The international journal of lower extremity wounds最新文献

{"title":"Study on the Microbiological Characteristics of Infection in Diabetic Foot Ulcers (Wagner Grades 2-4) and Their Impact on Outcomes.","authors":"Huanxiang Guan, Yaodong Wang, Hairui Fang, Yafeng Zhang, Tao Ding, Zewen Qiao","doi":"10.1177/15347346261480191","DOIUrl":"https://doi.org/10.1177/15347346261480191","url":null,"abstract":"<p><p>ObjectiveTo evaluate the influence of microbiological characteristics on Wagner grade and 12-month outcomes in hospitalized patients with Wagner grade 2-4 diabetic foot ulcers (DFUs).MethodsThis single-center retrospective cohort included 205 culture-positive infected DFUs with complete 12-month follow-up. Grade 4 was the severity outcome; nonhealing/readmission was adverse. Associations between each major organism and Wagner grade 4 were assessed using hierarchical logistic regression with sequential adjustment for host characteristics, HbA1c and WBC, and CRP, PCT, and ESR. Results were interpreted jointly across models, with Benjamini-Hochberg correction applied to the 11 organism-specific tests within each model.ResultsGrades 2/3/4 comprised 49/59/97 patients; 162 healed, 22 were unhealed, and 21 readmitted. <i>Staphylococcus aureus</i> was most frequent but not robustly associated. Of 19 <i>Enterococcus</i>-positive patients, 16 had grade 4. Enterococcus detection showed a positive association with grade 4 after adjustment for host characteristics, HbA1c, and WBC count (OR, 8.02; 95% CI, 2.11-30.46; q = 0.024). After additional adjustment for CRP, PCT, and ESR, the estimate remained positive but was attenuated (OR, 5.27; 95% CI, 1.16-23.89; raw P = 0.031) and did not meet the prespecified false-discovery-rate criterion (q = 0.172). No individual organism was robustly associated with the composite adverse outcome. Compared with one organism, two and ≥3 organisms yielded ORs 2.50 (95% CI, 1.09-5.72) and 4.89 (95% CI, 1.40-17.11); ≥3 organisms remained associated in sensitivity analysis (OR, 5.02; 95% CI, 1.42-17.76).ConclusionsAmong hospitalized patients with culture-positive Wagner grade 2-4 DFUs, Staphylococcus aureus was most common but showed limited independent associations with severity or 12-month outcomes. Enterococcus spp. clustered in grade 4 wounds, although its independent association was inconsistent across adjusted models. Detection may mark severe wound complexity but should not independently guide grading or treatment. Detection of ≥3 organisms was associated with increased risk of the 12-month composite adverse outcome, but the imprecise estimate requires prospective multicenter validation.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346261480191"},"PeriodicalIF":1.5,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148835899","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 Peripheral Neuropathy and Zinc.","authors":"Nikolaos D Karakousis, Dimitrios S Karagiannakis, Nikolaos Papanas","doi":"10.1177/15347346261481185","DOIUrl":"https://doi.org/10.1177/15347346261481185","url":null,"abstract":"","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346261481185"},"PeriodicalIF":1.5,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148835835","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 Therapeutic Sport Footwear in Prevention of Ulcer Recurrence in Persons with Diabetic Foot Disease.","authors":"Michela Di Venanzio, Ermanno Bellizzi, Marco Meloni, Federico Rolando Bonanni, Laura Giurato, Daniele Morosetti, Aikaterini Andreadi, Alfonso Bellia, Davide Lauro","doi":"10.1177/15347346261479522","DOIUrl":"https://doi.org/10.1177/15347346261479522","url":null,"abstract":"<p><p>Recurrence of diabetic foot ulcer (DFU) remains a major clinical challenge in patients with diabetes. Therapeutic footwear is a cornerstone of secondary prevention as it reduces plantar pressure and mechanical stress. However, most available evidence focuses on traditional orthopedic footwear, while prospective data on therapeutic sport footwear designed for daily physical activities are poor. This study aimed to evaluate the effectiveness of therapeutic sport footwear with a semi-rigid biomechanical sole (termed YDA) with combined insole in preventing ulcer recurrence in patients with diabetes at high risk of re-ulceration. The study was a single-arm, uncontrolled, retrospective observational study including consecutive patients with diabetes and a history of DFU referred to a tertiary diabetic foot center between January 2024 and March 2025. All included patients wore YDA as therapeutic footwear during the study period. In addition, they were managed through a multidisciplinary protocol including regular clinical follow-up, risk-factor monitoring, and structured patient education. The 1-year outcomes included: ulcer recurrence, minor and major amputations. Overall, 47 patients were included (68.1% male; mean age 68.3 ± 8.4 years). Peripheral neuropathy was present in all patients and peripheral arterial disease in 55.3%. At 1 year of follow-up, ulcer recurrence occurred in 14.9% of patients, minor amputation in 6.4%, and no major amputations were recorded. The multivariate analysis showed that discontinuous use of therapeutic footwear was strongly associated with ulcer recurrence (OR 8.9, 95% CI 2.1-37.5; p < 0.0001) and minor amputation (OR 10.5, 95% CI 2.0-55; p = 0.004). Peripheral arterial disease was independently associated with minor amputation (OR 5.2, 95% CI 1.3-20.6; p = 0.02). The use of specific sport footwear with a semi-rigid biomechanical sole resulted in a low rate of re-ulceration.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346261479522"},"PeriodicalIF":1.5,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804057","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":"Current Updates in Chronic Limb-threatening Ischemia and Peripheral Arterial Disease Management.","authors":"Saritphat Orrapin, Boonying Siribumrungwong, Supapong Arworn, Nikolaos Papanas, Kittipan Rerkasem","doi":"10.1177/15347346261478968","DOIUrl":"https://doi.org/10.1177/15347346261478968","url":null,"abstract":"","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346261478968"},"PeriodicalIF":1.5,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761622","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":"Windowed Angled Total Contact Casting for Resistant Weight-Bearing Plantar Ulcers in Charcot Neuroarthropathy: A Prospective Single-Center Study.","authors":"Mohamed Mosadak Zaied, Alaa Eldin Zaied, Moaaz Kamal Sharaf El-Din","doi":"10.1177/15347346261477129","DOIUrl":"https://doi.org/10.1177/15347346261477129","url":null,"abstract":"<p><p>Plantar ulcers associated with Charcot neuroarthropathy (CNO) are difficult to treat because of persistent abnormal pressure distribution and foot instability. Although traditional non-removable total contact casting (TCC) remains the standard offloading method, it limits direct wound inspection and routine dressing care. This prospective study evaluated the effectiveness and safety of a modified windowed angled TCC technique for resistant weight-bearing plantar ulcers in patients with Charcot deformities. This prospective single-center study was conducted between May 2024 and March 2026. Forty-eight diabetic patients with midfoot or hindfoot Charcot neuroarthropathy and chronic weight-bearing plantar ulcers resistant to previous conservative offloading methods were included. Adequate distal perfusion was confirmed in all patients using vascular assessment. Windowed angled total contact casts were customized by adjusting the ankle position according to ulcer location to reduce plantar pressure while maintaining direct wound access for regular inspection and dressing changes. The primary outcome was complete ulcer healing. Secondary outcomes included secondary infection and cast-related pressure complications. A total of 48 patients (23 males and 25 females) were evaluated; 29 patients (60.4%) had clinically infected ulcers. Complete ulcer healing was achieved in 44 patients (91.7%). Among healed ulcers, 9 patients (20.4%) healed within 12 weeks, 29 patients (65.9%) healed within 12-24 weeks, and 6 patients (13.6%) required more than 24 weeks. Four patients (8.3%) remained unhealed because of extensive tissue loss and severe deformity. Secondary infection during treatment occurred in 4 patients (8.3%), while minor cast-related pressure sores developed in 2 patients (4.1%). Windowed angled total contact casting was an effective and safe offloading technique for resistant plantar ulcers in patients with Charcot neuroarthropathy. The technique combines rigid immobilization with direct wound access, allowing effective pressure redistribution and regular wound care during treatment.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346261477129"},"PeriodicalIF":1.5,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148709174","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":"Ferroptosis and Iron Dyshomeostasis as Drivers of Wound Chronicity in Diabetic Foot Ulcers: Pathophysiological Mechanisms and Targeted Therapeutic Strategies.","authors":"Terry Hao-Yu Qin, Sulu Shen, Atiqah Aziz, Tunku Kamarul, Xiu-Wen Ling, Amber Haseeb, Eva Mahirah Zulkifli, Han-Ling Tan, Aiden Yi-Fei Wang","doi":"10.1177/15347346261476551","DOIUrl":"https://doi.org/10.1177/15347346261476551","url":null,"abstract":"<p><p>Backgrounddiabetic foot ulcers (DFUs) carry 5-year mortality rates of 50%-70% and recurrence rates of 65% at three to five years. Standard-of-care protocols fail to resolve wound chronicity in a substantial proportion of patients, reflecting incomplete understanding of the cellular mechanisms sustaining non-healing. This narrative review examines trace element dyshomeostasis as a mechanistically distinct driver of ferroptotic cell death across wound-bed cell populations and evaluates targeted therapeutic strategies within this framework.MethodsLiterature was identified through narrative searches of PubMed and Web of Science; emphasis was placed on DFU-relevant experimental models and clinical populations.ResultsLabile iron pool expansion, arising from hemolysis-derived Fe²⁺ release, vasa nervorum compromise, ferritinophagy dysregulation, and SASP-mediated ferroportin suppression, sustains iron-catalyzed lipid peroxidation across Schwann cells, endothelial cells, fibroblasts, and macrophages. Three upstream metabolic axes, comprising AGEs/RAGE-mediated SLC7A11 suppression, eNOS uncoupling with BH4 depletion, and macrophage iron overload-driven polarization arrest, collectively lower the ferroptotic threshold at the wound margin. AGE-induced ECM stiffening further impairs fibroblast antioxidant capacity via mechanotransduction, while impaired NCOA4-dependent ferritinophagy renders senescent fibroblasts ferroptosis-resistant, sustaining SASP-driven iron retention in neighboring cells. Localized deferoxamine delivery stabilizes HIF-1α and restores angiogenic signaling in preclinical models; selenium supplementation restores GPX4-mediated lipid hydroperoxide clearance. Stimuli-responsive biomaterials coordinating DFO and antioxidant release in response to pathological ROS, MMP, and pH signatures represent a tractable delivery framework.ConclusionIron dyshomeostasis and ferroptosis constitute a therapeutically actionable axis in DFU pathology unaddressed by current standard of care. Large animal model validation and pharmacokinetic profiling in the DFU wound environment remain necessary before clinical translation.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346261476551"},"PeriodicalIF":1.5,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148703239","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":"Relationship Between Fear of Falling, Foot Care Behaviors, and Comfort Levels in Patients With Diabetic Foot.","authors":"Busra Gurcay, Havva Sert, Feride Taskin Yilmaz, Alper Erkin","doi":"10.1177/15347346261476114","DOIUrl":"https://doi.org/10.1177/15347346261476114","url":null,"abstract":"<p><p>This study aimed to evaluate the relationship between fear of falling, foot care behaviors, and comfort levels in patients with diabetic foot. This descriptive and cross sectional study included 285 patients diagnosed with diabetic foot who attended the wound care clinic of a hospital. Data were collected using a patient assessment form, the Tinetti Falls Efficacy Scale, the Foot Care Behavior Scale, and the General Comfort Scale-Short Form (GCS-SF). The mean total score of the participants on the Tinetti Falling Efficacy Scale was 59.20 ± 17.16. A weak positive correlation was found between the total score of the Tinetti Falling Efficacy Scale and the total score of the Foot Care Behavior Scale (r = 0.278, <i>p</i> < .01). A weak positive correlation was found between the total score of the Tinetti Falling Efficacy Scale and the GCS-SF (r = 0.231, <i>p</i> < .01). Multiple linear regression analysis showed that Wagner classification was a significant predictor of Tinetti Falling Efficacy Scale scores (B = -7.910, β = -0.599, <i>p</i> < .001), whereas foot care behaviors and GCS-SF scores were not significant predictors. Fear of falling was correlated with foot care behaviors and comfort levels.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346261476114"},"PeriodicalIF":1.5,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148681748","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":"GLP-1 Receptor Agonists to Reduce Mortality in Patients with Diabetic Foot Ulcers: Insights from a Recent Nationwide Observational Study.","authors":"Dimitrios Pantazopoulos, Prashanth Rj Vas, Kittipan Rerkasem, Nikolaos Papanas","doi":"10.1177/15347346261474199","DOIUrl":"https://doi.org/10.1177/15347346261474199","url":null,"abstract":"","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346261474199"},"PeriodicalIF":1.5,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148611244","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 Landscape and Future Perspective of Hydrogel Dressings for Diabetic Foot Ulcer Therapy: From Lab to Workshop.","authors":"Haijian Wu, Mingyong Tao, Qingjun Kao, Zhe Wang","doi":"10.1177/15347346261469630","DOIUrl":"https://doi.org/10.1177/15347346261469630","url":null,"abstract":"<p><p>Diabetic foot ulcers (DFU), a prevalent chronic wound, pose severe threats to patients' quality of life. Recently hydrogel dressings have emerged as a promising therapeutic option for DFU. This study aimed to gain the current status, hotspots and research orientation of the field via analyzing the characteristics of both literature and patents on hydrogel dressings for DFU therapy. The literature and patents were retrieved and screened from the Web of Science Core Collection database and the IncoPat global patent database, respectively. The bibliometric analysis was conducted by CiteSpace 6.1.R6. We found that both articles and patents related to the field surged since 2019 in parallel. Research on this topic has involved 43 countries worldwide; two large-scale collaborative clusters were respectively led by China and Spain; Wenzhou Medical University and D.G. Armstrong are the core institution and researcher. Through analyzing literature, angiogenesis, drug delivery and inflammation are the core focus, while conductive hydrogels and therapy strategy have become emerging research hotspots. Given the patents, the focus of hydrogels for DFU are concentrated on clinical application scenarios, hydrogel preparation and drug loading. In conclusion, both literature publication and patent application have garnered increasing academic attention and recognition. Effective and productive hydrogel represent a promising therapeutic option for DFU patients.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346261469630"},"PeriodicalIF":1.5,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581940","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":"In Vitro and in Vivo Preliminary Pharmacological Evaluation of Two Algerian Plants Relevant to Accelerate Cutaneous Wound Healing in Wistar Rat's Skin.","authors":"Selma Daghbouche, Dorsaf Moalla Rekik, Neila Jardak, Samar Makni, Slim Tounsi, Tarek Rebai, Zouheir Sahnoun, Zahr-Eddine Djazouli","doi":"10.1177/15347346261469616","DOIUrl":"https://doi.org/10.1177/15347346261469616","url":null,"abstract":"<p><p>PurposeThis study aims to evaluate the antioxidant, antibacterial, and wound-healing properties of powders from <i>Cytisus triflorus</i> and <i>Teucrium polium</i>, plants endemic to Algeria harvested during two phenological stages and for enhancing wound care using a rat wound model.MethodsPhytochemical characterization of powders has involved: total phenol, flavonoids and condensed tannins content, as well as the carbohydrates composition. Such investigation was supported by their efficiency as antibacterial and antioxidant determined by different test systems, namely DPPH radicals scavenging activity, reducing power and β-carotene bleaching assay. In this regard, a rat excision wound model was used to assess wound healing. Wound contraction, hydroxyproline contents and histological evaluation were performed.ResultsPowders from studied plants differed predominantly in their total phenol, flavonoids and condensed tannins content as well as the carbohydrates composition between phenological stages. Indeed, the powders from both plants harvested at the flowering stage showed a potential antioxidant activity and exhibited significant antibacterial activity against Gram positive bacteria. After twelve days of treatment in excision wound model, wound contractions for Cfl'Ont and Tfl'Ont ointments mention a value of 100% which it showed highly significant temporal reduction in those wounds area (<i>P</i> < .01) followed by Cfr'Ont and Tfr'Ont ointments with 98.11%, 96.88%, decreased epithelialization time, arranged derma and increased hydroxyproline content over the reference groups during the trial.ConclusionOur findings have proved, for the first time, scientific evidence of the efficiency of Algerian plants namely <i>Cytisus triflorus</i> L'Her and <i>Teucrium polium</i> to possess a remarkable wound healing activities supporting the folkloric assertion.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346261469616"},"PeriodicalIF":1.5,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551891","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}