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The aim of this in-service evaluation was to assess the performance, safety, and usability of a superabsorbent polymer dressing in moderate to highly exuding wounds. An in-service evaluation was conducted for two weeks on 12 patients being treated for venous leg ulcers, postoperative wounds, diabetic foot ulcers and lymphoedema ulcers at an outpatient vascular clinic in England. Most of the patients (67%, n=8) required three or fewer dressing changes. The number of patients with maceration was reduced by 29% (n=2) from baseline (n=7), the mean pain score was reduced by 8% and no malodour was reported in 67% (n=8) of the patients by the end of two weeks. The dressing managed exudate well (50%) or very well (50%). The findings demonstrate the performance and safety of the dressing in managing exudate volume, wound odour and improving periwound skin condition without requiring a high frequency of dressing changes. [ABSTRACT FROM AUTHOR]

Pressure ulcers are often preventable and highlight the broader challenges of maintaining high standards of care, especially in vulnerable patient populations, such as those with psychiatric conditions. This article highlights the difficulties pressure ulcers pose for healthcare organisations, healthcare professionals and patients, while also exploring strategies to address these challenges in clinical practice. [ABSTRACT FROM AUTHOR]

Significance Diabetic foot ulcers are a major complication of diabetes and a significant public health issue, greatly impacting healthcare costs. These ulcers are commonly treated with conventional methods such as saline cleaning, debridement, antibiotics, and topical dressings. However, the rise in non-traumatic lower limb amputations related to diabetes, along with growing antimicrobial resistance, highlights the insufficiency of these standard treatments in achieving timely healing. Recent advances New light source adjuvant therapies, such as antimicrobial photodynamic therapy, are being tested to aid the healing of foot ulcers. This therapy involves using light (LASER or LED) to irradiate the lesion in combination with a photosensitising agent and tissue oxygen. This process promotes oxidative stress and reduces the microorganisms present in the ulcer. Critical issues A significant challenge in applying photodynamic therapy is the lack of comprehensive clinical studies and complete treatment protocols. Although there is growing evidence supporting this therapy's effectiveness in various conditions, the scarcity of well-documented clinical trials, and reliable replication of these studies, represents a major obstacle for other researchers seeking to replicate the results. Future directions This article provides a detailed and transparent protocol, which can be easily reproduced by other researchers, making significant step towards consolidating and expanding the use of photodynamic therapy in the treatment of diabetic ulcers. It is hoped that this study and the presented protocol will serve as a foundation for future research and innovations in photodynamic therapy, opening up new therapeutic possibilities and contributing to improving quality of clinical practice. [ABSTRACT FROM AUTHOR]

Copyright of Heilberufe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction The demanding nature of wound care, coupled with increased reports of elevated stress among healthcare staff in Saudi Arabia, warranted the examination of burnout and job satisfaction in this healthcare domain. Aim The study aimed to assess the prevalence of burnout and the level of job satisfaction among wound care professionals in Saudi Arabia. Methods A cross-sectional online survey was conducted among wound care staff in Saudi Arabia. Participants provided demographic information and responded to standardised questionnaires measuring burnout and job satisfaction. Results A total of 118 wound care professionals participated in the study. The results revealed alarming levels of burnout among wound care professionals, with many participants experiencing high disengagement (84.7%), exhaustion (83.1%), and burnout (79.7%). Job satisfaction scores were moderately low overall, highlighting the importance of addressing both burnout and job satisfaction in this workforce. Demographic factors such as age, gender, marital status, and working hours per duty showed no significant associations with burnout. However, differences were observed among professional roles, with nurses exhibiting lower burnout levels compared to other professions. Conclusion The study findings highlight the urgent need for targeted interventions to mitigate burnout and enhance job satisfaction among wound care professionals in Saudi Arabia. [ABSTRACT FROM AUTHOR]

This article describes the nursing process of a hemodialysis patient who had undergone toe amputation due to a diabetic foot infection. The recurrence of the foot infection delayed wound healing and the patient was worried that he may face amputation again. During the nursing period from August 29, 2019, to October 17, 2019, based on Gordon's 11 Functional Health Patterns, the following major nursing problems were identified: impaired skin integrity, lack of knowledge, and anxiety. In response to the aforementioned health problems, the author used the "TIME" model to assess wounds, identified factors that affect healing, introduced nursing strategies, established a good nursing relationship, guided the patient to express his feelings, and provided psychological support and nursing information. The author also taught the patient the correct way to dress changes and foot care to improve his awareness of caring for himself. By replying to messages concerning wound care methods, teaching the patient to use a mobile phone to take pictures, and recording wounds, the author confirmed that the case can perform correct daily self-care. Also, the patient was facing the treatment more positively and showing increased self-affirmation. This article can provide a reference for similar clinical care. [ABSTRACT FROM AUTHOR]

Background: Current undergraduate nursing students represent diverse backgrounds. Many students enter nursing school with a personal history of trauma. This project sought to identify trauma-sensitive teaching strategies (TSTS) that nurse educators can use in the clinical setting to support students who have been affected by trauma succeed in high-stress clinical environments. Method: A comprehensive integrative review was conducted to identify literature related to TSTS. The review revealed a gap in the literature related to TSTS in clinical nursing education. Results: Four key themes related to TSTS were identified: (1) relationship between the student and instructor; (2) respectful interactions; (3) recognition of trauma; and (4) responses to trauma. From the review, a framework was formulated specific to TSTS within clinical nursing education. Conclusion: This review identified TSTS that nurse educators can use to support nursing students affected by trauma succeed in the clinical environment. [J Nurs Educ. 2024;63(12):797–805.] [ABSTRACT FROM AUTHOR]

We adopted a qualitative descriptive design to gain a broad understanding of the experiences, needs and preferences. Semi‐structured interviews were conducted with 21 patients with diabetes‐related foot ulcers using an interview guide. Patients were recruited from the four multidisciplinary foot centres in the Eastern Danish Region of Zealand. The methodology utilised a phenomenological hermeneutical perspective, allowing participants to share their experiences. The data analysis was inspired by Paul Ricoeur's philosophy of text interpretation. Three themes were identified: (1) Becoming dependent on patient involvement to cope and comprehend, (2) Experiences and needs regarding the involvement of relatives and equals and (3) Being vulnerable and limited by diabetes‐related foot ulcers while striving for normality. This study emphasised the complexity of, and the highly burdensome, life that the participants experienced living with treatment‐required diabetes‐related foot ulcers while needing individualised and family‐centred approaches, which are highly dependent on the healthcare professionals' communication skills. One of the most crucial aspects of patient care is providing individualised and person‐centred information. The information necessitates the enhancement of healthcare professionals' communication skills. By emphasising the need for family‐centred strategies, we can improve health and well‐being by involving patients, relatives and patients' networks as active team players in the care process. [ABSTRACT FROM AUTHOR]

A wide variety of microbial species, including Trichophyton spp., have been detected in diabetic foot ulcers (DFUs). In particular, Trichophyton spp. cause tinea pedis (i.e., athlete's foot) and onychomycosis. However, investigations regarding the correlation between Trichophyton spp. and delayed wound healing are limited to case reports. Moreover, histological changes in wounds caused by Trichophyton spp. remain unclear. In this study, we sought to confirm the delayed wound healing phenotype caused by Trichophyton mentagrophytes infection in a full‐thickness excisional wound ob/ob mouse model through histopathological analysis. The inoculation of skin wounds in ob/ob mice with T. mentagrophytes sporules resulted in significant delay on wound healing. Further histopathological analyses demonstrated that the delayed wound healing in ob/ob mice was accompanied by reduced collagen fibre formation and inhibited granulation tissue formation, with spores and elongated mycelia retained in the wound bed and along the wound edges. This suggests that T. mentagrophytes colonization of wounds potentially contributes to delayed wound healing in patients with diabetes. These results suggest that neglected tinea pedis is a potential risk factor for delayed wound healing and progression to refractory wounds in patients with DFU. [ABSTRACT FROM AUTHOR]

Negative pressure wound therapy is used often in the management of surgical incisions, chronic wounds and subacute lesions, and there are numerous publications discussing its clinical application and outcomes. However, whilst clinical use and associated literature have expanded since these systems became commercially available in the 90s, important research and discussion around the mode of action have waned, leading to a deficit in the understanding of how this important therapy influences healing. Further, much research and many publications are predominantly reflective, discussing early theorem, some of which have been proven incorrect, or at least not fully resolved leading to misunderstandings as to how the therapy works, thus potentially denying the clinician the opportunity to optimise use towards improved clinical and economic outcomes. In this narrative review, we discuss established beliefs and challenges to same where appropriate and introduce important new research that addresses the manner in which mechanical strain energy (i.e., deformations) is transferred to tissue and how this influences biological response and healing. In addition, we assess and discuss the effect of different negative pressure dressing formats, how they influence the mode of action and how this understanding can lead to more efficient and effective use and clinical economic outcomes. [ABSTRACT FROM AUTHOR]

The objective of the study was to show the clinical performance and cost‐effectiveness of a Silicone foam dressing with 3DFit™ Technology compared to current standard of care. This was an open‐labelled, two‐arm, randomised controlled multicentre study conducted from February to December 2023. One hundred and two participants with an exuding, non‐infected and chronic ulcer were randomised in a 1:1 fashion and treated with either a Silicone foam with 3DFit™ Technology or standard of care (a filler combined with a secondary dressing), stratified by venous leg ulcers and diabetic foot ulcers. After a 4‐week study period, wound size and total costs were evaluated. After 4 weeks of treatment, a comparable percentage in wound area reduction was observed in both treatment arms with mean and 95% confidence interval of 54.3% (37.1%; 71.5%) and 43.0% (26.5%; 59.6%) for the investigational and comparator dressing, respectively. This corresponded to a mean difference of 11.3% ([−10.22; 32.86], p = 0.299). Total mean estimated costs were significantly lower for the investigational dressing (£14.3, 95% confidence interval [£9.6; £19.0]) compared to the two‐dressing regime (£21.4 [£16.9; £26.0]), corresponding to a 33% price reduction (p = 0.033) after 4 weeks of treatment. With this RCT, a conforming Silicone foam dressing with 3DFit™ Technology was shown to be clinically comparable and a cost‐effective alternative to using a filler and a secondary dressing at a significantly lower cost in both venous leg ulcers and diabetic foot ulcers up to 2 cm in depth. [ABSTRACT FROM AUTHOR]

Background and Aims: Diabetic foot ulcers are the main complication of diabetes mellitus. There is limited information on the prevalence and factors of diabetic foot ulcers in Ethiopia, particularly to the study setting. The study aimed to assess the prevalence of diabetic foot ulcers and determinant factors among adult diabetic patients who attend the diabetic follow‐up at Adwa General Hospital, Ethiopia, 2019. Methods: An institutional‐based cross‐sectional study was conducted. The data was collected using face to face interviews, direct observation, and a patient's records reviews. Data were cleaned, entered, and analyzed using SPSS version 23. Bivariate and multivariable logistic regression was used to identify factors associated with a diabetic foot ulcer. Finally, p < 0.05 in multivariable logistic regression was used to declare statistical significance. Results: The prevalence of diabetic foot ulcer was 13%. Being a rural residence (AOR = 7.180, 95% CI: 2.663–19.359), oral hypoglycemic medication (AOR = 2.521, 95% CI: 1.001–6.349), medication nonadherence (AOR = 4.480, 95% CI: 1.954–10.269), poor diabetic foot self‐care practice (AOR = 4.350, 95% CI: 1.378–13.731), lost to follow‐up (AOR = 4.838, 95% CI: 1.828–12.801), neuropathy (AOR = 4.938, 95% CI: 1.565–15.580), and alcohol drink (AOR = 4.178, 95% CI: 1.592–10.966) were the determinant factors. Conclusion: The prevalence of diabetic foot ulcer was high. Being a rural residence, oral hypoglycemic medication, medication nonadherence, poor diabetic foot self‐care practice, lost to follow‐up, neuropathy, and alcohol drinks were the determinants of diabetic foot ulcer. Health education on diabetic foot self‐care practice, alcohol drink, and the other determinants are important to prevent diabetic foot ulcer. [ABSTRACT FROM AUTHOR]

Background: Lower extremity raw areas are a common clinical challenge, resulting from diverse etiologies such as trauma, infections, or chronic diseases. This study aimed to evaluate the clinical and microbiological profile of raw areas to enhance understanding and management strategies. Methods: This prospective observational study was conducted at the Himalayan Institute of Medical Sciences, Dehradun, over 12 months. Fifty patients with raw areas in the lower extremities were included. Data collection involved clinical examinations, microbiological evaluations through swab cultures, and assessment of demographic and wound characteristics. Descriptive statistics were used for data analysis. Results: The majority of subjects (31.37%) were aged 21-30 years, with a mean age of 40.78 years. Pallor (33.3%), peripheral edema (17.6%), and cyanosis (7.8%) were prevalent systemic findings. Raw areas were most commonly located on the foot (40.6%) and lower third of the leg (35.9%). Ill-defined margins (59.4%) and unhealthy granulation tissue (76.3%) predominated. Sensorymotor deficits and exposure of bones or tendons were observed in 30.5% and 22.1% of cases, respectively. Conclusion: The study highlights the complex clinical and microbiological nature of lower extremity raw areas, necessitating integrated management approaches. Improved wound care strategies and addressing systemic comorbidities are crucial for optimizing outcomes. [ABSTRACT FROM AUTHOR]

When lovers sense anxiousness in their bodies—and want to "bite each other's heads off," they might go to couples counseling for help with communication. Like parents trying to help siblings "use their words," counselors try to help lovers talk. In couples dance/movement therapy, it is helpful to look at the physiology of language with awareness provided by the method called Chi for Two. Chi for Two—The Energetic Dance of Healthy Relationship was originated by a long-time dance/movement therapist. It synthesizes knowledge of nervous system functioning, infant development, and trauma patterning, which is passed down over generations, plus how the therapeutic relationship shifts attachment styles. Dance/movement therapists who have this knowledge can help lovers recognize when their interactions awaken unfinished infant/parent dances involving the "biting/snapping" rhythm from the Kestenberg Movement Profile system, adapted for Chi for Two. (The authors use the word "lovers" to name people who are engaging in mutually consensual sexual sharing with one another.) The biting/snapping rhythm is key in articulating language. When lovers can recognize what is happening in their bodies during their efforts to use words, they can learn to bring the bite/snap infant movement expressions to dance/movement therapists to work through those moves. When lovers work through the infant movement patterns with the dance/movement therapist in the presence of a romantic partner, but not acted out with the romantic partner, lovers can celebrate their partners' bravery in doing their individual healing and relational re-patterning. [ABSTRACT FROM AUTHOR]

Purpose of Review: Venous leg ulcers (VLUs) are one of the most common forms of chronic wounds and with nearly half the people having recurrent episodes, this significantly impacts a patient's quality of life. As such, VLU is a chronic disease that requires lifelong maintenance and awareness. A correct diagnosis of VLU is essential for management. Recent Findings: VLUs can be of mixed etiology and treatment should be aimed at optimizing the underlying venous hypertension based on its cause. If there is an anatomical venous reflux contributing to the non-healing of the VLU, early treatment of incompetent veins can improve healing rates. Summary: All aspects contributing to the patient's ongoing venous hypertension should be addressed to provide appropriate treatment. This can include venous interventions but also through conservative measures. Patient education and their engagement in their own care is essential for good outcomes. [ABSTRACT FROM AUTHOR]

Purpose: Wounds from assault rifles and their commercial offspring have been encountered with increasing frequency in civilian practice. Our aim is to summarize wound ballistics related to the main injury patterns that can also affect management strategies. Methods: An online search of the PubMed was conducted for research and review articles published after 2000 in English, using the MeSH terms "gunshot wounds", "mass casualty incidents", "war-related injuries", "soft tissue injuries", "vascular system injuries", "colon injuries", "wound infection", "antibiotic prophylaxis", "debridement", "hemorrhage", "penetrating head injuries", "pneumothorax" and additional free-text terms. Other academic databases were also searched for relevant articles and book chapters. Results: Consensus regarding recognition of high energy wounds from assault rifle projectiles is largely based on war experience. Studies of such wounds inflicted by expanding projectiles suggest that their wounding effects significantly increase tissue damage and adverse outcomes following injury, as a result of the temporary cavity and bullet fragmentation. The use of assault rifles in mass shootings has prompted utilization of tourniquet for control of life-threatening hemorrhage, also derived from military experience, while limited evidence indicates that tension pneumothorax rather than extremity wounds is the leading cause of potentially preventable death in these incidents. Conclusions: Wound ballistics provides a system for evaluation of injuries from assault rifles and risk analysis of shooting incidents. Lessons learned from armed conflicts can improve the management of victims, with due consideration given to characteristics of civilian injuries. Further research is required to define the impact on survival by key life-saving procedures in the prehospital setting, in order to prioritize these interventions. [ABSTRACT FROM AUTHOR]

Road traffic injuries remain one of the common and leading causes of death among children and adolescents till the age of 19 years. Road safety is important for children since their physical activity, active travel, independence and development are largely affected by it. Solutions for road safety with benefits for people as well as an economy exist which should be implemented effectively and efficiently. These solutions which combine engineering, legislation and behavioural interventions should be implemented in an integrated Safe Systems Approach. The future of the children must be safeguarded from these injuries and every effort towards it being converted into "bygone figures" must be done diligently and honestly. The various risk factors and interventions possibly explained in this review article shall help in better understanding of the causes and possible guidelines at a policy level to prevent road traffic injuries in children. [ABSTRACT FROM AUTHOR]

Purpose: Understanding the vascular morphology is fundamental for resuscitative endovascular balloon occlusion of the aorta. This study aimed to evaluate the effect of aging on length and diameter of aorta and iliac arteries in trauma patients, and to investigate the predictiveness of anatomical landmarks for aortic zones. Methods: A total of 235 patients in a regional trauma center registry from September 1, 2018, to January 3, 2024, participated in the study. Reconstruction of computed tomography was applied to the torso area. The marginal diameter and length of aorta and iliac arteries were measured. Anatomical landmark distances and aortic marginal lengths were compared. Results: The length and diameter of aorta and iliac arteries increased with age, and a tortuous and enlarged morphology was observed in older patients. There was a good regression between age and diameter of the aorta. Neither the jugular notch, the xiphisternal joint, nor the umbilicus could reliably represent specific margins of aortic zones. The distance between the mid-sternum and femoral artery (427 ± 25 to 442 ± 25 mm for right, and 425 ± 28 to 440 ± 26 mm for left) was predictive for zone 1 in all groups. The distance between the lower one-third junction of the xiphisternum to the umbilicus and femoral artery (232 ± 19 to 240 ± 17 mm for right, and 229 ± 20 to 237 ± 19 mm for left) was predictive for zone 3 aorta. Conclusion: Aging increases the length and diameter of aorta and iliac arteries, with a tortuous and enlarged morphology in geriatric populations. The mid-sternum and the lower one-third junction of the xiphisternum to the umbilicus were predictive landmarks for zone 1 and zone 3, respectively. [ABSTRACT FROM AUTHOR]

Background: Trauma especially road traffic injury is one of the major health-related issues throughout the world, especially in developing countries like India (Mattox 2022). Solid organ injury is the most common cause of morbidity and mortality in patients with blunt abdominal trauma. The non-operative management (NOM) is being consistently followed for hemodynamically stable patients with respect to solid organ injuries. This study aims to provide an evidence base for management modalities of solid organ injuries in blunt abdominal trauma. Aim: The aim of this study is to evaluate the effectiveness of various treatment modalities for solid organ injury in blunt abdominal trauma. Objectives: Evaluating the characteristics of blunt abdominal injury with respect to age and gender; distribution, mode of injury, most common organ injured, and severity of injury; effect of delay in getting treatment on the management outcome for patients with solid organ injury; evaluating the various modalities of treatment of CT-proven solid organ injury; incidence of complications in different modes of treatment. Methods: All patients aged more than 18 years and suffering from CT-proven solid organ injury secondary to blunt abdominal trauma between February 2021 and September 2022 were included in this prospective observational study. Sixty-five patients were enrolled in the study after meeting the inclusion criteria. Details such as age, gender, mechanism of injury, the time between injury to first hospital contact, presenting complaints, organ and grade of injury, Revised Trauma Score (RTS), Trauma Score and Injury Severity Score (TRISS), management, and outcomes were collected using self-designed pro forma and analyzed. Different modalities of treatment were evaluated and patients undergoing operative and non-operative management were compared. Patients in whom non-operative management failed were compared with patients with successful non-operative management. Results: The mean age of patients involved were 36.8 years with a male:female ratio of 7.125:1 and the most common age group affected being between 21 and 30 years. The most common mode of injury was noted to be road traffic accidents (72.3%). The most common presenting complaints were abdominal pain (64.6%) followed by chest pain (29.2%) and vomiting (13.8%). There was no significant relationship between latent period and type of intervention or failure of non-operative management. FAST positivity rate was noted to be 92.3%. Chronic alcoholism and bronchial asthma were significant predictors for patients undergoing upfront surgery (p = 0.003 and 0.006 respectively). The presence of pelvic and spine injury was statistically significant for predicting mortality in polytrauma patients (p = 0.003). Concurrent adrenal injury was found in 24.6% of patients but was not related to failure of non-operative management or mortality. RTS significantly predicts the multitude of organ involvement (p = 0.015). The liver was the most common organ injured (60%) followed by the spleen (52.3%) and the kidney (20%). The liver and the spleen (9.2%) were noted to be the most common organ combination involved. No specific organ or organ injury combination was noted to predict failure of non-operative management or mortality. But the multitude of organ involvement was statistically significant for predicting patients undergoing upfront surgery (p = 0.011). Out of 65 patients enrolled in the study, 7 patients (10.8%) underwent immediate surgery, and 58 patients (89.2%) underwent non-operative management. Among the 68 chosen for non-operative management, 6 patients (9.2%) failed non-operative management and 52 patients (80%) had success of non-operative management. A significant drop in hemoglobin (83.3%) on day 1 (66.6%) was seen to be the commonest reason for failure of non-operative management. The spleen was noted to be the most commonly involved organ intra-operatively (61.5%) followed by the liver (30.8%). Concordance between pre-operative and intra-operative grading of organ injuries was highest for liver and kidney injuries (100%) and lowest for pancreatic injuries (0%). Requirement of blood transfusion and liver injuries were significant factors for failure of non-operative management (p = 0.012 and 0.045 respectively). The presence of pancreatic leak was significant between the non-operated patients and patients operated upfront (p = 0.003). Mortality was noted to be 10.8% (7 patients) in our study. Conclusion: Solid organ injury in blunt abdominal trauma is an important cause of morbidity and mortality. RTS was noted to be a good predictor for solid organ injury in blunt abdominal trauma. Pancreatic injuries are notorious for being under-staged on CT findings; hence, the need arises for multimodality imaging for suspected pancreatic injuries. Non-operative management is a successful modality of treatment for majority of patients suffering from multiple solid organ injuries in blunt abdominal trauma provided serial close monitoring of patient's clinical signs and hemoglobin is instituted along with the presence of an emergency surgery team. [ABSTRACT FROM AUTHOR]

Antiphospholipid syndrome (APS) is a group of rare autoimmune diseases caused by antiphospholipid antibodies that is mainly associated with arterial or venous thrombosis and/or complications during pregnancy. Skin lesions occur in approximately 30% of APS patients as initial manifestations. However, previous studies have primarily focused on the treatment of APS rather than the management of skin lesions. Here, the authors report a case of an APS-related lower limb skin ulcer that had remained unhealed for more than 7 years. The difficulties in this case were the diagnosis of APS, the risk of bleeding during debridement, wound infection, biofilm formation, reduced venous return from the lower limbs, and compliance with compression therapy and follow-up. A three-step wound care regimen based on a multidisciplinary team approach resulted in effective control of APS and healing of the ulcer to the lower leg in 95 days. Over two follow-ups, there was no recurrence of the ulcer. [ABSTRACT FROM AUTHOR]

Background: Burn injuries are among the most complex and life-threatening conditions, involving both local and systemic effects on the body. These injuries can be caused by thermal, electrical, chemical, or radiation sources, each presenting distinct challenges for management and recovery. The pathophysiology of burns involves intricate biochemical processes that affect multiple organ systems, requiring comprehensive medical care to address both immediate and long-term consequences. Aim: This article aims to provide an in-depth exploration of the biochemical aspects, pathophysiology, classification, and treatment modalities of burn injuries, with a particular focus on the nursing care required throughout the recovery process. Methods: A thorough review of the existing literature was conducted to examine the classification, etiology, and biochemical responses to burn injuries, as well as the systemic effects and treatment options. Sources included peer-reviewed journal articles, clinical guidelines, and case studies focusing on burn care. Results: The findings reveal that burn injuries are classified based on the depth of injury and the total body surface area (TBSA) affected. Thermal burns remain the most common, though electrical, chemical, and radiation burns present unique management challenges. The pathophysiology involves a complex inflammatory response, with immediate effects on the skin, vasculature, and immune system. Innovative surgical techniques, such as skin grafting and tissue-engineering approaches, have advanced treatment. Additionally, nursing care remains crucial in managing pain, infection prevention, and rehabilitation. Comprehensive nursing interventions are essential for patient stabilization, wound care, psychological support, and long-term recovery. Conclusion: Burn injuries require multidisciplinary management, with nursing care playing a pivotal role in both immediate and long-term outcomes. Nurses are essential in performing accurate assessments, providing pain relief, ensuring infection control, and offering psychological support. With advancements in burn surgery and rehabilitation, the prognosis for burn victims has improved, but continued research is needed to optimize treatment and recovery processes. [ABSTRACT FROM AUTHOR]

An acid attack is a deliberate act of violence. Sulphuric acid is thrown at a person's face and body with the intention of harming and disfiguring the victim. Sulphuric acid is a dangerous weapon which can cause very serious injuries including severe skin damage, blindness, significant disfigurement and/or permanent disability. We report the case of Ioanna, a 34-year-old woman who was attacked with vitriol by a jealous woman in May 2020. Following her admission to hospital, where Ioanna was an inpatient for 85 days, she underwent nine operations. Since her discharge she has undergone ten more, with further interventions likely in the future. In addition, she has undergone various treatments and procedures to restore her skin. Ioanna's courage and strength has inspired thousands of young children and adults who cope with a variety of health problems. [ABSTRACT FROM AUTHOR]

Chronic wounds represent a persistent clinical challenge due to prolonged inflammation and impaired tissue repair mechanisms. Cannabidiol (CBD), recognized for its anti-inflammatory and pro-healing properties, shows therapeutic promise in wound care. However, its delivery via lipid nanoparticles (LNPs) remains challenging due to CBD's inherent instability and low bioavailability. This study developed and characterized a novel hydrogel scaffold composed of CBD-loaded LNPs (CBD/LNPs) integrated into a polyvinyl alcohol (PVA) and sodium alginate (SA) matrix, designed to enhance wound repair and mitigate inflammation. The characteristics of the hydrogel scaffold were observed including the degree of swelling and LNPs' release profiles. Furthermore, in the results, CBD/LNPs displayed enhanced stability and reduced cytotoxicity compared to unencapsulated CBD. In vitro assays demonstrated that CBD/LNPs significantly promoted fibroblast migration in gap-closure wound models and reduced intracellular reactive oxygen species, supporting their potential as a biocompatible and efficacious agent for cellular repair and oxidative stress attenuation. In vivo experiments using adult male Wistar rats with aseptic cutaneous wounds revealed that treatment with CBD/LNP-PVA/SA hydrogel scaffold significantly accelerated wound closure relative to blank hydrogel controls, demonstrating a substantial reduction in the wound area over time. Histological analysis confirms notable improvements in skin morphology in wounds treated with CBD/LNP-PVA/SA hydrogel scaffold with evidence of accelerated epithelialization, enhanced collagen deposition, and increased dermal thickness and vascularization. Additionally, skin histology showed a more organized epidermal layer and reduced inflammatory cell infiltration in CBD/LNP-PVA/SA hydrogel scaffold-treated wounds, corresponding to a 35% increase in the wound closure rate by day 28 post-treatment. These findings suggest that CBD/LNP-PVA/SA hydrogel scaffolds facilitate inflammation resolution and structural wound healing through localized, sustained CBD delivery. The dual anti-inflammatory and wound-healing effects position CBD/LNP-PVA/SA hydrogel scaffold as a promising approach for chronic wound management. Future investigations are warranted to elucidate the mechanistic pathways by which CBD modulates the skin architecture and to explore its translational applications in clinical wound care. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Veterinary Medical Research is the property of Beni Suef University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Traumatic brain injury (TBI) refers to a disruption in brain function or evidence of brain pathology caused by external physical forces. Globally, TBI affects approximately 50 million individuals annually, with nearly half of the population experiencing it at some point in their lives. Severe TBI is associated with a high mortality rate (30-40%) and long-term physical, psychological, and social impairments in up to 60% of cases. TBI ranges from scalp injuries to severe intracerebral damage, with severity assessed by injury severity scores and consciousness levels (Glasgow coma scale). Diffuse axonal injuries (DAI) cause minimal anatomical damage with severe loss of consciousness, affecting treatment and prognosis. Current Concepts: TBI treatment focuses on hemostasis and intracranial pressure (ICP) management to achieve the main goal of preventing secondary brain injury. Early avoidance of hypotension and hypoxia is crucial. Recent advancements include: first, multimodal brain monitoring by utilizing invasive and non-invasive ICP methods, brain oxygenation measurement, and cerebral blood flow assessments for early detection and treatment guidance; second, using biomarkers for TBI (such as GFAP, S100B, NSE, NFL, UCH-L1, and IL-1β) for diagnosis and prognosis prediction; third, target temperature management in which hypothermia therapy reduces ICP and controls inflammation; and fourth, investigating novel pharmacological therapeutics like corticosteroids, progesterone, erythropoietin, amantadine, and anticonvulsants, although several large-scale trials have revealed a lack of significant benefits. Discussion and Conclusion: TBI remains a leading cause of mortality with unresolved challenges. Research has focused on optimizing neuro-intensive care protocols, developing evidence-based surgical treatments, and exploring promising neuroprotective pharmacotherapies. Given TBI's pathological heterogeneity, personalized medicine and combination therapies are crucial, as no single treatment addresses all mechanisms. Advancements in monitoring technologies and biomarker development are expected to significantly enhance diagnosis, prognosis prediction, and tailored treatment strategies. [ABSTRACT FROM AUTHOR]

Background: Trauma remains a significant public health challenge in Korea, with preventable trauma-related death rate declining from 45% in 1999 to 13.9% in 2021 following advancements such as the establishment of regional trauma centers in 2012. This preventable trauma-related death rate in South Korea remains higher than that in advanced nations, highlighting the need for further refinement of trauma care. This article reviews the recent advancements and updated guidelines for prehospital emergency care and in-hospital trauma management, emphasizing evidence-based, patient-centered approaches. Current Concepts: In the prehospital phase, early and aggressive hemorrhage control is prioritized, with techniques such as tourniquet application, wound packing, and permissive hypotension becoming standard. Innovations, such as intraosseous vascular access and tranexamic acid administration, have improved outcomes. The emphasis on structured assessments, including the circulation, airway, and breathing (CAB) assessment, reflects the importance of controlling life-threatening hemorrhages. In the in-hospital phase, bleeding control is the central focus, with protocols established to emphasize the cautious use of fluids to avoid over-resuscitation and worsening coagulopathy. Efficient transfusion strategies are prioritized to address hypovolemia while maintaining balanced ratios of blood products. Additionally, streamlined interfacility transfer systems and improved communication tools, such as the situation, background, assessment, and recommendation (SBAR) tool, help to optimize patient care and minimize delays in receiving definitive treatment. Discussion and Conclusion: This review underscores the need to adopt advanced strategies that align with international standards and further reduce preventable trauma-related deaths. Enhanced education and resource allocation for prehospital and hospital-based trauma care are crucial for achieving these goals. [ABSTRACT FROM AUTHOR]

Bullous pemphigoid (BP) is a rare, chronic, inflammatory, subepidermal, blistering disease that primarily affects older people (Chan, 2020). The blisters are usually filled with clear fluid and the surrounding skin is often red and inflamed. These blisters can appear anywhere on the body but are typically found on the lower abdomen, groin, upper thighs and arms. The prevalence of BP has doubled in 20 years, due to population ageing and other factors (Persson et al, 2021a). This article provides details of the latest guidelines, explains what can trigger BP, and how it is diagnosed and treated. [ABSTRACT FROM AUTHOR]

Nitric oxide (NO) is one of the most studied molecules in medical science. The role of NO as an endogenous regulator of inflammation, as an antibacterial agent and as an endogenous gasotransmitter is well established. Even so, despite a plethora of excellent wound healing data, hard-to-heal (chronic) wounds are of epidemic proportions, and still growing in number. However, yet to be established and sorely needed is the identification of a single, continuous NO mechanism of action (MoA), where phase-to-phase variance in the complex sequence of cellular and molecular wound healing may elucidate the potential for placing hard-to-heal wounds on positive healing trajectories. Hence, the objectives of this review were to: identify salient MoAs for NO in each phase of skin wound healing; and to select and validate a single MoA that is both ubiquitous and continuous in NO across acute and hard-to-heal wound sequences, and which potentiates the ability to supplementally motivate and guide the recovery of a hard-to-heal wound onto a positive healing trajectory. The search began by selecting a detailed, multipart wound healing model. Next, as guided by the literature, was the identification of salient NO functionalities for each model segment. These modes of action were then be used to identify and validate a single NO MoA that is continuous across the healing spectrum. Finally, by using the principle of 'super position' of two continuous functions, this acute healing NO MoA solution was compared to a similar solution set describing a hard-to-heal or chronic wound. As both solution sets are continuous in a NO function, the resultant 'overlay' then helped to identify and guide the use of a NO MoA capable of placing any hard-to-heal wound on a positive healing trajectory. [ABSTRACT FROM AUTHOR]

Hard-to-heal (chronic) wounds are a challenge to wound care professionals, a burden to the health service and negatively impact affected individuals' quality of life. They also consume a great deal of healthcare resources globally and are found in all settings, including prisons. Therefore, the evaluation of wound care services is essential in order to develop an awareness of where improvement can be made. The main aim of this point prevalence study was to gather data on wounds, wound aetiology and wound management in a Maltese correctional facility. A secondary aim was to compare current practice with the best evidence-based practice and clinical practice guidelines, in order to provide a set of recommendations which can be implemented to improve the service. A retrospective study was carried out, auditing the medical records of people with justice involvement. The results of the audit reported a low prevalence of wounds. While practice met existing standards, for example, no unnecessary wound swab was taken, several shortcomings in wound management were noted. To improve adherence to the clinical guidelines in conjunction with improving the quality of the current service offered in the wound clinic, a number of short- and long-term clinical recommendations were proposed including: the incorporation of pain assessment tools and C-reactive protein blood testing for identifying infection; early referral to specialised care for individuals with diabetic foot ulcers, as well as the necessity for proficient personnel specialising in wound management training. [ABSTRACT FROM AUTHOR]

Objective: The most common severe exfoliative condition is toxic epidermal necrolysis (TEN), also known as Lyell's syndrome, for which patients may sometimes require admission to hospital burns units. This study analyses the experience of the authors and results in this condition at the Cruces University Hospital in Bilbao, Spain. Method: Over the last 22 years, the authors carried out a retrospective analytical observational study of TEN cases at the hospital and analysed risk factors including age, associated comorbidities, percentage of body surface area affected, positive bacterial culture, and treatment strategies used to assess their potential influence on prognosis. Results: The results indicated an association between mortality and age (ρ (rho)=0.60, 95% CI [0.29, 0.79], p<0,001), ocular (ρ=0.58, 95% CI [0.28, 0.78], p<0.001), oropharyngeal (ρ=0.64, 95% CI [0.36, 0.81], p<0.001), genitourinary (ρ=0.58 CI [0.28, 0.78], p<0.001) respiratory mucosa involvement (ρ=0.53, 95 % CI [0.28, 0.78], p<0.001) and bacteraemia (ρ=0.44, 95% CI [0.17, 0.64], p=0.020). Bacteraemia also showed a higher incidence in elderly patients (ρ=0.4, 95% CI [0.03, 0.67], p=0.033) and in those with a higher Score for Toxic Epidermal Necrolysis at admission (ρ=0.51, CI [0.17, 0.74], p=0.006). A reduction in mortality was found in patients who received systemic treatment; cyclosporine, etanercept or a combination of both (ρ=-0.44, Cl [-0.70, -0.09], p=0.018). Conclusion: TEN is a rare but serious exfoliative condition. Traditionally, management of denuded skin was seen as the main prognostic factor; yet, systemic damage, especially to the respiratory mucosa, significantly increases mortality risk. While life support is crucial and recovery is possible, preventing long-term sequelae relies on effective care protocols. Current treatments may offer benefits, though their efficacy remains unclear. Clinicians in burns units should develop standardised protocols and collaborate on long-term studies to enhance patient care. [ABSTRACT FROM AUTHOR]

Objective: To quantify race, sex, comorbidities, Medicaid status, and compare health outcomes for Medicare-only versus Medicare/Medicaid dual-enrolees who developed a hard-to-heal venous leg ulcer (VLU). Method: Medicare Limited Data Standard analytic hospital inpatient and outpatient department files were used to follow episodes of medical care for a VLU from 1 October 2015–2 October 2019. In an earlier study, patients diagnosed concurrently with chronic venous insufficiency and a VLU were propensity-matched. In this current work, cohorts were split into patients enrolled in Medicare-only and those enrolled in Medicare and Medicaid (dual-enrolees). Treatment methods were compared and the most commonly used cellular, acellular and matrix-like product (CAMP) among Medicare beneficiaries—dehydrated human amnion chorion membrane (DHACM)—was evaluated. Episode claims were used to document demographics, comorbidities and treatments of Medicare enrolees who developed VLUs and outcomes such as time to ulcer closure, rates of complications and hospital usage rates. Quality of life (QoL) metrics, such as pain and time to VLU closure, were compared across the groups. Results: Of the 555,284 Medicare beneficiaries evaluated in this analysis, 27% were Medicare/Medicaid dual-enrolees and 73% were Medicare-only enrolees. To qualify for Medicaid, patient income had to be ≤133% of the federal poverty level. Only 3% of Medicare-only patients and 6% of dual-enrolees had an Advantage plan, a lower rate than the general Medicare population. Dual-enrolees, compared to those covered by Medicare-only, demonstrated: a Charlson Comorbidity Index (CCI) score one point greater (p<0.0001); a higher percentage (16%) of patients from minority ethnic backgrounds; and significantly higher rates of emergency department visits (p<0.0001) and cellulitis (p=0.034). Dual-enrolees who received early and regularly applied CAMPs also reduced their treatment time by 21 days (p=0.0027), all of which can impact costs. Conclusion: The socioeconomic status of dual-enrolees included near poverty status, a higher percentage of patients from a minority ethnic background, and high rates of comorbidities compared to their Medicare-only counterparts. The VLUs of dual-enrolees took longer to close, developed more complications, and used significantly more hospital resources and expenses. Outcomes significantly improved when VLU episodes were treated with a CAMP, such as DHACM, while following parameters for use. Socioeconomic variables are associated with poor outcomes for patients with hard-to-heal (chronic) wounds. This should be tracked to find cost-effective interventions throughout their journey to provide equitable care and ensure they are not left behind. Greater access for dual-enrolees to CAMPs has the potential to improve clinical outcomes and patient QoL, while concomitantly reducing overall healthcare expenditure. [ABSTRACT FROM AUTHOR]

Wound healing is a series of complex and dynamic processes which occur in several stages. Optimal wound healing is essential for restoring the integrity and function of the affected area. Although medicated wound dressings have been extensively employed to control wound infection, the risks associated with antimicrobials make the use of non-medicated alternatives necessary. Nevertheless, the relationship between the concentrations of medicated wound dressings and their antimicrobial activities, along with their wound healing efficacies, still remains unclear. Non-medicated wound dressings are an alternative to dressings that contain active ingredients acting as antimicrobials or antiseptics. In the present study, the researchers examined the reduction of bacterial load as the primary endpoint and the healing rate as the secondary endpoint, comparing microporous ceramic dressings to silver-impregnated dressings in participants from two outpatient wound management clinics. The study included 25 participants in the silver-impregnated dressing (control) group and 28 participants in the ceramic dressing (study) group. The participants' wounds were assessed through MolecuLight i:X (MolecuLight Inc., Canada) wound tracing and MolecuLight i:X fluorescence imaging to measure the wound size, as well as presence of a bacterial load of >104 colony forming units/g at weeks 1, 2, 3 and 4. The results indicated that there was a significant difference in the distribution over the categories of bacterial load cleared after weeks 1, 2, 3 or 4 in the two groups. Moreover, the bacterial load cleared significantly faster in the study group (p=0.001). Mean wound size was 10.93cm2 (range: 0.10–37.95cm2) in the control group and 11.48cm2 (range: 0.80–60cm2) in the study group. In the maximum likelihood regression analysis, the mean reduction in wound area for the study group was greater than that for the control group. The study concluded that the ceramic dressings could be an effective alternative to silver-impregnated dressings when treating infected wounds. [ABSTRACT FROM AUTHOR]

Objective: Studies have suggested that ozone therapy stimulates antioxidant enzyme expression and activity, regulates growth factor production, increases local blood flow and provides antibacterial protection. We sought to analyse the evidence related to the use of ozone therapy in the treatment of diabetic foot ulcers (DFUs). Method: A systematic review and meta-analysis was conducted using published clinical trials indexed in the PubMed, Embase and Web of Science databases up to December 2020. Outcomes analysed included: number of ulcers cured; ulcer area reduction; length of hospital stay; changes in blood glucose levels; antioxidant activity; and number of amputations. Results: Initially, 61 studies were identified; however, only six met all of the eligibility criteria for inclusion in the final sample. It was found that patients receiving ozone therapy displayed higher rates of healing (i.e., healed ulcers), shorter hospital stays, increased catalase activity and reduced blood glucose levels. There was an observed increase in the number of ulcers healed; however, there was a considerable risk of bias in the studies evaluated. Conclusion: Although many studies have suggested ozone therapy as a promising candidate in the treatment of DFUs, further research is required, with a better scientific outline, to validate the results. [ABSTRACT FROM AUTHOR]

Frostbite, defined as tissue freezing due to cold weather exposure, is a major risk associated with mountaineering in cold climates. It represents a significant source of morbidity in the climbing population. In 2021, three individuals were evaluated at a single institution after developing frostbite while climbing Denali, Alaska, US. The affected patients were healthy men in the third to sixth decade of their lives, and all experienced frostbite injuries involving the fingers. Among the patients, one individual was unable to descend from the mountain due to the severity of his condition and required medical evacuation. The other men were able to descend without significant difficulty. After leaving the mountain, the patients were treated with thrombolysis, pentoxifylline, hyperbaric oxygen therapy, and/or regional sympathetic blockade. Exposure to cold weather, ascent to high altitudes, and increased mechanisms of heat loss were likely potential risk factors for frostbite injury in these patients. Psychological factors related to the COVID-19 pandemic may have also impacted these individuals' risk for frostbite injury. Prevention is the most effective way to avoid frostbite, and knowledge and understanding of the risks associated with the development of this condition may reduce future occurrences among mountaineers. Since frostbite is not a common diagnosis encountered in patients treated in outpatient wound centres, physicians should maintain awareness of the pathophysiology and treatment options for this condition. [ABSTRACT FROM AUTHOR]

Objective: Diabetic foot ulcer (DFU) is a common complication in patients with diabetes. With current treatment, only two-thirds of patients heal, with a median duration of 3–6 months. Hard-to-heal DFUs are a major source of morbidity and mortality. Improving wound healing via soft tissue reconstruction may be the key to improving clinical outcomes. Thus, the Diabetic Limb Salvage (DLS) service in Sengkang General Hospital, Singapore, was established to provide patients with a streamlined, one-stop, comprehensive service dedicated to DFU soft tissue reconstruction. The reconstruction was carried out using secondary closure, skin grafting, local flaps or free flaps, depending on the severity of the wound and patient suitability. This study aims to audit the early outcomes of the DLS service. Method: Patients with DFUs treated by the DLS service were compared with patients with DFUs treated prior to the launch of the DLS service (control). Outcomes including major and minor amputation rates, wound healing rate, mortality and DFU recurrence rates were analysed statistically. Results: A total of 103 patients took part in the study (50 in the DLS service cohort and 50 in the control cohort). There was no significant difference in demographics, comorbidities and wound profiles between the two cohorts. All (100%) patients in the DLS service cohort received soft tissue reconstruction versus only 13% in the control group. The DLS service cohort had a significantly higher healing rate (96% versus 68%, respectively), shorter healing duration (77±30 days versus 111±43 days, respectively), reduced major amputation rate (0% versus 9%, respectively), and reduced recurrence rate (6% versus 25%, respectively) compared with the control cohort within the one-year follow-up. Conclusion: The findings of this study showed that an orthoplastic multidisciplinary approach focused on DFU soft tissue reconstruction improved wound healing rates, shortened healing duration and, as a result, lowered amputation rates and reduced recurrence. [ABSTRACT FROM AUTHOR]

Objective: Negative pressure wound therapy (NPWT) and hyperbaric oxygen therapy (HBOT) have been widely used in the treatment of hard-to-heal (chronic) wounds, but there is still a lack of sufficient evidence for their combined use for the treatment of hard-to-heal wounds. This systematic review aimed to identify the clinical efficacy and safety of adding adjunctive HBOT to NPWT for hard-to-heal wounds. Method: Embase, PubMed, Cochrane Library, Web of Science, China National Knowledge Infrastructure and Wanfang were searched from the establishment of the database to March 2022. The literature was screened according to the inclusion criteria and exclusion criteria. We assessed the quality of each included study with the Cochrane Collaboration Risk of Bias tool and Newcastle–Ottawa Scale. A meta-analysis was performed using R programming software version 4.1.0 (R Project for Statistical Computing, US). The PRISMA 2020 guidelines were used to report data from systematic reviews and meta-analysis. Results: A total of 15 studies were identified, including nine randomised clinical controlled trials and six retrospective studies. Meta-analysis results showed that NPWT combined with HBOT had better outcomes compared with the NPWT alone with regards to: wound healing rate (odds ratio (OR)=6.77; 95% confidence interval (Cl): 3.53–12.98; p<0.0001); bacterial positive rate of wound (OR=0.16; 95% CI: 0.05–0.55; p=0.0037); wound healing time (mean difference (MD)= –3.86; 95% Cl: –5.18 – –2.53; p<0.0001); wound area (standardised mean difference (SMD)=1.50; 95% Cl: 0.35–2.65; p=0.0104); hospitalisation time (MD= –3.14; 95% Cl: –4.93 – –1.36; p=0.005); and hospitalisation cost (OR= –202.64; 95% Cl: –404.53 – –0.75; p=0.0492). There was no significant difference in pain score (MD= –0.43; 95% Cl: –1.15–0.30; p=0.25). Conclusion: The findings of this study demonstrated that adjunctive HBOT with NPWT is safe and effective in the treatment of hard-to-heal wounds. However, these findings should be interpreted with great caution given the limitations of the studies included. [ABSTRACT FROM AUTHOR]

Objective: Burns to the hand are a common injury in paediatrics and can be traumatic to children, both physically and psychologically. Timely conservative or operative management is critical to maximise healing and minimise long-term complications in these young patients. Here, we present the cases of patients treated with a novel skin substitute formed into a prefabricated glove. The glove (PermeaDerm, Inc., US) is a bioactive matrix composed of a silicone composite membrane embedded with collagen and aloe extract with variable porosity that allows moisture to pass to a secondary dressing. To our knowledge, our group was the first to treat a small set of paediatric patients with hand burns with the glove. Method: A chart review was conducted to analyse hospital course, treatment length, complications and outcomes for each patient. Results: The age range of the five patients included in this case series was seven months to three years. All five patients had scald burns to the hand. Overall, healing with the glove was successful, with little scarring or altered skin pigmentation, and a full range of motion at the affected joints. Conclusion: Hand burns in paediatric patients are traumatic and cumbersome to the patient and their families. This bioactive matrix glove allows for a one-time application, decreases operating room time and need, and reduces the demand for multiple dressing changes. In our set of five patients, the glove showed promising results as a safe and effective noninvasive treatment option for hand burns in paediatric patients. [ABSTRACT FROM AUTHOR]

To address the unique challenges of diabetic wound healing, wound dressings, particularly multifunctional hydrogels have garnered considerable interest. For the first time, a novel environmentally friendly soy protein‐based hydrogel is developed to accelerate the healing of diabetic chronic wounds. Specifically, this hydrogel framework is in direct formation through the dynamic Schiff base between oxidized guar gum and epigallocatechin‐3‐gallate (EGCG)‐modified soy protein isolate. Meantime, the addition of Ag+ enhances the cross‐linking of the hydrogel network by forming metal‐ligand bonds with the catechol groups in EGCG. Interestingly, the stretchability (up to 380%), swelling, and rheology properties of the hydrogel can be controlled by fine‐tuning the density of metal‐ligand bonds, endowing them with a high potential for precise matching. Additionally, various dynamic bonds endow hydrogel with excellent self‐healing ability, adhesiveness, and injectability. This hydrogel also exhibits good antibacterial properties, biocompatibility, and cell migration capabilities. Both in vivo and in vitro experiments demonstrated the outstanding anti‐inflammatory capacity of the hydrogel and its ability to modulate macrophage polarization. Consequently, the hydrogel has proven effective in promoting wound healing in a diabetic full‐thickness wound model through enhanced angiogenesis and collagen deposition. This eco‐friendly plant protein hydrogel offers a sustainable solution for wound care and environmental protection. [ABSTRACT FROM AUTHOR]

The retrograde approach is an adjunctive technique for endovascular intervention, particularly in the treatment of lower extremity arterial disease with multilevel vascular lesions. Combined with revascularization therapy, wound care plays a pivotal role in the management of patients with chronic limb-threatening ischemia. We present a case of chronic limb-threatening ischemia, with complex multilevel vascular lesions successfully treated using a retrograde endovascular approach alongside aggressive wound care management. Postintervention, the patient demonstrated a notable increase in ankle-brachial index from 0 to 1, along with accelerated wound healing and preservation of limb function. This case highlights the efficacy of the retrograde approach in restoring perfusion, particularly in chronic total occlusions, and emphasizes the importance of combining revascularization and wound care for optimal chronic limb-threatening ischemia management.

Background: Assessing clinical nurses’ wound management skills for diabetic patients is crucial for providing high-quality care. Improper handling of diabetes care can have serious repercussions, including foot sores or leg amputations. Aim: The aim of this study was to assess clinical nurses’ competency in diabetes wound care. Materials and Methods: A descriptive cross-sectional study design was chosen. Self-administered, content-validated questionnaires and observational checklists were used to gather data on clinical nurses’ proficiency on wound management. Convenience sampling was used to select 127 nurses as a representative sample. The Statistical Program for Social Sciences (SPSS) version 23.0 was utilized for data analysis, and Pearson’s Chi-square test (0.05) was employed to conduct an inferential analysis with a significance level of 5%. Results: In this study, 35.4% of respondents were between the ages of 38 and 47; 70.1% were females, and 55.2% were married. Approximately 31.5% of the population were registered nurses, while 28.3% had a bachelor’s degree in nursing. Remarkably, 37% of those surveyed also work in hospital surgical wards, and 95.2% of them have extensive understanding of diabetic patient wound care. The majority of the participants attest that there is not enough time to provide diabetics patients with thorough wound care. In addition, 36.2% of nurses accurately record the wound’s features during the assessment and dressing steps. However, the ground mean of clinical nurses’ proficiency in diabetics patients’ wound management was found to be average with X̅ = 2.79, standard deviation = 1.306. Moreover, a noteworthy correlation has been observed between the proficiency of clinical nurses in wound care and their corresponding experience levels (χ2 = 23.62, df = 4, and P ˂ 0.05). Conclusions: We found an average degree of proficiency and competency among clinical nurses. The study suggests that regular training, workshops, and evaluations be held, and that diabetes wound care is included in the nursing curriculum.

This study evaluated the clinical efficacy of the coronally advanced lingual flap (CALF) technique in terms of the extent of lingual and buccal flap advancement, the maintenance of primary wound closure, and safety in comparison to buccal flap advancement alone during horizontal ridge augmentation in the posterior mandible. A total of 14 patients were randomly allocated to two different groups: buccal flap advancement without the CALF technique (control), referred to as the NO-CALF group, and buccal flap advancement with the CALF technique (test), referred to as the CALF group. Wound healing was monitored weekly for the first 4 weeks, then at 2, 4, 6, and 9 months postoperatively for any sod tissue dehiscence (titanium mesh [TM] exposure) along the incision line. The extent of lingual and buccal flap advancement was measured, and any intraoperative and postoperative CALF-related complications were reported. The difference between groups was statistically significant (P < .0001) in terms of (1) TM exposure: 83.3% of cases in the NO-CALF group showed early Class П exposures, whereas the CALF group showed no exposure; (2) mean lingual flap advancement: 3.9 ± 1.1 mm and 14.4 ± 3.8 mm for the NO-CALF and CALF groups, respectively; and (3) mean buccal flap advancement: 15.8 ± 2.1 mm and 10.5 ± 1.4 mm for the NO-CALF and CALF groups, respectively. There were no reported complications related to the CALF technique. Tension-free primary wound closure was facilitated and maintained during the healing period by applying the CALF technique, which is a reliable technique to safely advance the lingual flap coronally. [ABSTRACT FROM AUTHOR]

Resumen: La cirugía dermatológica asocia un riesgo de complicaciones muy bajo. No existe un protocolo universalmente aceptado sobre las recomendaciones de curas poscirugía dermatológica. En esta revisión narrativa, discutimos la evidencia sobre productos y procedimientos para el cuidado de la herida quirúrgica. En general, encontramos escasos estudios y en muchas ocasiones, falta de diferencias estadísticamente significativas, posiblemente dada la baja tasa de complicaciones. Discutimos la evidencia sobre cuándo iniciar las curas y su frecuencia, el tipo de ungüento a aplicar, los antisépticos y el tipo de apósito a utilizar. Pese a los escasos estudios sobre las curas tras cirugía dermatológica, existe evidencia suficiente para desaconsejar la utilización de antibióticos tópicos profilácticos. También analizamos la evidencia publicada sobre el cuidado de la herida quirúrgica en situaciones especiales, como son los injertos cutáneos, las zonas dadoras de injertos cutáneos de espesor parcial, los xenoinjertos/biomembranas y las heridas quirúrgicas en las piernas. Abstract: Dermatologic surgery is associated with a very low risk of complications. There is no widely accepted, evidence-based protocol with recommendations for postoperative wound care after dermatologic surgery. In this narrative review, we will be discussing the evidence on surgical wound care products and procedures. Overall, we found relatively few studies and, in many cases, a lack of statistically significant differences, possibly because of the low rate of complications. We’ll be discussing the evidence on when we should initiate wound care procedures and their frequency, the type of ointment and antiseptics that should be applied, and the type of dressings that should be used. Despite the very few studies available on postoperative wound care following dermatologic surgery, there is sufficient evidence as to not recommend the use of prophylactic topical antibiotics. We also analyze the currently available evidence on surgical wound care in special situations, such as management of skin grafts, partial skin graft donor sites, xenografts/biomembranes, and surgical wounds to the legs.

Evelyn J Rizzo,1 Peter J Mallow,2 Aidan Jeffrey Noble,3 Kevin Foster4 1Mobility HEOR, Akron, OH, USA; 2Department of Health Services Administration, Xavier University, Cincinnati, OH, USA; 3The Ohio State University, Columbus, OH, USA; 4Arizona Burn Center, Valleywise Health, Phoenix, AZ, USACorrespondence: Evelyn J Rizzo, Email evelyn@mobilityheor.comAbstract: Over 40,000 patients in the United States (US) require hospitalization for burns annually. The treatment regimen can cost more than &dollar;6,000 a day and requires the use of numerous supplies to ensure the graft takes for successful wound healing. Irrigation of the wound is a critical step for burn treatment, yet little is known about the cost-effectiveness of different irrigation modalities. In a recent study, pure hypochlorous acid preserved wound cleanser (pHA) was shown to be safe and effective compared to mafenide. This study estimated the associated costs of two common wound irrigation modalities, pHA and mafenide solution, for the treatment of patients with burns. In this study, a patient-level Monte Carlo simulation model using data from a randomized control trial (RCT) was used to conduct the cost analysis from the US Hospital perspective. Based upon 100,000 simulated patients, pHA was expected to save &dollar;133 (&dollar;123 to &dollar;144, 10th to 90th percentile) for the hospital compared to using a mafenide solution over 14 days. Adoption of pHA should be considered a cost-saving strategy when treating patients with burns.Keywords: wound care, burn irrigation, economic evaluation

Abstract Background The care of wounds is an ongoing issue for Indigenous people worldwide, yet culturally safe Indigenous wound care training programs for rural and remote Australian Aboriginal Health Workers are largely unavailable. The higher prevalence of chronic disease, lower socioeconomic status and poorer access to services experienced by Aboriginal and Torres Strait Islanders compared to non-Indigenous people, leads to a greater incidence of chronic wounds in Aboriginal and Torres Strait Islander people. Identifying the barriers and enablers for delivering wound care will establish areas of need for facilitating the development of a specific wound care program for Aboriginal Health Workers and Aboriginal Health Practitioners. This paper reports the first phase of a larger project directly aligned to the Indigenous Australians’ Health Program’s objective of supporting the delivery and access to high quality, culturally appropriate health care and services to Aboriginal and Torres Strait Islander Australians. This study aimed to examine experiences of Aboriginal Health Workers, Aboriginal Health Practitioners, and nurses for managing chronic wounds within rural and remote Aboriginal Medical Services in Queensland, Australia. Methods Yarning facilitated by two Aboriginal researchers among Aboriginal Health Workers, Aboriginal Health Practitioners, and nurses currently employed within four Aboriginal Medical Services located in rural and remote areas of Queensland, Australia. Results Two themes were developed through rigorous data analysis of yarning information and responses: participants’ experiences of managing wounds and barriers and enablers to effective wound care. Conclusions This study contributes an insight into the experiences of Aboriginal Health Workers on the current barriers and enablers to timely treatment of chronic wounds. Results from this study indicate a significant barrier to obtaining timely and effective wound care in regional and remote settings is access to an appropriately skilled, culturally competent, and resourced health work force. A lack of education and professional development for Aboriginal Health Workers can compromise their ability to maximise patient outcomes and delay wound healing. Findings have informed the development of an evidence based, culturally competent open access chronic wound care education program for Aboriginal Health Workers.

Abstract Background The increasing use of telemedicine (TM) represents a major shift for health workers and patients alike. Thus, there is a need for more knowledge on how these interventions work and are implemented. We conducted a qualitative process-evaluation alongside a larger randomized controlled trial designed to evaluate a telemedicine follow-up intervention for patients with a leg- or foot-ulcer, who either have or do not have diabetes. Accordingly, the aim of this study was to explore how both health care professionals and patients experienced the implementation of TM follow-up in primary care. Methods The intervention comprised an interactive TM platform facilitating guidance and counselling regarding wound care between nurses in primary care and nurses in specialist health care in Norway. Nurses and patients from seven clusters in the intervention arm were included in the study. We conducted 26 individual interviews (14 patients and 12 nurses) in primary care between December 2021 and March 2022. Thematic analyses were conducted. Results The analyses revealed the following themes: (1) enhancing professional self-efficacy for wound care, (2) a need to redesign the approach to implementing TM technology and (3) challenging to facilitate behavioral changes in relation to preventive care. As to patients’ experiences with taking part in the intervention, we found the following three themes: (1) experience with TM promotes a feeling of security over time, (2) patients’ preferences and individual needs on user participation in TM are not met, and (3) experiencing limited focus on prevention of re-ulceration. Conclusions TM presents both opportunities and challenges. Future implementation should focus on providing nurses with improved technological equipment and work on how to facilitate the use of TM in regular practice in order to fully capitalize on this new technology. Future TM interventions need to tailor the level of information and integrate a more systematic approach for working with preventive strategies. Clinical trial registration NCT01710774. Registration Date 2012-10-17.

The global interest and substantial challenges on this subject contribute to its relevance. This analysis centers on the implementation of artificial intelligence within the medical field, with a specific focus on its application in managing wounds. Through an examination of numerous online studies and publications, we can gain insight into how artificial intelligence is being employed to enhance the diagnosis, treatment, and monitoring of wound healing. The integration of artificial intelligence in this sector has the capacity to transform medical practice by improving precision, effectiveness, and individualized patient care. As a result, it is a leading area of research and advancement on a global scale. We used the PubMed and Google Scholar electronic databases of medical publications, searching for abstracts using the following key phrases: artificial intelligence and wound management, artificial intelligence and gunshot wounds, artificial intelligence and war medicine, artificial intelligence and surgery. Based on search results, a literature analysis was performed. Conclusions. It is necessary to create numerous working groups of highly qualified specialists from each discipline and direction of medical activity, where the specific weight of each symptom, laboratory indicator, each radiological and ultrasound examination result is determined based on the data of real cases. And such work should have no less discipline and structure than medical research, it is optimal to get a universal software tool for this stage of work, which can be used with certain variations for the whole variety of pathological conditions and processes.

Objective: We conducted this meta-analysis to explore the risk factors and incidence of deep surgical site infections (DSSIs) after orthopaedic trauma surgery. Methods: A systematic search was conducted across various databases, including MEDLINE, Embase, Cochrane Library, and Web of Science, for studies examining risk factors associated with DSSIs after bone trauma procedures. The search concluded on September 1, 2024. Data analysis was performed using Stata 15.0. Results: Among 2,722 publications screened, 16 studies that met the eligibility criteria were included in the analysis, involving a total of 22,318 patients, of whom 894 experienced DSSIs. The meta-analysis revealed a combined incidence of deep infections after orthopedic trauma surgery at [ES = 6.7%, 95% CI (5.1%–8.2%)]. Risk factors identified included male gender [OR = 1.99, 95% CI (1.39, 2.86), p < 0.0001], current smoking status [OR = 2.60, 95% CI (1.85, 3.65), p < 0.0001], open injuries [OR = 3.17, 95% CI (1.72, 5.85), p < 0.0001], a BMI greater than 26.0 kg/m2 [OR = 1.95, 95% CI (1.24, 3.07), p = 0.004], wound class ≥ 2 [OR = 2.40, 95% CI (1.56, 3.70), p < 0.0001], and a surgery duration of 60 min or more [OR = 2.41, 95% CI (1.63, 3.55), p < 0.0001]. These factors significantly contribute to the risk of developing DSSIs post-surgery. However, age did not exhibit a significant difference. Conclusion: This study identifies key risk factors for DSSI following orthopedic trauma surgery, addressing a gap in the existing literature and offering some insights for clinical decision-making. To mitigate the risk of DSSI, clinical practice should encourage patients to lose weight and quit smoking prior to surgery, optimize surgical procedures, and improve wound management strategies. Future research should aim to standardize follow-up durations and further refine the classification of risk factors, in order to validate and expand on the conclusions of this study. [ABSTRACT FROM AUTHOR]