Advances in wound care最新文献

{"title":"Comparative Effectiveness of Amniotic and Chorionic Grafts in the Treatment of Lower-Extremity Diabetic Ulcers Using U.S. Medicare Real-World Evidence (2018-2022): A Retrospective Observational Cohort.","authors":"William V Padula, Swetha Ramanathan, Benjamin G Cohen, Francine Chingcuanco, Paul Steel, Kurt R Herzer","doi":"10.1089/wound.2024.0141","DOIUrl":"10.1089/wound.2024.0141","url":null,"abstract":"<p><strong>Objective: </strong>Lower-extremity diabetic ulcers (LEDUs) affect more than 500,000 U.S. Medicare beneficiaries each year. Dehydrated human amnionic and chorionic allografts (DHACAs) are clinically effective complements to standard of care (SoC; <i>e.g.,</i> surgical debridement, offloading, infection, and moisture control) when treating LEDUs. However, Medicare and commercial payer coverage have restricted access to DHACAs. Our objective was to compare the effectiveness of DHACAs versus SoC among Medicare beneficiaries with LEDUs for reduction of adverse outcomes such as mortality, recurrency, and major amputation.</p><p><strong>Approach: </strong>We analyzed a retrospective cohort of U.S. Medicare claims for LEDUs between 2018 and 2022. LEDU claims were collapsed into episodes of care (EOC). Frequency distribution of characteristics was compared using univariate and bivariate statistics. Zero-inflated binomial regression with 1:1 nearest-neighbor propensity score matching evaluated six main outcome measures: mortality; wound recurrence; major amputation; minor amputation; emergency department (ED) utilization; and readmission.</p><p><strong>Results: </strong>There were 25,760 Medicare EOCs between 2018 and 2022 representing 12,880 matched samples in the DHACA and SoC cohorts. DHACAs were associated with a 20% reduction in 30-day mortality (95% confidence interval [CI]:10%, 29%), 28% reduction in risk of major amputation (95% CI: 19%, 36%), 9% reduction in ED utilization (95% CI: 3%,14%), and 8% reduction in 30-day readmission (95% CI: 2%, 13%). DHACAs were noninferior for minor amputation rates and wound recurrence compared to SoC cohort.</p><p><strong>Conclusion: </strong>Beneficiaries with LEDUs benefit significantly from DHACAs on multiple outcomes, including a lower risk of mortality. Providers should examine the appropriateness of DHACAs for patients with LEDU as part of wound management. Medicare and commercial payers should consider improved outcomes when defining coverage policies that restrict access to DHACAs given the observed benefits.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"41-49"},"PeriodicalIF":5.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998612","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":"Chondrocyte Mitochondrial Quality Control: A Novel Insight into Osteoarthritis and Cartilage Regeneration.","authors":"Jinni Wu, Jiawen Xu, Menghan Zhang, Jiahui Zhong, Weijin Gao, Mengjie Wu","doi":"10.1089/wound.2024.0270","DOIUrl":"10.1089/wound.2024.0270","url":null,"abstract":"<p><strong>Significance: </strong>Osteoarthritis (OA), one of the most prevalent joint diseases affecting more than 240 million people, strongly influences human health and reduces life quality. This review aims to fill the current research gap regarding the application and potential of mitochondrial quality control (MQC) based therapies in the treatment of OA, thereby providing guidance for future research and clinical practice.</p><p><strong>Recent advances: </strong>Chondrocytes respond to the inflammatory microenvironment <i>via</i> an array of signaling pathways and thus are critical in cartilage degeneration and OA progression. Mitochondria, as an important metabolic center in chondrocytes, play a vital role in responding to inflammatory stimuli. Multiple MQC mechanisms, including mitochondrial antioxidant defense, mitochondrial protein quality control, mitochondrial DNA repair, mitochondrial dynamics, mitophagy, and mitochondrial biogenesis, sustain mitochondrial homeostasis under pathological conditions.</p><p><strong>Critical issues: </strong>Despite extensive OA research, effective therapies remain limited. Elucidating MQC mechanisms in disease progression and post-traumatic cartilage repair is crucial. While preclinical studies demonstrate potential, clinical translation requires addressing protocol standardization, patient stratification, and long-term efficacy, as well as safety validation.</p><p><strong>Future directions: </strong>Future research should focus on developing personalized MQC-based OA therapies guided by biomarker profiling and signaling pathway modulation. However, translational challenges persist, particularly regarding pervasive off-target effects, inadequate OA-specific targeting capacity, interpatient heterogeneity, and reliable evaluation of long-term therapeutic efficacy. Strategic prioritization of OA-specific MQC targets coupled with delivery system optimization may significantly improve both clinical translatability and therapeutic outcomes.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"50-70"},"PeriodicalIF":5.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958141","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":"Dual-Action Topical Therapy Accelerates Healing of MRSA-Infected Burn Wounds by Targeting Infection and Inflammation.","authors":"Miaoqing Xiang, Zongze Yao, Wei Shao, Mengru Chen, Wenjian Tang, Dandan Liu, Jing Zhang","doi":"10.1177/21621918251405876","DOIUrl":"10.1177/21621918251405876","url":null,"abstract":"<p><strong>Objective: </strong>Burn injuries affect over 11 million people annually, and methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) infection significantly delays healing by sustaining inflammation and promoting scarring. This study evaluated <i>N</i>-benzyl benzenamine 4k-a novel dual-action compound with antibacterial and anti-inflammatory properties-in a murine model of MRSA-infected burn wounds.</p><p><strong>Approach: </strong>Skin safety of 4k was assessed through acute toxicity, sensitization, and irritation tests in BALB/c mice. A full-thickness burn model infected with MRSA2858 (1 × 10⁸ CFU/mL) was treated topically with 4k, vancomycin (VAN), or vaseline. Outcomes included wound closure, bacterial load, histology, collagen organization, macrophage polarization markers (CD86/inducible nitric oxide synthase [iNOS] for M1; CD206/vascular endothelial growth factor [VEGF] for M2), cytokine levels, and nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) pathway proteins.</p><p><strong>Results: </strong>4k demonstrated excellent dermal tolerability with no toxicity or irritation. Topical 4k reduced MRSA colonization and accelerated wound closure (residual wound area at day 15: 4k = 8.4 ± 2.2%, VAN = 17.8 ± 3.5%). Histology revealed organized collagen deposition and minimal scarring in the 4k group (scar score: 2.33 ± 0.58 vs. 13.33 ± 0.58 for vaseline). Mechanistically, 4k suppressed NF-κB activation, downregulated M1 markers (CD86, iNOS, tumor necrosis factor-alpha, and interleukin [IL]-6), and upregulated M2 markers (CD206, VEGF, transforming growth factor-beta 1, and IL-10), promoting a prohealing immune environment.</p><p><strong>Innovation: </strong>This study introduces a dual-action topical therapy that combines potent antibacterial activity with immunomodulation, offering a promising strategy to overcome antibiotic resistance and improve burn wound outcomes.</p><p><strong>Conclusions: </strong><i>N</i>-benzyl benzenamine 4k effectively eradicates MRSA, accelerates wound healing, and minimizes scarring through NF-κB inhibition and macrophage polarization, supporting its potential as a next-generation burn care agent.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"21621918251405876"},"PeriodicalIF":5.7,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145832162","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":"Efficacy of a Novel Daily-Use Hydrocolloid Pad on Wound Healing: Findings of a 16-Day, Single-Center, Randomized, Controlled Study.","authors":"Jenny Du-Soriano, Diana Friscia, Robert S Kirsner","doi":"10.1177/21621918251405806","DOIUrl":"10.1177/21621918251405806","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate wound healing with a novel bandage with hydrocolloid pad designed for daily use/replacement in a new model of laser-induced burns/wounds.</p><p><strong>Approach: </strong>In this randomized, controlled, single-center, 16-day study, healthy adults aged 25-55 years of age with Fitzpatrick skin type I-III and who met all eligibility criteria (<i>N</i> = 34) had four laser-induced wounds generated on each arm and were randomized as follows: (1) uncovered wound (control); (2) standard of care bandage (SoC); (3) petrolatum-based antibiotic ointment + SoC (petrolatum + SoC); (4) bandage with hydrocolloid pad.</p><p><strong>Primary endpoint: </strong>composite healing score (sum of scores for general wound appearance, smoothness, and epithelial confluence, minus scores for erythema, edema, and crusting/scabbing) on Days 1-7.</p><p><strong>Results: </strong>Mean composite healing score was significantly better with the hydrocolloid pad (Days 1-7) and petrolatum + SoC (Days 2-7) than SoC, and with either treatment than untreated controls (Days 1-7), and significantly better with the hydrocolloid pad than petrolatum + SoC (Days 1 to 2 and 7). The hydrocolloid pad and petrolatum + SoC both significantly reduced crusting/scabbing while improving epithelial confluence, smoothness, and general wound appearance, compared with untreated controls and SoC.</p><p><strong>Innovation: </strong>A laser-induced burn model producing consistent wounds was used to evaluate healing with a novel bandage with hydrocolloid pad versus other typical treatments.</p><p><strong>Conclusion: </strong>Wound healing with the novel bandage with hydrocolloid pad used daily was superior to SoC (Days 1-7), untreated wound (Days 1-7), and petrolatum + SoC (Days 1 to 2 and 7). [Figure: see text].</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"21621918251405806"},"PeriodicalIF":5.6,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145848764","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 Role of Hydrogel Biomaterials in the Intervention of Wound Healing and Skin Regeneration via Exosomes: A Systematic Review and Meta-Analysis of Preclinical Animal Studies.","authors":"Yujia Yang, Jinlei Cui, Yajie Kong, Yu Hou, Haixia Zhang, Cuiqing Ma","doi":"10.1089/wound.2024.0058","DOIUrl":"10.1089/wound.2024.0058","url":null,"abstract":"<p><p><b>Significance:</b> The combination of hydrogel biomaterials with exosomes to facilitate wound healing and skin regeneration is a promising approach. <b>Recent Advances:</b> Recent preclinical animal studies have focused on investigating the efficacy of hydrogel-based delivery systems for exosomes in promoting wound healing and skin regeneration. <b>Critical Issues:</b> Despite encouraging results, critical issues remain unresolved, such as optimizing hydrogel properties to enhance the efficacy of combined therapy with exosomes for wound and bridging the translational gap between preclinical and clinical applications. <b>Future Directions:</b> Future research endeavors should concentrate on refining hydrogel design to enhance exosome delivery efficacy, conducting rigorous clinical trials to assess the safety and efficacy of exosome-loaded hydrogels in human wound healing and skin regeneration, and exploring innovative strategies to maximize therapeutic outcomes.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"669-684"},"PeriodicalIF":5.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141316460","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":"Comparison of \"Semiocclusive Dressing\" Treatment Using Plastic Wrap or Low-Adherent Absorbent Wound Dressings Versus Occlusive Dressing Treatment for Stage III/IV Pressure Injuries in the Inflammatory Phase: A Randomized Controlled Trial.","authors":"Jun Takahashi, Kayoko Nakae, Osamu Yokota, Rena Nakata, Hayato Hasegawa, Masaharu Miyagawa","doi":"10.1089/wound.2024.0041","DOIUrl":"10.1089/wound.2024.0041","url":null,"abstract":"<p><p><b>Objective:</b> To compare the effectiveness of \"semiocclusive dressing (SOD)\" treatment using plastic wrap or low-adherent absorbent wound dressings with that of occlusive dressing (OD) treatment for National Pressure Injury Advisory Panel stage III/IV pressure injuries in the inflammatory phase. <b>Approach:</b> This 12-week, open-label, randomized controlled trial was conducted at one hospital and three care facilities. Seventy-seven participants were enrolled; 40 comprised the SOD group and 37 comprised the OD group. The primary outcome was the surface area reduction. Secondary outcomes included the Bates-Jensen Wound Assessment Tool (BWAT) score reductions, incidence of adverse events, and material cost. This trial met the recommendations of the CONSORT 2010 statement. <b>Results:</b> The surface area reduction of the SOD group was greater than that of the OD group throughout the study period. The significant interaction was revealed between treatment and time course (<i>p</i> < 0.0001). The 95% confidence interval of the difference at 12 weeks was 3.4 to 21.9. The median BWAT score reduction of the SOD group at 12 weeks was 23, and that of the OD group was 18.5 (<i>p</i> = 0.0077). The incidence of adverse events was comparable between groups. The OD treatment cost was 3.0 times higher than the SOD treatment cost (<i>p</i> = 0.0012). <b>Innovation:</b> Because the SOD does not completely occlude the wound, excess exudate drains from the wound. Therefore, SOD can treat the wound with abundant exudate effectively and safely. <b>Conclusion:</b> SOD treatment is more effective and less expensive than OD treatment for stage III/IV pressure injuries. <b>Clinical Trial Registration:</b> UMIN Clinical Trials Registry [UMIN000023412]. Registered on July 31, 2016.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"635-644"},"PeriodicalIF":5.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141316459","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":"A Prospective Observational Study to Evaluate the Effectiveness of Platelet-Rich Plasma Therapy for Complex Wounds: Influential Clinical Variables on Wound Healing Outcomes.","authors":"Verónica Salgado-Pacheco, Ramon Oller, Marta Ferrer-Solà, Clara Masó-Albareda, Marta Casals-Zorita, Elisabet Sarri, Emma Puigoriol-Juvanteny, Joan Espaulella-Panicot, Marta Otero-Viñas","doi":"10.1089/wound.2024.0102","DOIUrl":"10.1089/wound.2024.0102","url":null,"abstract":"<p><p><b>Objective:</b> Autologous platelet-rich plasma (PRP) has shown promising outcomes in treating wounds, but the profile of patients benefiting most from this therapy is not known. This study aimed to identify influential variables in the success of this therapy, analyzing its personalized therapeutic potential for complex wounds. <b>Approach:</b> A prospective observational study was conducted in elderly patients with complex wounds receiving autologous PRP. Patient's data about sociodemographic parameters, comorbidities, frailty (FI-VIG score), complete blood count including albumin, wound depth, location, chronicity, and etiology were collected at the beginning of the study. The wound area was monitored weekly. The data were analyzed using descriptive and inferential statistics, longitudinal data analysis, and survival analysis. <b>Results:</b> Ninety-seven elderly patients were included. The FI-VIG, baseline wound area, depth, and etiology were significantly correlated with wound outcome. Strong differences in wound area variation from treatment initiation were observed in healed wounds (13% reduction/week) compared with stagnant and complicated wounds (1 and 2% reduction/week, respectively). The healing time analysis showed that nearly 80% of patients required at least 15 weeks for complete healing. In addition, patients with smaller wound sizes, younger age, or lower FI-VIG scores had shorter healing times. <b>Innovation:</b> This is the first study that identifies prognostic indicators for wound outcomes to guide clinician decision-making for using autologous PRP. It also highlights the relevance of patient health baseline and wound features and evolution for the success of this therapy. <b>Conclusion:</b> This study demonstrates that personalizing autologous PRP therapy to treat complex wounds in elderly patients is possible.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"655-668"},"PeriodicalIF":5.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589742","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 of Healing Trajectory of Chronic Wounds Using a Machine Learning Approach.","authors":"Anissa C Dallmann, Mary Sheridan, Soeren Mattke, William Ennis","doi":"10.1089/wound.2024.0095","DOIUrl":"10.1089/wound.2024.0095","url":null,"abstract":"<p><p><b>Objective:</b> New treatment options are emerging for chronic wounds, which represent a growing problem because of population ageing and increasing burden of chronic disease. While promising, the existing evidence for advanced modalities is commonly derived from small and/or poorly controlled studies and clear criteria for selecting patients, who are likely to benefit from these expensive options are lacking. In this study, we develop and validate a machine learning model to predict if a chronic wound, independent of etiology, is expected to heal within 12 weeks to identify cases in potential need of advanced treatment options. <b>Approach:</b> Retrospective analysis of electronic health record data from 2014 to 2018 covering 532 wound care clinics in the United States and 261,398 patients with 620,356 unique wounds. Prediction of 12-week healing trajectories with a machine learning model. <b>Results:</b> The best-performing model in a training dataset of a randomly drawn 75% subset of wounds contained variables for patient demographics, comorbidities, wound characteristics at initial presentation, and changes in wound dimensions over time, with the latter group being the most influential predictors. The final machine learning model had a high predictive accuracy with area under the receiver operating characteristic curves of 0.9 and 0.92 after 4 and 5 weeks of treatment, respectively. <b>Innovation:</b> A machine learning model can identify chronic wounds at risk of not healing by week 12 with high accuracy in the early weeks of treatment. <b>Conclusions</b>: If embedded in real-world care, the generated information could be able to guide effective and efficient treatment decisions.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"645-654"},"PeriodicalIF":5.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589765","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":"Nurse Staffing and Patient Outcomes: A Call to Action for Chronic Wound Care Policy Reform.","authors":"Eleanor Turi, Karen B Lasater, K Jane Muir","doi":"10.1177/21621918251400770","DOIUrl":"10.1177/21621918251400770","url":null,"abstract":"<p><p><b>Objective:</b> Patients with complex chronic wounds are at high risk for poor outcomes. This study assessed the relationship between nurse staffing and outcomes among patients with complex and noncomplex chronic wounds. [Figure: see text] <b>Approach:</b> This cross-sectional study linked three 2021 datasets: RN4CAST survey, Medicare Provider Analysis and Review claims, and American Hospital Association data. Nurse staffing was derived from the RN4CAST item asking nurses whether \"there are enough nurses to get the work done.\" We calculated the hospital-level percentage of nurses who reported staffing inadequacy. Multilevel statistical modeling measured the association between staffing and in-hospital mortality and length of stay, adjusted for patient and hospital covariates and stratified among patients with complex and noncomplex chronic wounds. We followed STROBE criteria. <b>Results:</b> The sample included 19,027 patients with chronic wounds (66.7% complex) in 216 hospitals. Every 10% increase in nurses reporting staffing inadequacy was associated with 6% higher odds of in-hospital mortality among patients with complex wounds, with no significant relationship among patients with noncomplex wounds. Every 10% increase in staffing inadequacy was associated with longer lengths of stay, by a factor of 1.04, for patients with both complex and noncomplex wounds. <b>Innovation:</b> By linking nurse-reported staffing to outcomes for patients with chronic wounds, this study identifies a policy-relevant pathway to improve outcomes, particularly for those with complex wounds. <b>Conclusion:</b> Nurse staffing adequacy is consequential for patients with chronic wounds as it relates to length of stay and is particularly important in preventing in-hospital mortality among the highest-risk patients-those with complex wounds.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13192300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145627457","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":"Improving Quality of Life in Patients with Malignant Wounds: Outcomes from a Specialized Wound Care Clinic.","authors":"Ian Nykaza, Anna Chen, Stephen Dusza, Jacqueline Bromberg, Cara Norelli, Shari Goldfarb, Rachel Sanford, Alina Markova","doi":"10.1177/21621918251393741","DOIUrl":"10.1177/21621918251393741","url":null,"abstract":"<p><p><b>Objective:</b> Evaluate quality of life (QoL) of patients with malignant wounds at baseline and through the course of management at a dedicated malignant wound care clinic. <b>Methods:</b> Retrospective review of patients with malignant wounds seen at a dedicated wound care clinic between January 2016 and April 2023 who completed the Skindex-16, a validated dermatologic QoL questionnaire. Clinical symptoms and management data were extracted from electronic medical records. <b>Results:</b> At baseline, patients reported high Skindex-16 scores across symptoms (mean = 64.2, standard deviation [SD] = 33.3), emotions (mean = 44.8, SD = 31.2), and functioning (mean = 67.7, SD = 29.7) domains. Overall Skindex-16 scores significantly improved over time, with a mean reduction of 4.9 points per visit (<i>p</i> = 0.002). Multimodal symptom management, including both topical and systemic treatments, and modern dressings were commonly utilized. <b>Clinical Implications:</b> Early referral to specialized wound care allows timely initiation of symptom-directed interventions to reduce pain, bleeding, odor, and infection risk. QoL improvements are often seen after the first follow-up visit, with the greatest benefit between the first and second visits. Access to structured wound care not only alleviates symptom burden but also supports continuation of oncologic treatment. <b>Innovation:</b> This study is the first to longitudinally assess malignant wound-related quality using a dermatology-specific instrument, the Skindex-16, in a real-world clinical setting. These findings highlight a model for integrating dermatologic wound care into supportive oncology and demonstrate that malignant wounds, often regarded as irreversible, can be meaningfully palliated with dedicated care. <b>Conclusion:</b> Dedicated wound care was associated with statistically significant improvements in QoL for patients with malignant wounds. Early referral to specialized wound clinics may enhance palliative care for these patients.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13529216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145480571","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}