The international journal of lower extremity wounds最新文献

{"title":"Authorship Disputes: An Endemic Plague.","authors":"Miltos K Lazarides, Nikolaos Papanas","doi":"10.1177/15347346251341635","DOIUrl":"https://doi.org/10.1177/15347346251341635","url":null,"abstract":"","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346251341635"},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082458","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":"Higher Serum Levels of Lipoprotein-Associated Phospholipase A2 are Associated with Diabetic Foot Osteomyelitis.","authors":"Haojie Sun, Shucai Zhang, Xuekui Liu, Houfa Geng, Jun Liang","doi":"10.1177/15347346251340757","DOIUrl":"https://doi.org/10.1177/15347346251340757","url":null,"abstract":"<p><p>BackgroundDiabetic foot osteomyelitis (DFO) is often difficult to detect in its early stages, making diagnosis challenging. This study is to investigate the relationship between lipoprotein-associated phospholipase A2 (Lp-PLA2) and DFO, while also evaluating the potential of Lp-PLA2 as an early diagnostic biomarker for DFO.MethodsA total of 265 patients with type 2 diabetes complicated by diabetic foot infections were selected for the study. Participants were divided into the Non-DFO group (184 cases) and the DFO group (81 cases). Serum Lp-PLA2 levels were measured. Logistic regression analysis was utilized to identify risk factors associated with DFO. Receiver Operating Characteristic curve analysis was performed to assess the diagnostic value of Lp-PLA2 in patients with DFO.ResultsLp-PLA2 in the DFO group were significantly higher than those in the Non-DFO group (<i>P</i> < .05). Lp-PLA2 (OR, 1.015 [95% CI, 1.011-1.019]; <i>P</i> < .001), lower extremity arterial disease (OR, 2.453 [95% CI, 1.147-5.247]; <i>P</i> < .05), and ESR (OR, 1.042 [95% CI, 1.026-1.059]; <i>P</i> < .001) were the independent risk factors for DFO. Lp-PLA2 and ESR were shown to be associated with DFO, with their respective areas under the curve (AUC) being 0.787 and 0.683. The sensitivity and specificity of Lp-PLA2 were 65.4% and 82.6%, respectively, while those of ESR were 48.1% and 95.1%. Combined Lp-PLA2 and ESR showed the best diagnostic performance (AUC 0.858, sensitivity 79.0%, specificity 84.2%).ConclusionAs a preliminary one, Lp-PLA2 demonstrates significant diagnostic value for DFO. The combination of Lp-PLA2 and ESR can significantly improve diagnostic accuracy of DFO.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346251340757"},"PeriodicalIF":0.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056352","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":"LncRNA SNHG14 Drives NLRP3 Inflammasome Activation in Diabetic Foot Ulcers: Mechanistic Insights and Diagnostic Implications.","authors":"Xincheng Liao, Zhengying Jiang, Zhonghua Fu, Mingzhuo Liu, Guanghua Guo","doi":"10.1177/15347346251339713","DOIUrl":"https://doi.org/10.1177/15347346251339713","url":null,"abstract":"<p><p>BackgroundDiabetic foot (DF), a severe complication of diabetes mellitus (DM), poses significant challenges in early diagnosis and mechanistic understanding. This study investigates the expression patterns and clinical relevance of long non-coding RNA SNHG14 (lncRNA SNHG14) and the NLRP3 inflammasome in DF pathogenesis.MethodsA total of 176 DM patients (88 DF cases vs 88 Non-DF controls) admitted between September 2022 and February 2024 were enrolled. Serum SNHG14 and NLRP3 levels were quantified via qRT-PCR, while DF severity was categorized using the Wagner grading system. Pearson's correlation assessed SNHG14-NLRP3 interactions, Spearman's rank correlation evaluated their associations with Wagner grades, logistic regression identified independent risk factors, and ROC analysis determined diagnostic efficacy.ResultsDF patients exhibited significantly prolonged diabetes duration, elevated HbA1c%, FPG, and upregulated SNHG14/NLRP3 expression compared to Non-DF controls (P < 0.05). A robust positive correlation was observed between SNHG14 and NLRP3 (r = 0.7006, P < 0.0001). Multivariate logistic regression revealed diabetes duration (OR = 7.423, P < 0.0001), HbA1c (OR = 19.478, P = 0.002), SNHG14 overexpression (OR = 5941.653, P < 0.001), and NLRP3 upregulation (OR = 529.864, P = 0.036) as independent DF risk factors. Both SNHG14 (r = 0.5953) and NLRP3 (r = 0.5554) positively correlated with Wagner grades (P < 0.0001). ROC analysis demonstrated high diagnostic accuracy for SNHG14 (AUC = 0.8688) and NLRP3 (AUC = 0.8074), with combined detection further improving performance (AUC = 0.8773, sensitivity = 77.27%, specificity = 93.18%).ConclusionOverexpression of SNHG14 and NLRP3 is intricately linked to DF progression, metabolic dysregulation, and ulcer severity. Their combined use synergistically enhances diagnostic precision, highlighting transformative potential in DF management.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346251339713"},"PeriodicalIF":0.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056775","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":"Transcutaneous Application of Gaseous CO₂ Improves Diabetic Distal Symmetrical Polyneuropathy in Patients with and Without Chronic Wounds.","authors":"Igor Frangež, Nikolaos Papanas, Vesna Đermanović Dobrota, Helena Ban Frangež, Vesna Lukinović-Škudar","doi":"10.1177/15347346251338680","DOIUrl":"https://doi.org/10.1177/15347346251338680","url":null,"abstract":"<p><p>The study explores the effects of non-invasive transcutaneous CO₂ therapy on diabetic symmetrical peripheral polyneuropathy (DSPN). Overall, we included 120 patients with diabetes: 40 patients with DSPN (group A) and 40 patients with DSPN and diabetic foot ulceration (DFU) (group B), both receiving 20 sessions of CO₂ therapy; 40 DSPN patients not receiving treatment (group C). Outcomes were assessed using the Semmes-Weinstein monofilament test, 128 Hz tuning fork vibration sensation, hallux temperature, wound dimensions, and adverse effects. There was a significant improvement in protective sensation for the CO₂-treated groups. Group A exhibited a 53% improvement, while Group B improved by 34% (p = .002). In Groups A, B vibration sensation improvement was 30% and 23%, respectively. Hallux temperature increased more in Group A (5.10 °C) compared with Group B (3.89 °C). Improvement in monofilament sensation was observed in both CO₂ treated groups, regardless of ankle-brachial index (ABI), with best results in patients having borderline ABI (67.5% in Group A and 53.1% in Group B). In conclusion, CO₂ therapy effectively alleviated DSPN symptoms in patients with/without DFUs, with normal or insufficient circulation, and it was well-tolerated without adverse effects.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346251338680"},"PeriodicalIF":0.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032639","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":"The Efficacy of Ischemia Modified Albumin (IMA) as a Predictor for Postoperative Healing among People with Diabetic Foot Ulcer.","authors":"Udyama Juttada, Satyavani Kumpatla, Rabeka Manikandan, Vijay Viswanathan","doi":"10.1177/15347346251332708","DOIUrl":"https://doi.org/10.1177/15347346251332708","url":null,"abstract":"<p><p>The aim of the study is to determine the efficacy of ischemia-modified albumin (IMA) among diabetic foot ulcers (DFU) individuals as a predictor for wound healing based on IMA values at different stages of treatment. In this hospital based cross-sectional follow up study a total of 71 (41 males and 30 females) individuals were recruited and divided into three groups: Group-I- Control without T2DM (n = 20). Group-II -T2DM without any complication (n = 15), Group-III T2DM with DFU (n = 36) DFU group is further subdivided into two with and without peripheral artery disease as PAD and nonPAD. Demographic and Biochemical characteristics were recorded. Serum IMA levels were measured using Human IMA ELISA kit at 4 regular intervals during treatment of ulcer ie Pre and Post Debridement or angiogram/angioplasty, after HBOT therapy and after healing. Mean age of the study participant was 51.6 ± 12.8 years. The clinical parameters were not associated with age, lipid profile, urea, creatinine, eGFR whereas positive association was observed in glucose level, ESR, Total albumin, WBC, HbA1c among the study groups. Serum IMA levels at baseline in the DFU groups were significantly higher than in the T2DM and control groups (<i>P</i> < .001). Whereas IMA levels when compared at 4 regular intervals showed drastic decline in IMA levels at each interval (<i>P</i> = .0059). IMA levels remained constant after HBOT therapy. In conclusion IMA is a highly sensitive marker and has a high predictive value, which might prove the usefulness of this as a biomarker for early detection of wound healing.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346251332708"},"PeriodicalIF":0.0,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036446","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":"Bridging Knowledge Gaps: Enhancing Burn Wound Management Through Evidence-Based Educational Interventions in Outpatient Settings.","authors":"Abdul-Monim Batiha","doi":"10.1177/15347346251337852","DOIUrl":"https://doi.org/10.1177/15347346251337852","url":null,"abstract":"<p><p>BackgroundKnowledge deficits in burn wound management among healthcare providers often lead to inconsistent practices and adverse patient outcomes. This study assessed how well a brief, evidence-based educational module affected the confidence and knowledge of Jordanian healthcare professionals.MethodsA pre-post intervention was conducted with 22 healthcare providers across two hospitals in Jordan. Participants attended a 25-min educational session focusing on evidence-based burn care practices. Knowledge and confidence were assessed before and immediately after the session, with follow-up testing conducted 5 weeks later. Paired Student's t-tests were used in the statistical analysis to assess score changes.ResultsThe mean knowledge score significantly increased from 3.8 ± 1.2 at baseline to 6.4 ± 1.1 immediately post-intervention (p = 0.001), with sustained improvement at 5 weeks (mean score: 6.2 ± 1.0, p = 0.001). Confidence levels also showed significant gains, rising from 2.3 ± 0.7 to 3.6 ± 0.6 (p = 0.001) post-intervention. These findings demonstrate the effectiveness of targeted education in addressing critical knowledge gaps and improving provider confidence.ConclusionThe results strongly support the need for integrating structured, evidence-based training modules in burn wound management to standardize practices, improve outcomes, and foster sustained learning among healthcare providers.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346251337852"},"PeriodicalIF":0.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056696","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":"The Effect of Local Use of Insulin on Wound-Ulcer in Diabetic or Non-Diabetic Patients: A Scoping Review.","authors":"Anastasia Stergioti, Vassiliki Karra, Maria Chatzopoulou, Maria Kalafati","doi":"10.1177/15347346251338182","DOIUrl":"https://doi.org/10.1177/15347346251338182","url":null,"abstract":"<p><p>Insulin regulates numerous metabolic functions and plays a pivotal role in the regulation of cellular growth. This scoping review was conducted due to insufficient evidence regarding the effects of topical insulin administration on ulcer-wound healing in adults, both with and without Diabetes Mellitus (DM). The main objective of this review was to investigate whether the local application of insulin to ulcers-wounds could be used safely to promote faster healing of ulcers. We conducted a comprehensive search of PubMed, Cochrane, and EBSCO databases for primary studies, with no date restrictions. Clinical trials, both randomized and non-randomized, involving adults (> 19 years) with wounds-ulcers, regardless of DM status, were included. A total number of 173 articles were initially identified. Following the application of the PICOS criteria, 14 articles were included in the study. The analysis revealed that topical insulin, via injection or dressing, accelerates ulcer healing, indicating its role beyond blood glucose regulation. The majority of studies reported better wound size reduction and closure with insulin than alternative treatments, with local injection being most effective. In most cases, applying insulin to wounds did not cause adverse effects. The review concluded that insulin may be a valuable addition to standard ulcer care treatments.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346251338182"},"PeriodicalIF":0.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029171","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":"Impact of Podiatric Surveillance on Amputation Rates in Patients with Diabetes and Chronic Kidney Disease.","authors":"Stephanie Behme, Christopher Girgis, Brian M Schmidt","doi":"10.1177/15347346251337862","DOIUrl":"https://doi.org/10.1177/15347346251337862","url":null,"abstract":"<p><p>Development of the triad of peripheral arterial disease, peripheral neuropathy, and end stage renal disease puts people with diabetes at an increased risk of diabetic foot ulcerations and subsequent infections that often precede lower extremity amputations. In patients on hemodialysis, there is a ten-fold increased risk of amputation and an estimated 40%-82% one-year mortality rate if the amputation is a major amputation. This study aimed to examine if patients presenting to a podiatric clinic with stage 3a or 3b chronic kidney disease and a diabetic foot ulcer had decreased rates of amputations as compared to patients who presented after initiating dialysis. Our results demonstrated all major amputations occurred in patients who did not establish with podiatry prior to initiating HD. Additionally, our study revealed a potential access to care disparity for African American patients with chronic kidney disease, as African American patients were established with podiatry prior to initiating dialysis less often in comparison to Caucasian individuals. Our study lays the groundwork for future work investigating the impact of podiatric surveillance on patients with diabetes and end stage renal disease.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346251337862"},"PeriodicalIF":0.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029164","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":"Pilot Implementation of a Thermography-Driven Preventive Foot Care Protocol for Diabetes-Related Foot Ulcers in Community Health Centers: Non-Randomized Controlled Trial.","authors":"Makoto Oe, Haryanto Haryanto, Kanae Mukai, Mao Kunimitsu, Suriadi Jais","doi":"10.1177/15347346251337267","DOIUrl":"https://doi.org/10.1177/15347346251337267","url":null,"abstract":"<p><p>AimThe purpose of this study was to clarify the effectiveness and implementation issues of a thermography-driven preventive foot care protocol for diabetes-related foot ulcers in Indonesian community health centers.MethodsIn the two trial centers examined between May 2023 and May 2024, one provided protocol-based care (Intervention group; n = 71), while the other provided standard education (Control group; n = 71). Participants were monitored for ulceration over a 1-year period.ResultsThere was no significant difference in the number of participants with ulceration between the intervention and control group (6 vs 8 cases, p = 0.573). However, there was a shorter time to ulceration (203.8 ± 8.7 vs 350.0 ± 13.9 days, p = 0.048) in the intervention group. Over the 1-year follow-up, protocol compliance was 100% for examinations, but 0% for callus and nail care. Participants without risk factors, such as neuropathy or angiopathy, also developed ulcers.ConclusionsResults suggested this protocol was ineffective in the community health center. It will be necessary to clarify the risk factors for foot ulcers in the target population, establish an appropriate protocol, prepare an environment for its implementation, and then conduct a randomized controlled trial in the future.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346251337267"},"PeriodicalIF":0.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029167","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":"Histopathology is More Reliable Than Microbiology for Detecting Residual Osteomyelitis After Conservative Surgery for Diabetic Foot: The Pitfall of False-Positive Cultures and the Role of Pseudomonas aeruginosa.","authors":"Gerardo Víquez-Molina, José María Rojas-Bonilla, Javier Aragón-Sánchez","doi":"10.1177/15347346251338689","DOIUrl":"https://doi.org/10.1177/15347346251338689","url":null,"abstract":"<p><p>The optimal method for assessing residual osteomyelitis after conservative surgery for diabetic foot infection remains controversial. Microbiological cultures are frequently used due to their rapid turnaround and utility in guiding antibiotic therapy, but their diagnostic reliability is uncertain. This study compared microbiological cultures and histopathology in evaluating bone resection margins, using histopathology as the gold standard. We included 93 patients undergoing conservative surgery for diabetic foot osteomyelitis. Bone samples were obtained from the proximal resection margin for both microbiology and histopathology. A microbiological result was considered contamination when cultures were positive but histopathology was negative. Microbiological cultures at bone resection margins yielded 52 true positives, 23 false positives (contamination), 10 false negatives, and 8 true negatives when compared to histopathology. This resulted in a sensitivity of 83.9%, specificity of 25.8%, positive predictive value of 69.3%, and negative predictive value of 44.4%. Contamination was not associated with the severity of infection, presence of soft tissue involvement, inflammatory markers, or glycemic control. No association was found between contamination and polymicrobial flora in the primary surgical specimen. However, <i>Pseudomonas aeruginosa</i> was the only species significantly associated with contamination (p = .008), suggesting species-specific factors may contribute to microbiological false positives. These findings emphasize that microbiology, while sensitive, is not a specific method for assessing residual bone infection and should not be used in isolation. Histopathology remains the more reliable diagnostic tool. Future research should explore biofilm-targeted strategies and intraoperative antiseptic protocols to reduce contamination of bone biopsy specimens obtained from resection margins.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346251338689"},"PeriodicalIF":0.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036444","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}