah M Thornton, Jessieka T Knazze, Nicole C Kane, Kip A Ludwig, D'Andrea T Donnelly, Samuel O Poore, Aaron M Dingle","doi":"10.1089/wound.2023.0203","DOIUrl":"10.1089/wound.2023.0203","url":null,"abstract":"<p><strong>Objective: </strong>Keloids represent a symptomatic, aberrant healing process that is difficult to treat with high recurrence rates spanning from 55% to 100% if treated <i>via</i> excision without adjuvant therapy. Electrical stimulation (ES) has demonstrated findings that suggest it could reduce the recurrence rate of keloids after resection. Therefore, the aim of this study is to conduct a scoping review to investigate ES as an adjuvant therapy for decreasing keloid recurrence after excision.</p><p><strong>Approach: </strong>A scoping review was performed using PubMed and Web of Science databases. The search strategy encompassed terms linking keloids and various aspects of electrical stimulation.</p><p><strong>Results: </strong>Our search yielded 2,229 articles, of which 115 articles were analyzed as full text and 1 article met inclusion criteria. Despite this, ES has demonstrated other evidence that suggests its utility. ES has been shown to counter keloidic features by reducing mast cell counts, shifting wound composition from M2 to M1 macrophages, promoting angiogenesis, and controlling fibroblast orientation and location. An alternating current will orient fibroblasts perpendicular to the current without unintended migration.</p><p><strong>Innovation: </strong>Our study indicates that, based on a compilation of clinical and preclinical <i>in vitro</i> data, the optimal scenario for ES in the role of keloid treatment is after excision with a biphasic pulsed application and square waveform.</p><p><strong>Conclusions: </strong>ES could serve as a multifaceted, adjuvant treatment after keloid excision, steering the healing process away from keloid-associated characteristics. Its cost-effectiveness means it could be adopted globally, providing a strategy to mitigate the burden of keloids irrespective of other available treatments or economic conditions.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"157-167"},"PeriodicalIF":5.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141417209","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":"AURKA Activates <i>FOXO3a</i> to Form a Positive Feedback Loop in the Proliferation and Migration of Keloid Fibroblasts.","authors":"Xi Chu, Jiaqi Sun, Siya Dai, Yehua Liang, Xifei Qian, Jinghong Xu, Jufang Zhang","doi":"10.1089/wound.2024.0055","DOIUrl":"10.1089/wound.2024.0055","url":null,"abstract":"<p><strong>Objective: </strong>Keloids are benign fibroproliferative disorders with invasive growth exceeding the wound boundary. Aurora kinase A (AURKA) is a serine/threonine kinase highly expressed in various tumors, facilitating tumor growth and invasion. Currently, the role of AURKA in keloid remains unclear.</p><p><strong>Approach: </strong>Fibroblasts were isolated from keloid and normal skin samples. AURKA was evaluated by qPCR, Western blot, and immunohistochemistry. Transcriptome sequencing and dual-luciferase reporter assays were applied to figure out targets of AURKA. Following expression alteration and MLN8237 (an AURKA kinase inhibitor, AKI) treatment, phenotypical experiments were conducted to clarify biological functions of AURKA along with its target, and to probe into the clinical potential of AURKA inhibition.</p><p><strong>Results: </strong>AURKA was upregulated in keloid tissues and fibroblasts. Forkhead box O 3a (FOXO3a) was verified as a downstream of AURKA. Further experiments demonstrated that AURKA transactivated <i>FOXO3a</i> by binding to FOXO3a, while FOXO3a directly transactivated <i>AURKA</i>. Functionally, AURKA and FOXO3a cooperated in enhancing the proliferation and migration of keloid fibroblasts <i>via</i> protein kinase B (AKT) phosphorylation. Although MLN8237 weakened the proliferation and migration in keloid fibroblasts, the transactivation of AURKA on <i>FOXO3a</i> was independent of kinase activity.</p><p><strong>Innovation: </strong>This study reveals that AURKA and FOXO3a compose a transactivation loop in enhancing the proliferative and migrative properties of keloid fibroblasts, and proposes AURKA as a promising target.</p><p><strong>Conclusion: </strong>AURKA/FOXO3a loop promotes the proliferation and migration of keloid fibroblasts <i>via</i> AKT signaling. Despite the anti-keloid effects of AKIs, AURKA acts as a transcription factor independently of kinase activity, deepening our understanding on AKI insensitivity.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"168-180"},"PeriodicalIF":5.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141791651","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":"Prevalent Types of Peristomal Skin Damage During Chemoradiotherapy and Their Risk Factors.","authors":"Yi Chen, Yan Lu, LiJuan Zhang, LaiJuan Li","doi":"10.1089/wound.2023.0215","DOIUrl":"10.1089/wound.2023.0215","url":null,"abstract":"<p><strong>Significance: </strong>Colorectal cancer is currently ranked third in terms of the global cancer incidence. Enterostomy, a common surgical procedure for colorectal cancer treatment, creates a temporary or permanent stoma in the abdominal wall for waste excretion. Cancer itself and the associated treatments, such as chemotherapy and radiation therapy, increase the likelihood of various types of peristomal skin damage.</p><p><strong>Recent advances: </strong>Recent research has focused on developing more targeted treatment approaches for peristomal moisture-associated skin damage (P-MASD). In addition, studies are investigating the potential of novel wound care products and therapies to enhance healing and reduce the risk of complications. There is also growing interest in understanding the different types except P-MASD during chemoradiotherapy. Different types match the varied treatments. Thus, we aimed to comprehensively review the most prevalent types of peristomal skin damage during chemoradiotherapy and their associated risk factors.</p><p><strong>Critical issues: </strong>The five prevalent types of peristomal skin damage that occur during chemoradiotherapy are peristomal radiodermatitis, P-MASD, peristomal acneiform rash, peristomal pyoderma gangrenosum, and peristomal abscess/infection/fistula. The risk factors vary depending on the type; however, they include the radiation dose, ileostomy surgery, chemoradiotherapy-associated diarrhea, use of epidermal growth factor receptor inhibitors, inflammatory bowel disease, and unclear factors.</p><p><strong>Future directions: </strong>This review guides the clinical identification of peristomal skin damage during chemoradiotherapy, laying a solid foundation for developing effective strategies to prevent this condition.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"181-190"},"PeriodicalIF":5.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254520","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":"Identification of Skin Multicellular Reprogramming Factors as Potential Treatment for Nonhealing Diabetic Foot Ulcers.","authors":"Ahmed S Abouhashem, Sherine K Saber, Sara Abouzekry, Mohammed Elkholy, Ahmed Moustafa, Ahmed Abdellatif, Hassan M E Azzazy, Ahmed A Elbaz, Kanhaiya Singh, Chandan K Sen, Hossam Sharara","doi":"10.1177/21621918251376348","DOIUrl":"10.1177/21621918251376348","url":null,"abstract":"<p><strong>Objective: </strong>In a complex environment such as that in a diabetic foot ulcer (DFU), multiple factors, including cross talk between distinct cell types of the affected tissue, play a significant role. We identified a transcription factor (TF) cocktail that induces a transition from nonhealing to healing states across multiple cell types.</p><p><strong>Approach: </strong>Thirty-three skin and wound single-cell RNA-sequencing samples (85,928 cells) from patients with diabetes with healing or nonhealing DFU were analyzed (GSE165816). The relative activity of cell type-specific TF in healing versus nonhealing DFU was compared, and the cumulative additive effect of different TF cocktails was assessed.</p><p><strong>Results: </strong>We used a cumulative additive-effect approach to identify five transcription factors, FOS Like 2, AP-1 Transcription Factor Subunit (<i>FOSL2)</i>, CAMP Responsive Element Binding Protein 3 Like 1, RELB Proto-Oncogene, NF-KB Subunit, ETS Proto-Oncogene 1 (<i>ETS1</i>), and X-Box Binding Protein 1, whose targets include 66.5% of pro-healing genes and only 12.5% of anti-healing genes across all cell types. In vascular endothelial cells, this TF panel accounted for 95% of vasculature-development genes; in myeloid cells, it regulated 85% of antimicrobial-response genes. <i>In silico</i> knockout of <i>ETS1</i> or <i>FOSL2</i> shifted cells toward nonhealing states, whereas Nuclear Receptor Subfamily 3 Group C Member 1 knockout shifted endothelial cells, fibroblasts, and myeloid cells toward healing-associated state.</p><p><strong>Innovation: </strong>This work recognizes a TF panel that is likely to have therapeutic value in promoting healing in nonhealing DFU.</p><p><strong>Conclusion: </strong>In this work, we identified a set of candidate TFs with the potential to induce a cell state transition favoring a switch from nonhealing to healing outcomes in patients with nonhealing DFU. Overall, our gene regulatory network-driven TF cocktail provides a rational blueprint for reprogramming DFU cell states and paves the way toward targeted regenerative therapies.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"139-156"},"PeriodicalIF":5.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13126601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197872","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":"Fisetin-Mediated Topical Modulation of Senescent Cells in Skin Improves Wound Healing Dynamics in Diabetic Mice.","authors":"Asfia Numani, Margarita Carrasco-Jeldres, Barbara Hernandez-Rovira, K-Raman Purushothaman, Matthew M Melin, James L Kirkland, Saranya Wyles","doi":"10.1177/21621918261426580","DOIUrl":"10.1177/21621918261426580","url":null,"abstract":"<p><strong>Objective: </strong>Diabetes mellitus affects over 25% of adults aged 65+ in the United States and is associated with a heightened risk of developing diabetic foot ulcers. Accumulation of senescent cells within the wound microenvironment can impair cutaneous repair, and senolytic therapies offer a promising approach to accelerate wound healing.</p><p><strong>Approach: </strong>In this study, topical fisetin, a flavonoid that promotes apoptosis of senescent cells, was evaluated for its impact on diabetic wound repair. Full-thickness excisional wounds were created on the dorsal skin of diabetic (db/db) mice. Animals were randomized to receive either topical vehicle (<i>n</i> = 12) or fisetin (<i>n</i> = 12) for three consecutive days per week, and wound healing outcomes were longitudinally assessed.</p><p><strong>Results: </strong>Topical fisetin significantly increased the ratio of healthy dermis to granulation by day 7 (<i>p</i> = 0.04) and reduced dermal fibrosis by day 21 (<i>p</i> = 0.03). Fisetin decreased p16+ cells (<i>p</i> = 0.01) but increased p21+ cells (<i>p</i> = 0.02) at day 7 in the dermis, indicating varied effects on senescent cells. M1 macrophages (CD80+) were decreased in the fisetin-treated group (<i>p</i> = 0.05) at day 21, accompanied by a decrease in pro-inflammatory senescence-associated secretory phenotype cytokines, tumor necrosis factor alpha (<i>p</i> = 0.03), and interleukin-1beta (<i>p</i> = 0.01) at day 7.</p><p><strong>Innovation: </strong>Fisetin is the first topical seno-modulatory agent shown to enhance wound repair when administered after injury onset. Its favorable safety and efficacy in both modulating senescence and inflammation highlight its potential as a novel therapy for diabetic wounds.</p><p><strong>Conclusion: </strong>Topical fisetin enhances diabetic wound healing by reducing fibrosis and promoting healthy dermal regeneration through senescence and inflammation modulation. [Figure: see text].</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"21621918261426580"},"PeriodicalIF":5.7,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13078590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147275398","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":"Frailty Predicts Postoperative Complications in Patients Undergoing Surgery for Diabetic Foot Ulcers.","authors":"Felix J Klimitz, Samuel Knoedler, Tobias Niederegger, Alzbeta Novotna, Stav Brown, Dany Y Matar, Aliyar Zahedi Vafa, Anna Pomahac, Alexander S Piribauer, Leonard Knoedler, Dennis P Orgill, Gabriel Hundeshagen, Martin Kauke-Navarro, Bohdan Pomahac, Adriana C Panayi","doi":"10.1177/21621918261421637","DOIUrl":"https://doi.org/10.1177/21621918261421637","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether frailty, as quantified using the Five-Item Modified Frailty Index (mFI-5), independently predicts postoperative complications in patients undergoing surgery for diabetic foot ulcers (DFUs), and to assess its utility as a clinical risk stratification tool.</p><p><strong>Approach: </strong>A retrospective cohort analysis was conducted using the American College of Surgeons National Surgical Quality Improvement Program database (2015-2021). Adults with type 2 diabetes and International Classification of Diseases, 10th Revision-coded DFUs (E11.621) undergoing elective surgery were identified and stratified into frail (mFI-5 >2) and prefrail (mFI-5 ≤2) groups. Preoperative variables, perioperative characteristics, and 30-day postoperative outcomes were compared using univariate tests, followed by multivariable logistic regression adjusting for clinically relevant confounders. The study design, reporting, and analysis followed the Strengthening the Reporting of Observational Studies in Epidemiology guidelines for observational cohort studies.</p><p><strong>Results: </strong>Among 2,819 patients, 714 (25.3%) were classified as frail. Frail patients had significantly higher rates of overall complications (50.6% vs. 32.9%), mortality (4.1% vs. 1.6%), and medical complications, including reintubation and urinary tract infection. In adjusted models, frailty independently predicted any postoperative complication (odds ratio [OR] = 1.34, 95% confidence interval [CI] 1.05-1.70, <i>p</i> = 0.02) and medical complications (OR = 1.53, 95% CI: 1.12-2.07, <i>p</i> = 0.007).</p><p><strong>Innovation: </strong>This is the first large-scale study applying the mFI-5 to DFU surgery, demonstrating that frailty provides prognostic information beyond traditional comorbidity-based assessments and offers a rapid, objective tool for perioperative risk evaluation.</p><p><strong>Conclusion: </strong>Frailty, as measured by the mFI-5, independently predicts postoperative morbidity and mortality after DFU surgery. Incorporating preoperative frailty screening may improve surgical decision making, resource allocation, and enhance outcomes in this high-risk population.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"21621918261421637"},"PeriodicalIF":5.6,"publicationDate":"2026-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146140656","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}