The international journal of lower extremity wounds最新文献

{"title":"Botulinum Toxin to Improve the Prognosis of Skin Transplantation: A Short Narrative Review.","authors":"Xiangyan Hu, Yang Liu, Fengying Yang, Weigang Hu, Xifeng Sun","doi":"10.1177/15347346241228334","DOIUrl":"https://doi.org/10.1177/15347346241228334","url":null,"abstract":"<p><p>Skin transplantation is a traditional and well-established method of repairing skin loss, especially deep second-degree postburn wounds. Complications often happen amid the healing process, including necrosis and skin contracture, which has raised widespread concern from patients and doctors. Since the first recorded medical application of botulinum toxin for strabismus, accumulating evidence has enclosed all-round potential of botulinum toxin, more than aesthetic management. In recent decades, botulinum toxin also has been revealed to improve the prognosis of skin grafts. This literature review aims to briefly summarize the history and latest advances of its use for skin transplantation.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346241228334"},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139652491","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":"Efficacy and Safety of Platelet-Rich Plasma for Pressure Ulcers: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Zhonglin Hu, Haona Xv, Aiping Feng, Senmao Wang, Xuefeng Han","doi":"10.1177/15347346241227001","DOIUrl":"https://doi.org/10.1177/15347346241227001","url":null,"abstract":"<p><p>Pressure ulcers are common chronic wounds in clinical practice, severely affecting patients' quality of life and causing substantial economic burdens. Platelet-rich plasma (PRP) has been explored for its potential in treating pressure ulcers. Herein, a study was carried out to evaluate the efficacy and safety of PRP in comparison to conventional treatments for pressure ulcers. A comprehensive search was conducted in databases including PubMed, Embase, Web of Science, and Cochrane Library, covering studies published from the inception to May 20, 2023, with only randomized controlled trials (RCTs) assessing the effect of PRP on the healing of pressure ulcers included. The outcomes of interest included healing rates, ulcer area, ulcer volume, Pressure Ulcer Scale for Healing (PUSH) score, healing time, and complications. Finally, 9 RCTs, involving 511 patients with 523 pressure ulcers, met the inclusion criteria. Our meta-analysis revealed a significant improvement in the healing rate, as evidenced by a weighted odds ratio (OR) of 3.40 (95% CI = 1.87 to 6.21, <i>I</i>² = 32%, <i>P</i> < 0.0001). Additionally, the standard mean difference (SMD) for healed ulcer area favored the PRP group, reflecting an improvement of 1.38 cm² (<i>P</i> = 0.02). Furthermore, the reduction in PUSH scores within the PRP group outperformed that observed in the control group, demonstrating a SMD of 1.69 (<i>P</i> = 0.01). Nevertheless, complications and the SMD for ulcer volume reduction revealed no statistically significant differences between the groups. From these findings, PRP stands out as a promising and safe therapeutic approach for pressure ulcers. For a deeper understanding of PRP's role in pressure ulcer healing, it is crucial to conduct more well-structured, high-quality RCTs in upcoming studies.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346241227001"},"PeriodicalIF":0.0,"publicationDate":"2024-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139492945","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, Placebo-controlled, Double-blind Clinical Trial of Bacteriophage Cocktails in Chronic Wound Infections.","authors":"Subhash Lal Karn, Satyanam Kumar Bhartiya, Arvind Pratap, Sanjay Kumar Saroj, Rajesh Kumar, Minakshi Sahu, Mayank Gangwar, Gopal Nath","doi":"10.1177/15347346231226342","DOIUrl":"https://doi.org/10.1177/15347346231226342","url":null,"abstract":"<p><strong>Background: </strong>Chronic wounds are prevalent globally at endemic proportions. The common features associated with chronic wounds are prolonged inflammatory phase, infection with multidrug-resistant (MDR) bacteria, and subsequent biofilm formation. The present randomized-controlled trial (RCT) study was undertaken on chronic wounds of ≥6 weeks longer duration using customized phages to evaluate the efficacy and safety of bacteriophage therapy.</p><p><strong>Methods: </strong>The study was conducted from December 2021 to August 2023. Thirty patients in each of the arms (placebo and bacteriophage) were recruited with chronic wounds. The patients, both arms, received the conventional treatment of wound debridement, local antiseptics, and local and systemic antibiotics at the discretion of the treating surgeon. However, before applying the customized bacteriophage cocktail or placebo, the wound surface was thoroughly washed to remove the residual antiseptics. The phage cocktails or placebo were applied on alternate days. The wounds were evaluated using the Bates-Jensen Wound Assessment Tool for the progress of wound healing.</p><p><strong>Results: </strong>A total of 93.3% of the wound became sterile in 39 days (median sterility time), followed by complete healing by the end of 90 days in the phage group. Contrary to this, 83.3% of those on placebo therapy remained colonized by original bacteria or additional new bacteria without healing for up to 90 days.</p><p><strong>Conclusion: </strong>With the well-designed RCT, we could conclude that customized bacteriophage therapy using bacteriophage cocktails will definitely cure the chronic wound, irrespective of age, sex, diabetes status, and infection by MDR bacteria.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346231226342"},"PeriodicalIF":0.0,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139486903","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":"Folic Acid and Diabetic Foot Ulcers.","authors":"Elisavet E Pyrgioti, Nikolaos D Karakousis, Petros N Georgakopoulos, Dimitrios S Karagiannakis, Nikolaos Papanas","doi":"10.1177/15347346241226677","DOIUrl":"https://doi.org/10.1177/15347346241226677","url":null,"abstract":"<p><p>Diabetic foot ulcers (DFUs) remain a major cause of morbidity. This narrative mini-review aimed to investigate the potential role of folic acid (FA) in DFUs. Individuals with DFUs exhibit lower levels of FA and lower daily intake, compared to those without DFUs. There is preliminary evidence that FA administration may contribute to improved DFUs healing. In this context, regular evaluation of dietary FA intake may prove important towards reduction or even prevention of DFUs. However, data are still limited and further research is required to enable definitive conclusions and any recommendations.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346241226677"},"PeriodicalIF":0.0,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139486904","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":"Plantar Thermography in High-Risk Patients With Diabetes Mellitus Compared to Nondiabetic Individuals.","authors":"Gabriela Verónica Carro, María Laura Noli, María Gabriela Rodriguez, Miguel Ticona, Mariana Fuentes, María de Los Ángeles Llanos, Federico Caporaso, Guillermo Marciales, Sebastián Leandro Emanuel Turco","doi":"10.1177/15347346231218034","DOIUrl":"https://doi.org/10.1177/15347346231218034","url":null,"abstract":"<p><p>Diabetic foot (DF) is one of the most devastating complications of diabetes mellitus (DM). Infrared thermography has been studied for its potential in early diagnosis and preventive measures against DF ulcers, although its role in the management and prevention of DF complications remains uncertain. The objective of this study was to determine the average temperatures of different points of the plantar foot using infrared thermography in patients with DM and history of DF (DFa group, at the highest risk of developing foot ulcers) and compare them to people without DM (NoDM group). One hundred and twenty-three feet were included, 63 of them belonged to DFa Group and the other 60 to NoDM Group. The average temperature in the NoDM Group was 27.4 (26.3-28.5) versus 28.6 (26.8-30.3) in the DFa Group (<i>p</i> = .002). There were differences between both groups in temperatures at the metatarsal heads and heels, but not in the arch. Average foot temperatures did not relate to sex, ankle-brachial index, and age, and had a mild correlation with daily temperature (Spearman 0.51, <i>p</i> < .001). Data provided in our study could be useful in establishing a parameter of normal temperatures for high-risk patients. This could serve as a foundational framework for future research and provide reference values, not only for preventative purposes, as commonly addressed in most studies, but also to assess the applicability of thermography in clinical scenarios particularly when one foot cannot serve as a reference, suspected osteomyelitis of the remaining bone, or instances of increased temperature in specific areas which may necessitate adjustments to the insoles in secondary prevention.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346231218034"},"PeriodicalIF":0.0,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138813412","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":"Effectiveness of Specific Single-Use Incisional Negative Pressure Wound Therapy (PICO System) After Major Lower Extremity Amputation.","authors":"Hiroshi Takahashi, Shinsuke Takeda, Yoshihiro Tanaka, Ryutaro Shibata, Hiroki Ito, Shingo Kurahashi, So Mitsuya, Hideki Murakami","doi":"10.1177/15347346231221116","DOIUrl":"https://doi.org/10.1177/15347346231221116","url":null,"abstract":"<p><p>Lower extremity amputation (LEA), particularly in patients with diabetes or peripheral vascular disease, often results in complications such as surgical site infections (SSIs) and wound dehiscence. This study examined whether utilizing the portable and user-friendly PICO system (Smith and Nephew Medical Ltd, Hull, UK) as incisional negative-pressure wound therapy can reduce post-LEA complications. This study was conducted at a Japanese tertiary medical center and involved a retrospective analysis of LEA cases (n = 32) between January 2021 and December 2022. The PICO dressing group (n = 16) was compared to the conventional dressing group (n = 16) for post-LEA wound management. The primary outcome was the incidence of postoperative wound complications, including SSI and wound dehiscence, within 15 days of LEA. Superficial/deep SSI and wound dehiscence occurred less frequently in the PICO dressing group than in the conventional dressing group (12.5% vs 43.8%; p = .054). There were no cases of deep SSIs in the PICO dressing group. Although this study has limitations owing to its retrospective design and small sample size, the results suggest the potential of the PICO system for improving outcomes in post-LEA wound management.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346231221116"},"PeriodicalIF":0.0,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138813484","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":"Wound Healing: A Brief Look at the Inflammatory Stage and Role of Medicinal Plants and Their Derivations on Modulating the Inflammatory Responses: A Systematic Review.","authors":"Omidreza Raei Abbasabadi, Mohammad Reza Farahpour","doi":"10.1177/15347346231212331","DOIUrl":"https://doi.org/10.1177/15347346231212331","url":null,"abstract":"<p><p><b>Aims:</b> Wound is believed to be a major disorder in certain organs and/or tissues, which could be transmitted to other tissues. Skin is constantly exposed to infections, injuries, scratches, and burns. Wound dressings are commonly utilized for the treatment of wound site and protect it from external contamination. The biological importance of natural agents, such as herbal medicines and their derivations including extracts, essential oils and active compounds in the wound healing process has attracted the attention of researchers and also some manufacturers of wound dressings. Such natural agents improve wound healing by their antioxidant and antibacterial properties. This novel review article was conducted to evaluate the effects of medicinal plants and their derivations on inflammatory responses in surgical wound infection. <b>Methods:</b> The data were collected from various databases using specific keywords. <b>Results:</b> The results revealed that different medicinal plants and their derivations decrease the inflammation in the wound healing process by modulating in gene expression of inflammatory cytokines and immune cells. <b>Conclusion:</b> Active compounds of medicinal plants can alleviate inflammation in the wound healing process, which must be taken into consideration in pharmaceutical industries.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346231212331"},"PeriodicalIF":0.0,"publicationDate":"2023-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138813420","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":"Acellular Dermal Matrix for Treatment of Diabetic Foot Ulcer: An Overview of Systematic Reviews.","authors":"Li Lingyan, Zhao Han, Li Jialu, He Bingyang, Ma Yuanyuan, Qin Peiwei, Ma Peifen, Xu Liwei","doi":"10.1177/15347346231201696","DOIUrl":"https://doi.org/10.1177/15347346231201696","url":null,"abstract":"<p><p><b>Aims:</b> To evaluate the reliability of the methodological quality and outcome measures of systematic reviews (SRs)/metaanalyses (MAs) of the acellular dermal matrix (ADM) for diabetic foot ulcer (DFU). <b>Methods:</b> We searched and retrieved SRs and MAs on the application of ADM for DFU from PubMed, Web of Science, The Cochrane Library, EMBASE, CNKI, CBM, WanFang, and VIP databases. We employed AMSTAR 2 to assess methodological quality, Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system to grade, and the strength of evidence of included SRs/MAs. We excluded the overlapping randomized controlled trials (RCTs) and conducted a re-MA of the primary RCTs. <b>Results:</b> A total of 7 SRs/MAs were included. Results from the AMSTAR 2 evaluation revealed a low overall quality; the GRADE system showed that the evidence was of moderate to very low quality. Our re-MA showed that ADM was superior to standard of care (SOC), with regards to complete wound healing rate at 12 weeks (RR = 1.74, 95% CI:1.34-2.25, <i>P </i>< .0001), complete wound healing rate at 16 weeks (RR = 1.50, 95% CI: 1.26-1.77, <i>P </i>＜ .00001); healing time (MD = -2.06, 95% CI: -2.57 to -1.54, <i>P </i>< .00001) and adverse events (RR = 0.62, 95% CI: 0.49-0.80, <i>P </i>= .0002). However, a consensus has not yet been reached between ADM and SOC groups with regard to outcome indicators of the reduction of ulcer area and quality of life; and subgroup analyses showed no statistically significant differences between the xenograft ADM and SOC groups (RR = 1.36, 95% CI: 0.95-1.93, <i>P </i>= .09) at 12 weeks. <b>Conclusion:</b> Current evidence suggests that ADM is more effective than the standard of care in the treatment of DFU, particularly for full-thickness, noninfected, and nonischemic foot ulcers, but with low evidence quality. Therefore, the results of this overview should be interpreted dialectically and prudently, and the role of ADM in DFU needs further exploration.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346231201696"},"PeriodicalIF":0.0,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138453434","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":"Retrospective Review of Management and Overall Survival Rate of Patients With Vascular Pythiosis of the Lower Extremity: 20 Years Experience.","authors":"Supapong Arworn, Termpong Reanpang, Poon Apichartpiyakul, Saranat Orrapin, Kittipan Rerkasem","doi":"10.1177/15347346231214291","DOIUrl":"https://doi.org/10.1177/15347346231214291","url":null,"abstract":"<p><p>Pythiosis is an infectious disease in humans and animals caused by an aquatic fungus-like micro-organism, <i>Pythium insidiosum</i>. Vascular pythiosis is a difficult condition to treat and can lead to loss of limb in addition to being a potentially life-threatening infection. The condition is furthermore unfamiliar among healthcare workers, which often results in delayed treatment or even misdiagnosis. In this study, we report our findings, which have been gathered over a 20-year period in caring for vascular pythiosis in Maharaj Nakorn Chiang Mai Hospital, Chiang Mai, Thailand. We made a retrospective medical review of 32 patients presented with arterial occlusion who have serum anti-<i>Pythium insidiosum</i> antibodies. All patients underwent computed tomography angiography to confirm the level of arterial occlusion and decided on a treatment plan. Twelve out of 22 patients with infrainguinal disease, femoropopliteal or below-knee vascular occlusion, survived. The mean survival time is 6.58 years. Eight in 10 patients presented with suprainguinal disease died during the follow-up with a mean survival time of 31.6 months. The suprainguinal extension of the disease influenced the outcome, resulting in a higher mortality rate. However, patients presented with chronic limb ischemia had a much greater rate of survival compared to other clinical presentations. Extensive surgical resection combined with antifungal treatment and immunotherapy have proven to be effective in patients with vascular pythiosis in our findings.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346231214291"},"PeriodicalIF":0.0,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138453435","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 Pink Doughnut Sign-A Clinical Clue to Recognize Basal Cell Carcinoma Presenting as Chronic Leg Ulcer.","authors":"Matiar Madanchi, Alina Müller, Mara Lynda Zehnder, Simon Mirari Müller","doi":"10.1177/15347346231215596","DOIUrl":"https://doi.org/10.1177/15347346231215596","url":null,"abstract":"<p><p>Chronic lower leg ulcers (LLUs) are a very common and associated with a high subjective and economic burden. They can be caused by a variety of factors. We have observed a common clinical feature in patients suffering from LLUs, which ultimately proved to be basal cell carcinomas (BCCs). We have nicknamed this sign \"the pink doughnut sign.\" The pink doughnut sign can aid in the early recognition of such BCCs, which is crucial to prevent unnecessary suffering, treatment costs, and poor local outcomes.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346231215596"},"PeriodicalIF":0.0,"publicationDate":"2023-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138292618","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}