The international journal of lower extremity wounds最新文献

{"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":"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":"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":"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":1.5,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12353821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Effects of Weekly and Biweekly Low-Frequency Ultrasound Debridement Versus Standard of Wound Care in Patients with Diabetic Foot Ulcers: A Pilot Randomized Clinical Trial.","authors":"Sebastián Flores-Escobar, Yolanda García-Álvarez, Francisco Javier Álvaro-Afonso, Mateo López-Moral, Marta García-Madrid, José Luis Lázaro-Martínez","doi":"10.1177/15347346251332795","DOIUrl":"https://doi.org/10.1177/15347346251332795","url":null,"abstract":"<p><p>The aim of this study was to evaluate clinical effects of weekly (UD/week) and biweekly (UD/2-weeks) low-frequency ultrasound debridement (UD) on wound healing, healing time, wound area, granulation tissue, and transcutaneous oxygen pressure (TcPO₂) in patients with diabetic foot ulcers (DFUs), compared to the standard of care (SoC). A pilot randomized clinical trial was conducted involving 30 patients with DFUs who received either UD/week (n = 10), UD/2-weeks (n = 11), or SoC (n = 9) every week over a 12-week treatment period. Healing rates at 6 months were 70% in the UD/week, 54.4% in the UD/2-weeks, and 33.3% in the SoC (<i>P</i> = .27). The healing times were 11 (IQR 7-19) weeks for UD/week, 18 (IQR 15-36) weeks for the SoC, and 24.5 (IQR 16-30) weeks for the UD/2-weeks group (<i>P</i> = .036). Wound area was reduced by 87.5 ± 18.5% in the UD/week, 68.6 ± 26.2% in the UD/2-weeks, and 38.9 ± 16.6% in the SoC (<i>P</i> = .014). Wollina wound scores were 7 (IQR 6-7) in the UD/week, 7 (IQR 6.5-7) in the UD/2-weeks, and 4 (IQR 3-6) in the SoC (<i>P</i> = .002). UD/week showed not significantly higher healing rates than the UD/2-weeks and SoC, but experienced significantly shorter healing time, a greater percentage of wound area reduction and higher Wollina wound score. These findings suggest that UD/week could be a valuable therapeutic option in clinical practice, particularly for patients in whom sharp debridement is not a viable option or who require an alternative approach to promote wound healing. This study is registered in ClinicalTrial.gov.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346251332795"},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034391","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":"Low Serum Uric Acid Levels are Associated with Severe Diabetic Foot Infection: A Cross-Sectional Study from China.","authors":"Jie Zhao, Xiaowei Wei, Ping Zhu, Mei Zhang, Zhangrong Xu, Aihong Wang","doi":"10.1177/15347346251319080","DOIUrl":"https://doi.org/10.1177/15347346251319080","url":null,"abstract":"<p><p><b>Diabetic</b> foot ulcers (DFUs) are among the most serious complications of diabetes which are associated with high disability and mortality rates. This study aims to investigate the associations between uric acid (UA) levels and diabetic foot ulcer (DFU) characteristics. In total, 1820 participants with DFUs were included in this study; 192 and 1628 participants were included in the hyperuricemia group (HUA, UA > 420 µmol/L) and the nonhyperuricemia group (NHUA, UA ≤420 µmol/L), respectively. The NHUA group was divided into a middle-UA subgroup (SMUA, 420 µmol/L ≥ UA ≥ 180 µmol/L; 304 individuals) and a low-UA subgroup (SLUA, UA <180 µmol/L; 1324 individuals). There were no significant differences in the rates of deep ulcers, severe infection or amputation between NHUA and HUA. In univariate analysis of subgroups, the differences in the rates of deep ulcers, severe infection and amputation were significant. After adjusting for confounders (sex, fasting glucose level, diabetes duration, eGFR, deep ulcers and severe infection) in multivariate analysis, the severe infection rate (OR = 4.0, 95%CI 1.6-10.0, P < 0.01) was still significantly greater in the SLUA group than in the SMUA group while the rate of deep ulcers (OR =2.4, 95%CI 1.0-6.1, P = 0.06) and amputation (OR =1.1, 95%CI 0.3-4.3, P = 0.91) showed non-statistical difference. UA levels below 180 µmol/L can be a risk factor for severe infection in DFUs.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346251319080"},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059363","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 Prevalence of Contact Allergies for Wound Dressings in Patients With Diabetic Foot Ulcers (PAID Study), an Observational Prospective Trial.","authors":"Birgitte M Visch, Daphne van der Veen, Luuk Smeets, Roland Toeter, Arianne van Bon, Diana Romijn","doi":"10.1177/15347346251332028","DOIUrl":"https://doi.org/10.1177/15347346251332028","url":null,"abstract":"<p><p>This investigator initiated prospective observational study investigates the prevalence of contact allergies in patients with a Diabetic Foot Ulcer (DFU). Patients with a DFU received a combined PATCH-test (a test used to investigate the origin of an allergic reaction on the skin) at the upper back, with the European baseline series, the European leg ulcer series, and local used material for leg ulcers. A total of 108 patients with DFU were included of which 86 (79.6%) were male, and 9 (8.3%) and 99 (91.7%) patients had Type 1 and Type 2 diabetes, respectively. Twenty-one patients had a sensitization in the standard series, 30 patients in the leg ulcer series, and 11 patients in both series. Two patients had a positive reaction for one of the local used materials. Most frequent sensitizations were found for Perubalsem (N = 6) and Fragrance-Mix II (N = 4) in the standard series. A sensitization for Povidone-Iodine (N = 20) was most frequently seen in the leg ulcer series. In the local used materials a sensitization for silver sulfadiazine (N = 1) and cutimed-gel (n = 1) were seen. In conclusion, this study provides novel information about sensitizations in patients with DFU, but more research is needed to demonstrate the relationship between allergic reactions and delayed wound healing. The study protocol was registered in www.clinicaltrials.gov (NCT04085705, PAID study).</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346251332028"},"PeriodicalIF":0.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059595","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":"Exploring the Relationship Between SVS WIfI and IWGDF Scoring Systems and Reamputation Risk in Patients With Diabetic Foot and Peripheral Artery Disease.","authors":"Alkan Bayrak, Mustafa Yalın, Mehmet Utku Çiftçi, Malik Çelik, Vedat Öztürk, Serdar Hakan Basaran","doi":"10.1177/15347346251333835","DOIUrl":"https://doi.org/10.1177/15347346251333835","url":null,"abstract":"<p><p>Determining the optimal amputation level in diabetic foot (DF) and peripheral artery disease (PAD) patients is crucial for minimizing reamputation risk while preserving functionality. The Society for Vascular Surgery Wound, Ischemia, and Foot Infection (SVS WIfI) and International Working Group on Diabetic Foot (IWGDF) scoring systems are widely used for risk stratification, but their predictive value for reamputation remains unclear. The current study aimed to evaluate the predictive utility of these scoring systems for reamputation risk in patients undergoing amputations due to DF or PAD. A retrospective cohort study was conducted on 108 patients who underwent unilateral amputations due to DF or PAD between 2016 and 2021. Patients were categorized based on WIfI and IWGDF classifications, and clinical outcomes, including reamputation rates, ICU admissions, and mortality, were analyzed using logistic regression and post hoc analyses. Reamputation occurred in 41 (38%) patients. Higher WIfI (OR: 3.85, 95% CI: 2.10-7.05, <i>P</i> = .001) and severe IWGDF scores (OR: 3.25, 95% CI: 1.80-5.88, <i>P</i> = .008) significantly correlated with increased reamputation risk. Patients with high-risk scores also exhibited higher ICU admission (<i>P</i> = .03) and mortality rates (<i>P</i> = .01). Male gender (OR: 3.47, 95% CI: 1.45-8.31, <i>P</i> = .005), diabetes (OR: 2.32, 95% CI: 1.10-4.90, <i>P</i> = .027), and prolonged hospitalization (OR: 1.04, 95% CI: 1.01-1.08, <i>P</i> = .021) were independent predictors, while above-ankle amputations were protective for reamputation (OR: 0.22, 95% CI: 0.11-0.43, <i>P</i> < .001). Both scoring systems are effective in predicting reamputation risk, with WIfI providing a more comprehensive risk assessment. Combining these tools may enhance decision-making and improve patient outcomes in terms of reamputation prevention, hospital stay, ICU admission, and mortality.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346251333835"},"PeriodicalIF":0.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060410","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}