The international journal of lower extremity wounds最新文献

{"title":"Therapy with Vancomycin-Loaded Polymethylmethacrylate Cement Demonstrates Limited Advantage in the Treatment of Infected Diabetes-Related Foot Ulcers: Only Patients with Osteomyelitis Benefited.","authors":"Xin Guo, Jun He, Xiaorui Jiang, Feng Liu, Bo Lei, Hao Pan, Kai Xiao, Ruokun Huang","doi":"10.1177/15347346251383638","DOIUrl":"https://doi.org/10.1177/15347346251383638","url":null,"abstract":"<p><p>BackgroundThe use of vancomycin-loaded polymethylmethacrylate cement (vPMMA) has been widely implemented in the treatment of infected diabetes-related foot ulcers (IDFUs). However, its clinical efficacy remains controversial due to limited sample sizes and significant biases in existing studies.MethodsA total of 66 patients diagnosed with IDFUs were retrospectively analyzed and assigned to four groups based on the sensitivity of the isolated pathogens to vancomycin and whether vPMMA was administered. Each group was further stratified into two subgroups according to the presence of osteomyelitis or simple soft tissue infection (STI). Clinical outcomes, including wound healing duration, number of debridement procedures, and pathogen-positive duration, were collected to evaluate the therapeutic effect of vPMMA.ResultsAfter verifying statistical comparability using the WIfI (Wound, Ischemia, and foot Infection) classification system, the statistically significant improvement in wound healing duration was observed in the subgroup A + (with osteomyelitis caused by vancomycin-sensitive pathogens, treated with vPMMA) (69.0 ± 29.6 days, P < 0.05). While, no significant differences were observed among the four groups (A, B, C, D) with respect to wound healing duration (71.5 ± 25.2, 93.5 ± 26.5, 91.0 ± 41.9, 97.1 ± 43.2 days, P > 0.05), debridement numbers (P > 0.05), or pathogen-positive duration (P > 0.05).ConclusionsContrary to previous reports, our findings do not support the use of vPMMA as a universally effective treatment for IDFUs. The therapy demonstrated superior efficacy compared to simple debridement only in cases where osteomyelitis was present and complete surgical clearance of the lesion was not feasible.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346251383638"},"PeriodicalIF":1.5,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heel Diabetic Foot Osteomyelitis: A Current Challenge in the Clinical Practice.","authors":"Martina Salvi, Federico Rolando Bonanni, Luigi Uccioli, Ermanno Bellizzi, Valeria Ruotolo, Aikaterini Andreadi, Alfonso Bellia, Davide Lauro, Marco Meloni","doi":"10.1177/15347346251376115","DOIUrl":"https://doi.org/10.1177/15347346251376115","url":null,"abstract":"<p><p>The current study aimed to evaluate the outcomes of heel diabetic foot osteomyelitis (DFO) managed in a specialized diabetic foot service. The research is a single-center retrospective observational study including a population of patients with diabetic foot ulcers (DFUs) complicated by DFO and requiring hospitalization, managed between 2019 and 2022 in a tertiary level diabetic foot service. According to the location of bone infection, patients were divided into two groups: those with heel DFO and those with forefoot/midfoot DFO. After one year of follow-up, the following outcomes were evaluated and compared between groups: healing, healing time, major amputation, and mortality.Overall, 114 patients were included. The mean age was 67.9 ± 12, most of them were male (72.8%) and had type 2 diabetes (91.2%); 84 (73.7%) of patients reported forefoot/midfoot DFO, while 30 (26.3%) reported heel DFO. Patients with heel DFO showed greater rates of soft tissue infection (80 vs 68.7%, p = 0.04), ulcer size >5 cm (93.3 vs 34.3%, p = <0.0001), gangrene (63.3 vs 22.9%, p = <0.0001), higher C-reactive protein values (67.6 ± 25 vs 24 ± 16 mg/dl, p = 0.0002) and concomitant peripheral arterial disease (PAD) (83.3 vs 52.4%, p = 0.0002).Outcomes for heel DFO and forefoot/midfoot DFO were: wound healing (66.7 vs 97%, p = <0.0001), healing time (14 ± 6 vs 6.8 ± 5 weeks, p=<0.0001), major amputation (10 vs 0%, p = 0.0002), and mortality (6.6 vs 4.8%, p = 0.3) respectively. At the multivariate logistic regression analysis, heel DFO [OR 8.4, CI95% (2.1-14.8), p=<0.0001] and PAD [OR 3.5, CI95% (1.1-4.2), p = 0.001] were independent predictors of major amputation, while heel DFO [OR 6.8, CI95% (1.9-10.5), p=<0.0001], PAD [OR 4.8, CI95% (1.4-7.6), p = 0.0001], and ulcer size [OR 1.5, CI95% (1.2-2.6), p=<0.0001] were independent predictors of non-healing.Heel DFO resulted associated with a higher risk of major amputation and reduced chance of healing.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346251376115"},"PeriodicalIF":1.5,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pyoderma Gangrenosum Treated with Intravenous Immunoglobulin and Negative Pressure Wound Therapy: Clinical Insights from Adults to Pediatrics.","authors":"Bo-Ye Qi, Chao Lian, Xuan-Fen Zhang","doi":"10.1177/15347346251378890","DOIUrl":"https://doi.org/10.1177/15347346251378890","url":null,"abstract":"","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346251378890"},"PeriodicalIF":1.5,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetic Foot Screening: A Systematic Review of Global Guidelines and Questionnaire-Based Tools.","authors":"Glenys Shu Wei Quak, Jaime Hui Xian Lin, Huiling Liew, Elaine Tan, Donna Tan, Loo See Yeo, Jo Ann Lim, Tiffany Chew, Yuan Teng Cho, Shaun Wen Yang Chan, Sadhana Chandrasekar, Zhiwen Joseph Lo","doi":"10.1177/15347346251381091","DOIUrl":"https://doi.org/10.1177/15347346251381091","url":null,"abstract":"<p><p>Diabetic foot ulcers are a significant complication of diabetes mellitus, contributing to high morbidity, prolonged hospitalisations, and increased healthcare costs. Early detection through diabetic foot screening (DFS) and preventive management strategies are therefore crucial in reducing the incidence of diabetic foot ulcers and improving patient outcomes. Hence, this study aims to review and summarise the current practices in DFS and risk stratification to aid subsequent clinical management. A systematic search of PubMed and Embase was conducted to identify articles relevant to DFS guidelines and questionnaire-based screening tools. Of 1761 studies screened, 15 met the inclusion criteria. While national and international guidelines provide comprehensive protocols for DFS with similarities in screening components, differences exist in risk stratification approaches, frequency of assessments, and integration of questionnaire-based tools such as Q-DFD, Thai Q-DFD, DFSQ-UMA and MNSI. Analysis of DFS guidelines identified three key components: neuropathy assessment, vascular assessment, and visual inspection. The screening methods include monofilament testing, vibration perception, and pedal pulse palpation with additional tools such as ankle-brachial index being used in some of the guidelines. These can be performed by various healthcare providers, including general practitioners, diabetes nurses, and podiatrists, ensuring accessibility across different healthcare settings. Risk stratification models classify patients into low-, moderate-, or high-risk categories, guiding screening frequency which varies from annual to quarterly assessments depending on risk level. Effective DFS, based on standardised guidelines and risk stratification models, is essential for preventing diabetic foot ulcers. The integration of DFS into routine clinical practice, supported by tools such as validated questionnaires, can significantly improve outcomes for diabetic patients.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346251381091"},"PeriodicalIF":1.5,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Artificial Dermal Scaffolds Compounded with Recombinant Human Epidermal Growth Factor on Wound Repair in Rats: A Comparative Study.","authors":"Teng Li, Chunbing Zhao, Ke Li, Hongtao Yu, Lei Chen","doi":"10.1177/15347346251379705","DOIUrl":"https://doi.org/10.1177/15347346251379705","url":null,"abstract":"<p><p>BackgroundWound complications are a significant concern globally. Artificial dermal (AD) scaffolds, a novel material used in wound repair, hold promise for enhancing wound repair. However, it is limited by challenges such as prolonged vascularization time. This study aimed to investigate the effects of AD scaffold composites with recombinant human epidermal growth factor (Rh-EGF) on wound repair in rats<b>.</b>MethodsRh-EGF absorption and release from the artificial dermis were evaluated using an enzyme-linked immunosorbent assay. Cell proliferation was assessed using the Cell Counting Kit-8 (CCK-8) assay. Cell adhesion was examined via electron microscopy and confocal microscopy. Rats were divided into four groups: (1) AD/Rh-EGF composite scaffolds, (2) AD scaffolds alone, (3) Rh-EGF alone, and (4) untreated control. Wound healing was assessed over 21 days via histological analysis and wound closure rates.ResultsAbsorption and release experiments confirmed that the artificial dermis can retain and release Rh-EGF. In cell co-culture experiments, the Rh-EGF-combined AD scaffolds enhanced L929 cell proliferation and adhesion. The Rh-EGF composite artificial dermis promoted wound healing <i>in vivo</i>. Histological and immunohistochemical analyses revealed that the Rh-EGF composite artificial dermis stimulated epithelial tissue regeneration, collagen production, cell proliferation, and angiogenesis while showing a potential trend toward reduced scar formation based on molecular markers.ConclusionThe AD/Rh-EGF composite scaffold accelerates wound repair while minimizing scar formation, providing a theoretical basis for its potential clinical applications.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346251379705"},"PeriodicalIF":1.5,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research Trends on Diabetic Foot in Latin America: A Bibliometric Analysis (2000-2025).","authors":"Ariana Marie Martin, Alfredo Verastegui, Oscar A De la Torre, Cristo G Sanchez, Mario Alejandro Fabiani, Mauricio Gonzalez-Urquijo","doi":"10.1177/15347346251380036","DOIUrl":"https://doi.org/10.1177/15347346251380036","url":null,"abstract":"<p><p>AimsDiabetes-related foot disease (DFD) is a prevalent and costly complication of diabetes in Latin America (LATAM). Our bibliometric study aims to identify emerging research output from LATAM countries, knowledge gaps, and future opportunities in research.MethodsA bibliometric analysis between 2000 and 2025 was done using PubMed and Scopus databases. English-language articles with corresponding authors affiliated with LATAM institutions were included. A total of 1423 records were screened, with 435 meeting inclusion criteria. Data on authorship, country, study type, citations, journal impact, and collaboration type were extracted and analyzed.ResultsOverall, Brazil contributed to 51.5% publications, followed by Mexico (18.6%) and Cuba (7.8%). Citation analysis revealed a total of 9397 citations, with a median of seven citations per publication. Venezuela and Barbados had the highest median citations per article, despite low output. Collaboration analyses showed that only 1.6% involved intra-LATAM collaborations. International collaborations outside the region were associated with higher median citations. Observational studies (n = 198) were most prevalent, with experimental, trial, and review studies showing significant growth over time.ConclusionDespite the recent growth of DFD research in Latin America, structural barriers such as research equity, international visibility, and regional collaboration persist. Addressing these by strengthening intra-regional collaboration, improving funding equity, and investing in research infrastructure may enhance scientific visibility and improve healthcare outcomes for DFD in the region.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346251380036"},"PeriodicalIF":1.5,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Efficacy of Different Epidermal Dressings in Patients with Second Degree Burns: A Systematic Review and Bayesian Network Meta-Analysis.","authors":"Liang Ge, Jinlong Xu, Weijing Sun, Shijie Li, Yongxing Wang, Lixia Di, Yan Ou, Dezhi Han","doi":"10.1177/15347346251374829","DOIUrl":"https://doi.org/10.1177/15347346251374829","url":null,"abstract":"<p><p>BackgroundA variety of dressings are used for burn patients in the clinic, and the difference in efficacy between different dressings is controversial Therefore, we used Bayesian net meta-analysis to evaluate the clinical efficacy of 14 dressings in patients with second-degree burns.MethodsPubMed, Cochrane Library, Web of Science, Embase, and China Knowledge Network databases were searched to collect randomised controlled trials on different dressings used in the treatment of second-degree burns that met the inclusion criteria from 2010-01 to 2024-12 in each database. Literature was screened by 2 investigators, who independently collected and organised the data for extraction, assessed the quality of the included studies using the Cochrane Risk of Bias tool and Review Manager 5.4, and scored the evidence using GRADEPro. Network meta-analysis (NMA) was performed using R Studio, and SUCRA was used to rank the included dressings for each outcome indicator.ResultsA total of 28 studies containing 2072 patients with second-degree burns and 14 different interventions were included, and the results of the network meta-analysis showed that:1) the top 3 results of the ranked probability of wound healing rate within 2 weeks were: human amniotic membrane (85.3%)>Recombinant human granulocyte macrophage colony stimulating factor(81.7%)>Recombinant Human Erythropoietin(78.1%); ②The top three results in terms of wound healing time were: Recombinant Human Erythropoietin(1.6%)ConclusionBased on the SUCRA values and NMA results, we found that Human amniotic membrane can significantly increase the wound healing rate of patients with second-degree burns, Recombinant Human Erythropoietin can significantly shorten the wound healing time, and Heparin has a better effect on reducing the pain of burn patients.However, limited by the quality of the included literature, further high-quality clinical studies are needed to confirm this.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346251374829"},"PeriodicalIF":1.5,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Small Artery Disease as a Predictor of Wound Healing in Patients with Diabetic Foot After Revascularization.","authors":"Radka Jarosiková, Theodor Adla, Patrik Turza, Michal Dubsky, Veronika Wosková, Dominika Sojáková, Věra Lánská, Vladimira Fejfarová","doi":"10.1177/15347346251323938","DOIUrl":"10.1177/15347346251323938","url":null,"abstract":"<p><p>The aim of study was to confirm the hypothesis that advanced medial arterial calcification (MAC)/ small artery disease (SAD), much like the progression of peripheral arterial disease (PAD) stages can adversely impact the outcomes in DFU patients, even after successful endovascular procedures. In retrospective study, we enrolled 54 patients with DFUs who underwent percutaneous transluminal angioplasty (PTA). MAC was quantified using a three-level scoring system based on radiographs. Patients were categorized based on their MAC score into three groups. Study groups were compared in terms of primary DFU outcomes (healing, amputations) and secondary DFU outcomes (mortality, changes in transcutaneous oxygen pressure (TcPO2)) three and six months after PTA. The MAC/SAD score increased significantly with age (<i>p </i>= 0.014). The MAC/SAD score was't associated with the risk of amputation or the healing of DFUs up to three months after revascularization. However, a significant association was observed after six months (<i>p </i>= 0.043). The MAC/SAD score correlated significantly with severity of PAD, as classified by the Global Limb Anatomic Staging System (<i>p </i>= 0.042) and the Graziani system (<i>p </i>= 0.019). We found a negative correlation between the MAC/SAD score and absolute levels of TcPO2 after PTA. MAC/SAD score was significantly associated with long-term unhealed DFUs and the risk of lower limb amputations.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"621-629"},"PeriodicalIF":1.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Randomized Clinical Trial Study on the Prevention Strategy and Early Detection of Ulcer Recurrence in Patients with Type 2 Diabetes Mellitus Using the Risk of Recurrence Ulcer Tool.","authors":"Haryanto Haryanto, Yunita Sari, Elveria Panjaitan, Juminar Juminar, David Armstrong","doi":"10.1177/15347346241283160","DOIUrl":"10.1177/15347346241283160","url":null,"abstract":"<p><p>This study aimed to evaluate the effectiveness of prevention strategies and detect the risk level of recurrence. A randomized controlled trial (RCT) was conducted. Sixty participants were split into two groups: an intervention group consisting of 30 individuals and a control group also with 30 participants. For the intervention group, education and guidance on foot examination, foot care, dietary habits, exercise, and stress management were provided for 1 to 1.5 h each month. However, the control group only received standard care and education through a pamphlet at baseline. The both groups, the baseline risk level of ulcer recurrence score was assessed using INDIFURUTO (Indonesian Diabetic Foot Ulcer Recurrence Assessment Tool). The follow-up period was three months. A General Linear Model (GLM) repeated measures (ANCOVA) analysis was employed to compare the quality of life and risk level between the two groups at baseline and third follow-up. Risk factors for recurrence score in the intervention group significantly decreased after 3 months. These included improvements in mobility (<i>P</i> = .04), anxiety/depression (<i>P</i> < .001), EuroQol Visual Analogue Scale score (<i>P</i> = .004), and INDIFURUTO score (<i>P</i> = .004). The combination of preventive strategies could reduce the risk of recurrence ulcer and improve the quality of life.Trial registration numberClinicalTrials.gov Identifies: NCT06434922.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"655-663"},"PeriodicalIF":1.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Simple Guide to Randomized Controlled Trials.","authors":"Aris Liakos, Eirini Pagkalidou, Thomas Karagiannis, Konstantinos Malandris, Ioannis Avgerinos, Eleni Gigi, Eleni Bekiari, Anna-Bettina Haidich, Apostolos Tsapas","doi":"10.1177/15347346241236385","DOIUrl":"10.1177/15347346241236385","url":null,"abstract":"<p><p>Randomized controlled trials represent the cornerstone for the regulatory approval of drugs and evidence-based medicine and policy. Compared with observational studies random assignment of participants to each study arm guarantees an equal distribution of potential confounders thus achieving impartiality in the evaluation of between group differences and allowing for causal inferences to be drawn. These complex and costly medical experiments are tightly regulated and require substantial planning with great attention to several methodological aspects ranging from allocation concealment and blinding to sample size estimation, statistical analysis, and handling of protocol deviations. This brief guide offers useful insights into the design, conduct, and interpretation of clinical trial findings for beginners.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"518-524"},"PeriodicalIF":1.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139992196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}