WOUNDS-A COMPENDIUM OF CLINICAL RESEARCH AND PRACTICE

The use of an acellular wound matrix for Mohs surgical reconstruction: a case series
Ansert EA, Thornton JF, Du A, Thornton A and Kim PJ
Malignancies of the foot are relatively rare and pose a problem for clinicians, with malignant melanoma in this area associated with poor prognosis. The foot has unique anatomy for weight bearing, and preserving this role is imperative; as such, smaller-than-recommended margins are often taken to preserve patient function.
Advancing chronic wound care with near-infrared spectroscopy imaging: clinical applications, measurement parameters, and insights into healing dynamics
Oropallo A, Ortega-Loayza AG, Korzendorfer H, James F, Dotson P, Khimchenko A, Driver VR and Sonenblum SE
Chronic wound management is a global health care challenge affecting patient morbidity and quality of life while presenting a substantial economic burden. A critical limitation in effective wound care is the inability to accurately assess microvascular tissue health in real time. This review of near-infrared spectroscopy (NIRS) imaging and its use in wound care emphasizes relevant clinical end points and explores key measurement parameters assessed via NIRS imaging.
Recurrent Martorell ulcer in a patient with hypertension: a therapeutic success with pentoxifylline
Sorensen PA and Palmisano K
Martorell ulcer is a rare skin condition that occurs in individuals with a history of long-standing uncontrolled hypertension. Martorell ulcer is often misdiagnosed on initial evaluation. Treatment primarily consists of tight pharmaceutical control of blood pressure and skin grafting. These treatments have high rates of success and often result in complete healing of the ulcer.
Use of a novel debriding agent based on collagenase and hyaluronate lyase to enhance angiogenesis, stimulate healing, and reduce pain in chronic cutaneous wounds
Garza-Cerna JA, Mecott-Rivera GÁ, Castro-Govea Y, Pérez-Trujillo JJ, de Oca-Luna RM, Salas-Treviño D, Kopytina V and Berroa JL
Chronic wounds pose a serious health challenge, reducing patient and caregiver quality of life and demanding substantial resources. Debridement is essential for healing, with collagenase being one of the most widely used agents.
Effect of negative pressure wound therapy with instillation and dwell time on health care utilization and costs in South Africa
Moeng MS, Vadia S, Collinsworth AW, Lookess S and Capelli P
Negative pressure wound therapy with instillation and dwell time (NPWTi-d) provides repeated wound cleansing plus the therapeutic benefits of traditional NPWT and has been elevated to a first-line therapy in some regions given evidence of its effectiveness.
Determinants of delayed wound healing in postoperative patients: a multihospital-based prospective study performed in South India
Joseph N, Vishnoi M, Garg P and Hedge A
Delayed wound healing (DWH) leads to various health problems and increases the cost of health care for patients.
Closure rate of chronic wound with sinus tract based on morphological and pathological features of the endoscopic evaluated classification
Ma X, Aobuliaximu Y, Zhang D, Niu Y, Tang J, Liu Y, Wu M, Huang L, Zhou J, Wu F, Wang C, Dong J, Tian M, Song F, Cao X, Lu Y, Wang H and Lu S
The endoscopic evaluated classification known in China as the China-Lu classification is a morphological and pathological feature-based classification for chronic wound with sinus tract (CWST).
A precision-based approach for bioactive skin allograft application in nonhealing wounds using bacterial fluorescence imaging
Knott JL, Wang KK, deLahunta DP, MacIntyre D and Ennis WJ
Chronic wounds present significant clinical challenges and often require advanced modalities such as cellular and/or tissue-based products (CTPs), also referred to as cellular, acellular, and matrix-like products. Bioactive skin allograft (BSA) is a type of CTP composed of living fibroblasts, keratinocytes, cytokines, and collagen that is widely used for nonhealing wounds. Before applying a BSA, standard of care involves lowering the bioburden through wound bed preparation; however, classic methods to assess bioburden can be unreliable. Bacterial fluorescence imaging (FL-imaging) is a recent technology that allows for the detection of clinically significant bioburden using a noninvasive, point-of-care device. Few studies have applied FL-imaging directly to BSA management.
Phytotherapy for chronic wound management in the era of antibiotic resistance
Rawat K and Gabrani R
Chronic wounds, which exhibit prolonged inflammation, impaired healing, and vulnerability to infections, remain a global health challenge, largely driven by the persistence of microbial biofilms and escalating antimicrobial resistance (AMR). Biofilm protects pathogens from the host's immune defenses and conventional antibiotic treatments, sustaining wound chronicity and fostering resistance. Due to the inefficacy of traditional antibiotics in penetrating biofilms and mitigating resistant strains, alternative therapeutic strategies are urgently required.
The use of near-infrared spectroscopy in assessment of viability and monitoring of healthy trajectories in skin tears
Reiter HJ and Andersen C
Reliable methods of assessing skin tear flap viability beyond visual inspection would conserve flap tissue and improve outcomes. Near-infrared spectroscopy (NIRS) is a noninvasive, noncontact means of assessing the oxygenation and perfusion status of superficial tissue.
Fat pad augmentation using human adipose allograft yields durable closure in recalcitrant plantar ulcers
McGinness K, Peck B, Javed U, Hitto A, Lundberg T and Ricks D
Fat pad atrophy or migration leads to high pressure, a key factor in chronic plantar ulcer development. Current standard of care (SOC) only offers temporary pressure relief through off-loading, without addressing underlying fat pad defects.
Prevalence of biofilm in chronic wounds: systematic review with meta-analysis
Coelho MMF, Avelino BMA, de Oliveira BA, Rios MA, do Amaral Gubert F, Martins MC, Coutinho JFV, Nogueira PSF, Barbosa RGB and Cavalcante VMV
To estimate the prevalence of biofilms in chronic wounds.
The trial design of the concurrent optical and magnetic stimulation (COMS) therapy study for refractory diabetic foot ulcers (MAVERICKS): a multicenter, randomized, sham-controlled, double-blind investigational device exemption clinical study
Galiano RD, Li RA, Lantis JC, Oropallo A, Ulloa J, Iafrati M, Lavery LA, O'Connell J and Nouvong A
Diabetic foot ulcers (DFUs) are a major clinical challenge, particularly among patients with refractory ulcers, that often lead to severe complications such as infection, amputation, and high mortality. Innovations supported by strong clinical evidence have the potential to improve healing outcomes, enhance quality of life, and reduce the economic burden on individuals and health care systems.
Efficacy of cellular and/or tissue-based product applications on all non-pressure injury chronic wound types in a Medicare private practice model
Carpenter S, Ferguson A, Bahadur D, Estapa A, Bahm J and Burst S
This retrospective analysis is a derivative cohort study based on a prior retrospective investigation by this author group.
Accelerating patient transitions from hospital to home in the United Kingdom with single-use negative pressure wound therapy: a discharge pathway
Portou MJ, Collinsworth AW and Lookess S
Initially limited to inpatient use, negative pressure wound therapy (NPWT) is now frequently used in community settings. However, complexities in wound management step-down strategies in the United Kingdom, including regional variations in referral processes, lack of consensus on funding criteria, and limited availability of NPWT units, have led to extended hospital length of stay (LOS) for patients ready for discharge but still needing NPWT. Single-use NPWT (sNPWT) can serve as a bridge between hospital and community NPWT.
Use of a novel zipper device for wound closure of cutaneous abscesses in pediatric outpatients: a case series
Bingting W, Chen Y, Wei M, Mingjing X, Yang X, Tingting W and Xuebing Z
Current management of pediatric cutaneous abscesses involves either spontaneous healing by secondary intention or suturing through tertiary intention, which are often lengthy processes that cause discomfort and distress among children. As it is noninvasive and simple, a novel zipper device is widely used for the primary wound closure of surgical incisions.
Pulsed electromagnetic field stimulation therapy for Charcot foot ulcer: a randomized controlled trial
Eltayeb NM, Abdelhamid MM, Yousuf HZ and Abd-Elrashid NA
Charcot foot is a debilitating complication of peripheral neuropathy and is primarily associated with diabetes, leading to structural damage, ulceration, and osteomyelitis. Pulsed electromagnetic field (PEMF) therapy is a promising treatment modality for wound healing and bone metabolism.
Kirschner wires combined with elastic tape for multilayer tension-reducing repair of a large stage 4 pressure injury of the greater trochanter: a case report
Qiliang X, XiaoHua L, Haoxiong C, Liang Z, Jingchao T, Linlin Z and Junxing Y
Pressure injuries are common, difficult to manage, and carry a high economic burden. They are challenging to physicians and a burden to society.
Obstructive sleep apnea is an independent risk factor for split-thickness skin graft failure
Li KR, Rohrich RN, Lava CX, Diaz PJ, DeLeonibus SF, Li W, Hannallah MS and Attinger CE
Obstructive sleep apnea (OSA) is an underdiagnosed and undertreated disease that has been significantly associated with diabetes, cardiovascular disease, peripheral arterial disease, and poor wound healing.
Acid-fast bacilli staining for nonhealing ulcers: a case report of cutaneous Mycobacterium chelonae infection
Behme S, Zhou S, Brown A and Rothenberg GM
Cutaneous infections due to nontuberculous mycobacteria (NTM) are rare, and they can be challenging to treat, often requiring prolonged therapy with multiple antibiotics. Although recent literature challenges the idea of routine acid-fast bacilli (AFB) testing in diabetic foot infections, this report presents a case of Mycobacterium chelonae (M chelonae) infection in a patient with nonhealing ulceration.
The impact of an aggressive clinic-based diabetic foot protocol: a single-center case series
Jia Q, Yin X, Qin W and Bai J
The considerable health and economic burden of hard-to-heal wounds has become increasingly prominent. Diabetic foot ulcers (DFUs), as a representative type of these wounds, pose substantial challenges for health care professionals in both treatment and long-term management.