From crosslinking to clotting: Mechanistic insights into calcium chloride-crosslinked hydrogels for wound hemostasis.

Multidrug-resistant (MDR) bacterial infections demand antibacterial strategies that circumvent conventional resistance pathways and enable localized action with minimal host toxicity. Photodynamic therapy (PDT) represents a non-invasive approach; however, its effectiveness is constrained by insufficient bacterial targeting, aggregation-caused quenching, and limited reactive oxygen species (ROS) generation under physiological conditions. Herein, we develop two membrane-anchoring naphthalimide-based aggregation-induced emission (AIE) photosensitizers, TPAPV-NIM-mPy-M and TPAPV-NIM-Py-M, engineered via a donor-π-acceptor molecular design to integrate near-infrared (NIR) fluorescence imaging and antibacterial PDT. Both photosensitizers display visible-light absorption, pronounced AIE characteristics, and NIR emission, providing bright signals upon aggregation and facilitating rapid bacterial visualization. Under low-intensity white-light irradiation, they efficiently generate ROS via both type I and type II pathways, supporting oxygen-dependent and partially oxygen-tolerant mechanisms. The introduction of cationic pyridinium units promotes rapid bacterial binding and membrane-specific localization in Gram-positive and Gram-negative bacteria, thereby confining ROS at the bacterial envelope and enhancing photoinactivation. Notably, TPAPV-NIM-Py-M, benefiting from extended π-conjugation and stronger intramolecular charge transfer, exhibits higher ROS output and superior antibacterial efficacy against Escherichia coli (E. coli), Staphylococcus aureus (S. aureus), vancomycin-resistant Enterococcus faecium (VR E. faecium), and multidrug-resistant Escherichia coli (MDR E. coli), while maintaining negligible dark toxicity. Cytotoxicity and hemolysis assays confirm a favorable biocompatibility profile. TPAPV-NIM-Py-M also shows strong antibiofilm activity. Furthermore, TPAPV-NIM-Py-M enables effective in vivo photodynamic elimination of bacteria in an E. coli-infected wound model, significantly accelerating wound closure and tissue regeneration without systemic toxicity. This work establishes a membrane-targeted molecular engineering strategy for high-performance AIE photosensitizers and highlights their potential for image-guided photodynamic treatment of MDR bacterial infections and infected wounds. STATEMENT OF SIGNIFICANCE: Antibiotic resistance and biofilm-associated infections are driving demand for non-antibiotic antibacterial therapies. This study introduces naphthalimide-based aggregation-induced emission photosensitizers that anchor to bacterial membranes, enabling near-infrared fluorescence imaging and localized generation of reactive oxygen species for photodynamic killing. Membrane targeting improves efficacy against both Gram-positive and Gram-negative pathogens, including multidrug-resistant strains, and supports treatment of infected wounds in vivo with good biocompatibility. The work provides a general molecular design strategy for image-guided antimicrobial photodynamic therapy.

Wound infections pose a substantial clinical challenge and an escalating healthcare burden, further complicated by the rapid increase in multidrug-resistant bacteria. Antimicrobial peptides (AMPs) offer an alternative to conventional antibiotics, but their rapid degradation, hemolytic activity, and potential cytotoxicity complicate systemic delivery and can have negative impact on wound healing. Here we show a bacterial nanocellulose hyaluronan (BC-HA) hybrid hydrogel wound dressing functionalized with mesoporous silica nanoparticles (MSNs) for localized, enzyme responsive delivery of a sequence optimized antimicrobial peptide (SOAP) for treatment of infected wounds. The dressings provide moisture retention and excellent skin conformability while enabling infection-triggered AMP release by bacterial and host proteases. In vitro, SOAP-loaded dressings showed potent activity against clinical wound pathogens while remaining compatible with human primary dermal fibroblasts and keratinocytes. In a contaminated porcine wound model, the dressings significantly reduced bacterial load while accelerating wound re-epithelialization and epithelial maturation compared to the controls. By integrating a dual-function hydrogel that promotes healing and provides on-demand antimicrobial activity, critical limitations in the use of AMPs in wound care can be addressed, providing new possibilities to treat infected wounds.

The effective management of third-degree burns remains challenging due to high risks of infection, oxidative stress and prolonged inflammation. While several medicinal plants are traditionally used in wound care, scientific evidence supporting their efficacy is often lacking. This study aimed to evaluate the therapeutic effect of an ointment formulated with the ethanolic extract of Lawsonia inermis leaves on the healing of severe burns. Twenty-one adult male Wistar rats were randomly assigned to three groups: Negative control, positive control (standard drug) and test group (L. inermis). Standardized third-degree burns (200°C for 10 seconds) were induced on the animals' backs and treated topically for 27 days. Wound contraction was monitored throughout the study and histological analysis was conducted at the end. Additionally, phytochemical screening and in-vitro assays were performed to assess the antioxidant (DPPH, FRAP and FIC), anti-inflammatory and antibacterial activities of the extract. The results demonstrated that Lawsonia inermis exhibits significant antioxidant, anti-inflammatory and antimicrobial activities. Furthermore, its topical application promoted wound healing in a manner comparable to conventional treatments. These findings highlight the therapeutic potential of L. inermis as a promising natural alternative for the management of severe burn wounds.

The authors present an autologous skin shave micrografting (ASSM) technique for treating stage 3 to 4 pressure injuries (PI). Between 2024 and 2025, 7 patients with stage 3 and 4 PIs were treated using skin micrografting. Seven patients with 10 PIs (3 stage 3 and 7 stage 4) underwent ASSM. The average PI size was 7.2cm2. The average depth was 0.3cm. The average donor site measured 1.5cm2. All patients demonstrated complete healing within 4 months. Five of 7 patients remained recurrence-free during a 9-month follow-up period, and only 1 out of 10 PIs was open at 9 months. ASSM is a promising modality for the treatment of select PIs and may be considered as part of the reconstructive ladder for advanced pressure injuries. JOURNAL/aswca/04.03/00129334-202607000-00004/figure1/v/2026-06-13T090907Z/r/image-jpeg. To increase knowledge of the application of the autologous skin shave micrografting (ASSM) technique for the management of advanced-stage pressure injuries (PI). This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and registered nurses with an interest in skin and wound care. After participating in this educational activity, the participant will:Evaluate patient-specific factors to select optimal treatment strategies for managing PI.Apply the techniques and procedural steps of ASSM for the treatment of advanced-stage PIs.Explain the underlying pathophysiologic mechanisms by which ASSM promotes healing in advanced-stage PIs.

Multidisciplinary care for endometriosis often includes surgical diagnosis and management, and within this context, the registered nurse first assistant (RNFA) plays a critical leadership role across the perioperative continuum. Surgical intervention is critical in endometriosis, particularly for individuals with moderate to severe disease and symptoms unresponsive to medical suppression. As integral members of the surgical team, RNFAs are actively involved in preoperative education, surgical preparation, intraoperative coordination, and postsurgical care. Postoperative responsibilities include pain management, monitoring for complications, wound care, discharge planning, and implementing recovery protocols, while promoting adherence and reinforcing long-term care strategies. Beyond clinical tasks, RNFAs also often advocate for equitable access to skilled surgical care and provide vital support during a frequently physically and emotionally demanding experience for patients. By ensuring continuity and consistency throughout the surgical journey, RNFA contributions and leadership are essential not only to a safe operative experience but also to long-term outcomes, including improved quality of life, symptom management, and functional recovery for individuals undergoing surgery for endometriosis. This article outlines key RNFA responsibilities in endometriosis surgery, aiming to strengthen perioperative coordination, patient support, and outcomes.

A synergistic Janus nanofiber dressing enables spatiotemporal sequential treatment of acute wounds.

Photothermal hydrogel based on copper-loaded mesoporous polydopamine for synergistic treatment of infected wounds

Energetic metabolism-regulatory glycopeptide hydrogel accelerates pressure ulcer wound repair.

Limited data are available regarding partial foot amputation (amputation of two adjacent digits, excluding the first digit) in cats. Three domestic shorthair cats with a median age of 4.2 yr were presented for partial foot amputation between 2010 and 2022. Neoplasia was the indication for partial foot amputation in two cats; one cat underwent partial foot amputation for treatment of a chronic wound. All cats underwent lateral partial foot amputation (excision of digits 4-5) of a thoracic limb. One cat had excisions at the level of the metacarpal-phalangeal joint, and two cats had excision at the level of the distal metacarpal bone. No cats experienced surgical complications intraoperatively. All cats achieved resolution of lameness postoperatively at a median duration of 28 days, although one cat experienced a long-term grade 1 complication associated with a wound that developed where weight bearing occurred. Lateral partial foot amputation of a thoracic limb was overall well tolerated in these three cats, with favorable long-term functional outcomes and manageable complications. Results support the role of partial foot amputation as a viable limb-sparing option in cats, although additional data are needed to assess outcomes for other partial foot amputation locations (medial, central, and pelvic limb) in cats.

Dynamic enzyme-mimetic peptide hydrogel for the treatment of bacterial-infected inflammatory wounds.

Retraction notice to "The efficacy of a paeoniflorin-sodium alginate-gelatin skin scaffold for the treatment of diabetic wound: An in vivo study in a rat model" [Biomedicine & Pharmacotherapy 151 (2022) 113165

The optimal method of wound closure after ileostomy reversal remains uncertain. Purse-string approximation reduces surgical site infections but requires prolonged wound care. Combining negative pressure wound therapy with primary linear closure may offer a more convenient approach while maintaining acceptable infection rates. To determine whether primary linear closure with negative pressure wound therapy is noninferior to purse-string approximation in preventing surgical site infection after ileostomy reversal. Prospective, nonblinded, multi-institutional, noninferiority randomized controlled trial. Community tertiary hospital and academic medical center. Adults undergoing elective ileostomy reversal between October 2018 and March 2024. Participants were randomly assigned to undergo either primary linear closure with negative pressure wound therapy or purse-string approximation for skin closure after ileostomy reversal. The primary outcome was the occurrence of surgical site infection, with a noninferiority margin set at 16%. Secondary outcomes included time to wound healing and scar appearance using the validated Patient and Observer Scar Assessment Scale. One hundred twelve patients completed the study, with 61 in the negative pressure wound therapy arm and 51 in the purse-string approximation arm. Primary linear closure negative pressure wound therapy was noninferior to the purse-string approximation arm in terms of surgical site infection: 7% and 2%, respectively, with an absolute risk difference of 5% (95% CI, 2.5%-12.5%). Early wound healing at 2 weeks was achieved in 77% vs 23.5% of patients, respectively ( p < 0.001, generalized estimating equation analysis). All wounds healed by 6 weeks in both groups. No negative pressure wound therapy device malfunctions occurred. Nonblinded study limited to 2 institutions. Ileostomy reversal by primary linear closure negative pressure wound therapy is noninferior to purse-string approximation in terms of the occurrence of surgical site infections while achieving significantly faster wound healing. The method is safe, convenient, and cosmetically acceptable. See Video Abstract . Advocate Aurora Health IRB, IRB# 22.034 (7082). ANTECEDENTES:El método óptimo para el cierre de heridas tras la reversión de una ileostomía sigue siendo incierto. La aproximación en jareta reduce las infecciones del sitio quirúrgico, pero requiere un cuidado prolongado de la herida. La combinación de la terapia de presión negativa para heridas con el cierre lineal primario podría ofrecer un enfoque más conveniente, manteniendo al mismo tiempo tasas de infección aceptables.OBJETIVO:Determinar si el cierre lineal primario con terapia de presión negativa para heridas es no inferior a la aproximación en jareta en la prevención de infecciones del sitio quirúrgico tras la reversión de una ileostomía.DISEÑO:Ensayo controlado aleatorizado, prospectivo, no enmascarado, multiinstitucional y de no inferioridad.ESCENARIOS:Un hospital terciario comunitario y un centro médico académico.PACIENTES:Adultos sometidos a una reversión electiva de ileostomía entre octubre de 2018 y marzo de 2024.INTERVENCIÓN:Los participantes fueron aleatorizados para recibir, como cierre cutáneo tras la reversión de la ileostomía, bien un cierre lineal primario con terapia de presión negativa para heridas, bien una aproximación en jareta.MEDIDAS DE RESULTADO PRINCIPALES:El resultado primario fue la aparición de infecciones del sitio quirúrgico, con un margen de no inferioridad establecido en el 16%. Los resultados secundarios incluyeron el tiempo hasta la cicatrización de la herida y el aspecto de la cicatriz, evaluados mediante la Escala de Evaluación de Cicatrices por el Paciente y el Observador (Patient and Observer Scar Assessment Scale), la cual está validada.RESULTADOS:Ciento doce pacientes completaron el estudio: 61 en el brazo de terapia de presión negativa para heridas y 51 en el brazo de aproximación en jareta. El cierre lineal primario con terapia de presión negativa para heridas resultó no inferior a la aproximación en jareta en términos de infecciones del sitio quirúrgico (ISQ): 7% y 2%, respectivamente, con una diferencia de riesgo absoluta del 5% (IC del 95%: -2,5% a 12,5%). Se logró una cicatrización temprana de la herida a las 2 semanas en el 77% de los pacientes del primer grupo frente al 23,5% del segundo (p < 0,001; análisis GEE). Todas las heridas habían cicatrizado a las 6 semanas en ambos grupos. No se produjeron fallos de funcionamiento en los dispositivos de terapia de presión negativa para heridas.LIMITACIONES:Estudio no enmascarado, limitado a dos instituciones.CONCLUSIONES:La reversión de la ileostomía mediante cierre lineal primario con terapia de presión negativa para heridas es no inferior a la aproximación en jareta en términos de la aparición de infecciones del sitio quirúrgico, logrando al mismo tiempo una cicatrización de la herida significativamente más rápida. Este método es seguro, conveniente y estéticamente aceptable. (AI-generated translation )Registro del ensayo:IRB de Advocate Aurora Health, N.º de IRB 22.034 (7082).

Lower Extremity Reconstruction in Acute Burns.

Adverse drug reactions (ADRs) can lead to severe consequences and increased morbidity and mortality rates. Phenobarbital is one of the most common anti-epileptic drugs that has numerous adverse drug reactions, including toxic epidermal necrolysis. The event is rare and a medical emergency. A six-year-old female epileptic child with phenobarbital-induced toxic epidermal necrolysis was referred for the management of diffuse exfoliative lesions involving her eyes and buccal mucosa. Associated with the skin lesions, the patient reported high-grade fever, reddish eye discoloration, dysphagia and dry cough. The exfoliative skin lesion involved 90% of her total body surface area. The patient was managed with withdrawal of phenobarbital, IV antibiotics, systemic corticosteroid, twice daily wound care, analgesic, and nutritional support. Early recognition, discontinuation of offending medications and prompt intervention are crucial to mitigate harm. Raising awareness about ADRs and their management is vital for enhancing patient safety and outcomes.

Negative pressure wound therapy (NPWT) has transformed the management of complex wounds across surgical disciplines. However, widespread adoption in low- and middle-income countries is constrained by the high cost and proprietary nature of commercial systems. This narrative review examines appropriate low-cost NPWT alternatives and discusses strategies to mitigate commonly cited limitations through protocol-driven care. Wider adoption supported by pragmatic evaluation and standardized protocols offers an opportunity to expand equitable access to advanced wound care in resource-constrained settings.

Harm reduction vending machines (HRVMs) provide low-barrier access to supplies that reduce overdose deaths and infections. Evidence within Veterans Affairs (VA) and supportive housing settings is limited. We evaluated 8-month HRVM implementation measures at a VA Health Care System, mapped to RE-AIM (reach, effectiveness, implementation) domains. Prospective, single-system, single-arm, descriptive implementation evaluation across 15 HRVMs in VA health care and supportive housing settings. Measures/variables (RE-AIM): Reach-Veteran HRVM sign-ups/pathway, proportion accessed ≥1 product, sociodemographics; Effectiveness-resource acceptance (naloxone, overdose education, community harm reduction resources, substance use treatment, infection testing/care); Implementation-most frequently accessed products, comparisons by setting (total dispensed; proportion during business versus nonbusiness hours). HRVM software; staff-completed survey for Veterans at HRVM sign-up. Case descriptive analyses were used. Reach: 281 Veterans signed up for HRVM access, most commonly with colocated/on-site staff (54.8%). During the 8-month period, 70.8% accessed ≥1 product. Veterans were mean age of 60.2 ± 13.8 years, primarily male (90.2%), and represented diverse groups, with 40.2% white/Caucasian, 31.1% black/African American, and 10.8% Hispanic/Latinx. Among all Veterans, 44.8% accepted naloxone, 19.9% overdose education, 13.5% community harm reduction resources, 11.4% substance treatment resources, and 10.3% infection testing/treatment. 3567 products were dispensed, with a greater share at supportive housing versus health care settings (61.5% versus 38.5%), and housing settings showed substantially more after-hours dispensing (66.6%). On-site HRVM sign-ups were strongly associated with site-level dispensing (Spearman ρ = .80, P < .001). Frequently accessed items included syringes (n = 422), hygiene kits (n = 350), condoms (n = 337), and wound care kits (n = 312). HRVM colocation across health care and supportive housing reached Veterans and supported after-hours access where needs were greatest, while also linking many to naloxone, education, and health care resources. Findings demonstrate a feasible, scalable approach for integrating HRVMs into Veteran-centered public health strategies. Future research should evaluate longer term clinical outcomes, participant-reported outcomes, and cost.

"This tough love sh*t is just not love": Exploring harm reduction in Massachusetts homeless shelters.

Prophylactic Absorbable Antibiotic Beads in Groin Reconstruction Following Vascular Procedures.

To explore the specific needs of patients with diabetic foot ulcers (DFUs), caregivers, and health care professionals (HCPs) for a mobile health (mHealth) app, aiming to inform the design and development of effective mHealth service solutions. This descriptive qualitative study was conducted from June to September 2024 in the wound care clinics of 2 local hospitals. Participants included patients with DFUs, caregivers, and HCPs directly involved in their care. Interview data were analyzed, synthesized, and refined using content analysis. Five key themes emerged: the pressing need to implement mHealth app services, convenient and personalized access to information, continuous and specialized health guidance, a multidisciplinary approach to disease management, and free access alongside privacy and legal protections. This study provides valuable insights for the design and development of an mHealth app for DFU. During the development process, it is essential to consider user needs and ensure the app meets the expectations of patients and related groups for personalized, continuous, and specialized health guidance; free access; privacy protection; and multidisciplinary collaboration. A balance should be struck between convenience and security of the app's features, to encourage user engagement and enhance the app's value and effectiveness.