Wound Management Research Articles

Abdominal trauma remains a major cause of preventable death, primarily due to uncontrolled hemorrhage and infection. Conventional hemostatic agents often prove inadequate for noncompressible wounds and can cause secondary damage. To address this, we developed a bioinspired multifunctional hydrogel by engineering quaternized carboxymethyl chitosan (QCMCS) and oxidized hyaluronic acid (OHA). QCMCS enhanced cationic hemostasis, significantly reducing blood loss and accelerating clotting versus a commercial sponge. Dopamine-grafted OHA (OHA-Dop) provided strong wet tissue adhesion. The hydrogel demonstrated rapid hemorrhage control in rat liver models and potent antibacterial activity (>99% reduction against E. coli and S. aureus). It also promoted tissue healing by fostering a regenerative microenvironment and activating relevant signaling pathways. This design effectively bridges emergency hemostasis with infection prevention, offering a promising strategy for managing complex abdominal trauma.

Infected wound healing is a clinical problem owing to excessive inflammatory responses. In this study, a multicomponent hydrogel GOP was prepared by employing salmon polydeoxyribonucleotide (PDRN), oxidized sodium alginate (OSA), and gelatin (Gel) as starting materials. The hydrogel with three-dimensional structure was synthesized through the Schiff-base cross-linking of PDRN, Gel, and OSA. Hydrogen bonding and electrostatic interaction also participated in the formation of the three-dimensional network. Hydrogel GOP demonstrated a good mechanical property and tissue adhesion ability. In vitro studies revealed the antibacterial activity of hydrogel GOP toward S. aureus and E. coli, along with remarkable antioxidant activity. Biocompatibility tests showed high cell viability (>80%) and good ability to promote cell migration. Hemolysis assay revealed minimal hemotoxicity (<2.1%). Using a murine full-thickness dermal injury model, GOP treatment achieved small residual wound area (2.3%) on day 14. Histological analyses demonstrated reduced inflammation cells and enhanced collagen deposition. Immunofluorescence analyses showed suppressed inflammation level (increased IL-10) and improved angiogenesis (upregulated CD31 and α-SMA). These results revealed that hydrogel GOP represented a promising multifunctional dressing for infected wound management.

USP7 inhibition promotes wound healing by suppressing M1 macrophage polarization via NF-κB/MAPK signaling pathway.

Significance: Wound healing in pediatric patients is affected by physiology, growth, and development considerations unique from those in adults. In the following report, we review the primary literature on aging and wound healing and highlight clinical wound healing applications for the pediatric patient across age ranges from neonates and infants in the first year of life to adolescents (aged 10-19 years by World Health Organization definition). Recent Advances: We characterize the differences in wound healing biology between infants, adolescents, and adults and discuss wound care strategies for pediatric surgical patients, highlighting evidence-based guidelines for wound management. We discuss relevant animal models and review the multidisciplinary aspects of providing wound care for children. Critical Issues: Pediatric surgical patients have specialized wound care needs. Optimizing wound care outcomes for infants, children, and adolescents relies on an understanding of their wound-healing biology and unique physiological, psychological, and social considerations. Future Directions: Future directions in pediatric wound care will focus on validating and optimizing emerging technologies through pediatric-specific clinical trials, while also addressing key knowledge gaps in topical agent pharmacokinetics and advancing regenerative approaches like mesenchymal stem cell therapies tailored to the unique biology of infants and children.

Background Optimizing acute wound care after resurfacing lasers is essential for healing, downtime, and cosmetic outcomes. Demand for effective topicals has led to use of various products. Objective This study compares the efficacy of silicone-based fluid gel versus white paraffin ointment in managing acute post-resurfacing laser wounds. Methods In this intra-individual, split-face study, 15 patients treated for acne scars applied silicone gel to one facial half and white paraffin to the other. Two blinded dermatologists assessed acute reactions using the VISIA Complexion Analysis system. Patient satisfaction was measured with two tools. Results The silicone-treated side showed greater erythema, pruritus, scaling, and crusting than the paraffin side, though differences were not statistically significant. VISIA demonstrated significantly worse redness, higher porphyrin levels, and greater textural change on the silicone side (p = 0.04), suggesting increased susceptibility to acneiform eruptions. Patient-reported outcomes and physician global assessments revealed no significant difference in overall aesthetic results between sides. Conclusion White paraffin ointment provided comparable or superior management of acute post-resurfacing wounds. Silicone-based gel may elevate porphyrins and potentially predispose to acneiform eruptions, warranting further study.

Functionalized hydrogel microspheres hold great promise in tissue regeneration, yet their clinical translation is often hindered by high production costs, complex fabrication processes, and reliance on external bioactive additives. To overcome these challenges, multifunctional gelatin-tea polyphenol (GTP) microgels using a simplified, cost-effective, microfluidics-inspired platform are reported, which is composed of an injection unit, a reciprocating apparatus, and a collection substrate. Using a microinjection pump, uncrosslinked microspheres with precisely controlled diameters (125-570µm) are generated, followed by in situ crosslinking to form GTP microgels, which exhibit excellent stability (>28 days) and rapid water absorption (>300% within 1min). These GTP microgels display outstanding hemostatic performance, potent antioxidant activity, and excellent photothermal effects. In mouse burn models, GTP microgels combined with photothermal stimulation accelerate wound healing by reducing inflammation and promoting angiogenesis. By integrating intrinsic therapeutic functions, such as hemostasis, anti-inflammation, and pro-angiogenesis, with a simplified fabrication process, GTP microgels offer a clinically viable approach for advanced wound management.

Wound care presents a significant, yet often under-prioritised, challenge within the UK healthcare system. Despite affecting millions of patients and costing the NHS an estimated £8.3 billion annually (based on data primarily from England), wound management remains highly variable across regions, specialties, and care settings throughout the UK. This article explores the impact of inconsistent clinical practice, the economic implications of chronic and non-healing wounds, and the inequities experienced by patients, especially those with complex care needs. It also highlights the absence of a UK wound care database, which would enable the systemic and standardised monitoring of patient numbers, wound type prevalence, healing rates, and complications. A national wound care database would support quality assurance through the monitoring of outcomes, allow for benchmarking among healthcare providers as well as supporting the provision of robust data for research. Furthermore, it would strengthen healthcare policy, guideline development and support more efficient allocation of resources and commissioning across the four nations of the UK. This lack of coordinated data hinders meaningful research and service planning, quality improvement, equitable evidence-based care, and the opportunity to inform appropriate commissioning and targeted investment. Key strategies are proposed including the adoption of standardised pathways, investment in education, and the development of a UK-wide data infrastructure to support a more coordinated, evidence-based, and cost-effective approach to wound care in the UK.

Lippia nodiflora leaves have been traditionally used by healers in Silent Valley, Palakkad district of Kerala, for treating wounds. This study aimed to scientifically validate the wound-healing potential of the methanol extract of L. nodiflora leaves (MELN) to support its ethnopharmacological claims. Phytochemical profiling using UPLC-QTOF-MS identified key constituents, and network pharmacology analysis revealed potential pathways and targets involved in wound healing. These findings were further supported by molecular docking, in vitro, in vivo, and reverse transcription quantitative polymerase chain reaction (RT-qPCR) analyses. No toxicity was observed in either in vitro or in vivo models. Network pharmacology indicated that MELN may act through the epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor resistance pathway. Core compounds such as quercetin, 3-methylherbacetin, eupafolin, 6-hydroxyluteolin 3'-methyl ether 7-sulfate, and syringic acid beta-glucopyranosyl ester likely contribute to the wound-healing activity, as supported by docking studies. RT-qPCR analysis demonstrated upregulation of genes related to cell migration and proliferation. In vitro assays showed enhanced cell proliferation and migration, indicating pro-healing properties. In vivo excision wound models confirmed significant wound closure, complete epithelialization, and improved histopathological features in MELN-treated groups. Overall, this study provides scientific evidence supporting the ethnopharmacological claim of L. nodiflora in wound management and establishes MELN as a potential herbal formulation for wound healing.

The fibula free flap (FFF) is a mainstay in maxillofacial reconstruction, yet donor site morbidity remains a significant clinical concern. Closure technique is a key factor influencing complication rates, but comparative data remain heterogeneous. This study provides a technique-dependent analysis of 60-day donor site wound healing in FFF with skin paddles and reports a two-stage closure approach. A retrospective review of 211 patients undergoing FFF between 2017 and 2024 was conducted. Donor site complications within the first 60 postoperative days were assessed and stratified by closure technique: one-stage split-thickness skin grafting (STSG) with or without negative pressure wound therapy (NPWT), and a two-stage closure consisting of one-week NPWT followed by STSG. Multivariate logistic regression was applied to identify independent predictors for complications. Overall, 50.2% of patients experienced donor site complications, with wound healing disorders (31.8%) and (partial) skin necrosis (23.7%) most prevalent. Regarding wound closure, STSG coverage without NPWT was associated with the highest morbidity and a complication rate of 91.0%. Despite being limited in sample size, the two-stage closure, despite larger skin defects, showed complication rates comparable to one-stage closure with NPWT. Multivariate analysis identified STSG with NPWT (OR 0.1 [0.01; 0.4], p = 0.002) and two-stage closure (OR 0.1 [0.01; 0.5], p = 0.01) as protective factors for wound healing complications. Donor site morbidity following FFF harvest with skin paddles is significantly impacted by closure technique. Wound management using one- or two-stage STSG with NPWT is preferred. Initial results of the two-stage closure indicate potentially beneficial outcomes for extensive defects and warrant further prospective validation.

Rigid electronic devices suffer from poor adaptability and low comfort, limiting real-time physiological monitoring. Owing to its outstanding electrical, mechanical, and biocompatible properties, graphene has emerged as an ideal core material. This paper reviews the research progress of graphene-based flexible wearable devices. At the level of device innovation, it covers not only research on optimizing device performance through hetero structure design, but also the development of laser-induced graphene batch preparation processes to lay a solid foundation for the large-scale production of devices. In terms of system integration technology, in-depth exploration of multimodal sensing synergy mechanisms to achieve precise collection of multiple physiological signals, as well as research on hybrid energy supply schemes to ensure long-term stable operation of the equipment. In the field of clinical applications, a detailed analysis of its practical cases of real-time capture of cardiac electrical activity in dynamic electrocardiogram monitoring, facilitating early warning of cardiovascular diseases, and real-time monitoring of wound microenvironment in diabetic wound management, to promote wound healing. At the same time, it clearly points out the key challenges currently faced in this field: the high cost of large-scale preparation restricts the popularization of the technology; The lack of long-term stability affects the reliability of equipment use. Finally, looking forward to the future development direction, propose the core path of combining artificial intelligence and edge computing to improve data processing efficiency and building a closed-loop diagnosis and treatment system to achieve precise disease intervention.

A 60-year-old female patient with a prolonged history of immunosuppression due to a 20-year condition of rheumatoid arthritis, managed with long-term glucocorticoids and immunosuppressants, developed atypical erysipelas caused by Escherichia coli , complicated by septic shock and multiple organ dysfunction. Clinically, she presented with abrupt onset of redness, swelling, warmth, and pain in the left lower limb, which rapidly evolved into multiple vesicles and blood-filled blisters (2–3 cm in diameter) with rupture and exudation within 24 hours, subsequently progressing to septic shock and multiple organ dysfunction. Both vesicle fluid culture and next-generation sequencing (NGS) of blood samples confirmed the presence of Escherichia coli . Following the initial ineffective treatment with cefuroxime, the regimen was escalated to meropenem in combination with teicoplanin. Upon confirmation of the pathogenic microorganism, the treatment was de-escalated to piperacillin/tazobactam within 24 hours, supplemented by comprehensive wound management (iodophor wet dressing, lithospermum oil application, and red light therapy) and organ support therapy. After 10 days of intensive treatment, the patient recovered, and the wound healed completely after 4 months of care. This case underscores three critical warnings: 1) the pathogen spectrum of erysipelas in immunosuppressed hosts shows a significant shift, necessitating vigilance against the possibility of Gram-negative bacterial infections, such as Escherichia coli; 2) atypical bullous skin lesions can serve as an early indicator of severe infection, with a rapid clinical course progressing to shock within 24 hours; 3) a tiered anti-infective strategy is paramount – initially broad-spectrum coverage for both Gram-negative and Gram-positive bacteria (e.g., anti-pseudomonal β-lactams plus glycopeptides), followed by de-escalation within 24 hours of pathogen identification. It is advisable to conduct early combined microbial culture and NGS testing for immunosuppressed patients presenting with skin infections, and to implement individualized broad-spectrum antibiotic regimens to enhance prognosis.

Introduction: Increasingly adopted in healthcare education for their ability to engage learners, develop teamwork and critical thinking skills, escape rooms are defined as ‘live-action, team-based games where players discover clues, solve puzzles, and accomplish tasks in one or more rooms in order to accomplish a specific goal’ [1]. The literature suggests that escape rooms have the potential to engage learners[2,3]. Our simulation team, consisting of academic and simulation technicians, created a virtual escape room using IntuifaceTM software for our immersive learning environment. This interactive touchscreen experience allowed nursing students to practice critical thinking, communication, and teamwork as they navigated a virtual patient’s home, consisting of a linear storyline of puzzles within a 40-minute limit. These were focused on wound assessment and management. Methods: This learning experience involved groups of up to 12 students, structured with rotating participation of 5-6 active learners, and 5-6 active observers who contributed suggestions and insights. Solving the sequential puzzles demanded effective teamwork, clear communication, and the application of knowledge relevant to the scenario’s phases: history taking, information gathering, the correct utilization of wound assessment tools, and the selection of appropriate wound dressings. A simulation technician facilitated the technical operation, while an academic facilitator guided the in-experience discussions and debriefing to enhance learning. Results: Feedback was collected from participants at the end of each session via a QR code. A total of 6 sessions were delivered in 1 day. 65 students took part, with 31 completing the evaluation form (response rate of 47.7%). Overall, student feedback indicated a positive learning experience and participants reported high levels of enjoyment and engagement with the activities, with evidence of perceptions of successful teamwork and communication. Additionally, at least one student noted the development of valuable skills such as critical thinking and problem-solving. The unique and fun nature of the session appears to have contributed to this learning opportunity, see Figure 1. Discussion: The feedback identified a potential area for improvement which was highlighted by “more time and guidance”, suggesting that some students may have felt pressed for time, or required additional support to fully benefit from the activities. This warrants consideration in future session planning to ensure adequate time allocation and appropriate levels of guidance are provided to accommodate all learners. Despite this point for potential enhancement, the feedback suggests the learning experience was innovative and well-received by the participating students, and will be embedded in future nursing curricula. Ethics Statement: As the submitting author, I can confirm that all relevant ethical standards of research and dissemination have been met. Additionally, I can confirm that the necessary ethical approval has been obtained, where applicable.

Wound infection complicated by excessive inflammation remains a persistent challenge in clinical healthcare. Curcumin (Cur), a natural diketone compound, holds therapeutic potential in treating infected wounds. However, its application is limited by poor aqueous dispersibility and low stability. To overcome this dilemma, a versatile capsule as an effective Cur carrier is developed by encapsulating Cur in succinic acid-modified cyclodextrin via hydrophobic interactions, and then loading it into a Zn2+-mediated crosslinked injectable hydrogel for infected wound healing. The composite hydrogel exhibits adjustable rheological properties, modulus, swelling ratios, and degradation rate by control over Zn2+ concentration. This unique tactic enables the sustained Cur release, ensuring long-term antioxidant activity and reactive oxygen species (ROS) scavenging. An in vivo experiment in a rat S. aureus-infected wound model demonstrates that the composite hydrogel significantly accelerates wound healing by massacring bacteria, inhibiting inflammation, as well as promoting collagen deposition and angiogenesis. Overall, this effort paves the way for arming Cur, offering a potent antibiotic-free candidate for bacteria-invaded wound management.

Burn wounds are challenging to treat because they often heal slowly and are susceptible to complications. The inflammatory phase plays an essential role in the repair process. However, prolonged inflammation can delay tissue healing. The total leukocyte count is an important parameter to evaluate the process, as it reflects the balance between inflammation and the initiation of tissue regeneration. Oyster mushrooms (Pleurotus ostreatus) contain β-glucans and phenolic compounds with anti-inflammatory and antioxidant properties, which may help regulate leukocyte activity and promote wound healing. This study aimed to evaluate the effect of oyster mushroom powder on total leukocyte counts during burn wound healing in Rattus norvegicus. Twenty-seven healthy male rats aged 2-3 mo were randomly divided into 3 groups, with 9 rats in each group. The negative control group received aquadest, the positive control group received bovine serum albumin, and the treatment group received 10% oyster mushroom powder. All groups received identical topical wound management with 1% silver sulfadiazine ointment to prevent infection and maintain a moist wound environment during healing. Blood samples were collected on days 0, 4, 8, and 12 after burn induction, and leukocyte counts were measured. The results showed that the treatment group consistently had lower leukocyte counts compared with control groups. On day 0, the treatment group had significantly lower leukocyte levels compared with the negative control (p = 0.019). On day 8, leukocyte counts in the treatment group were also significantly lower than the positive control (p = 0.030). By day 12, all groups showed a decrease, but the treatment group demonstrated the most gradual and stable reduction over time. In conclusion, oyster mushroom powder reduces leukocyte levels and supported a more controlled inflammatory phase, allowing faster progression to proliferation and improved burn wound healing.

ABSTRACTIntroductionA lower extremity amputation has traditionally been considered as a last resort treatment option for people with a diabetes‐related foot ulcer (DFU). However, some people will opt for an earlier amputation to overcome the daily lifestyle challenges from ongoing conservative wound management. Even so, making the decision for non‐emergency amputation is challenging due to the lack of clear recommendations or evidence‐based resources. Therefore, this study aimed to gather recommendations from people with lived experience of a DFU or amputation, family members, health practitioners, and experts to guide decision‐making for amputation due to diabetes.MethodsNominal group technique was used to gather and vote on recommendations to support people making decisions for amputation. This technique allows all voices to participate and inform ideas. Two separate cohorts were recruited, one group was comprised people with lived experience (of DFU or amputation due to diabetes) and family members (n = 4 participants). The other group consisted of health practitioners and experts (n = 5 participants). During these workshops, research findings from a previous scoping review (94 papers) and interviews with people with lived experience and health experts (n = 26) were presented to participants to gather iterative feedback. Recommendations were constructed using the previous findings and the participants' experience and expertise, which were voted on and later analysed using summative content analysis.ResultsA total of 13 recommendations were established by the people with lived experience and their family members, and 15 recommendations from health experts. Seven categories were established from these combined recommendations which described the priority considerations: ‘Consider timing, with early discussions to move forward’, ‘Address every element of quality of life’, ‘Understand individual goals and priorities to make personalised decisions’, ‘Collaborate with support networks’, ‘Provide information and options’, ‘Communicate with respect and transparency’, and ‘Offer functional person‐centred systems’.ConclusionsThe recommendations highlight the need for early and transparent discussions that prioritise individual goals, quality of life needs and collaboration with support networks, to enable person‐centred and evidence‐based decisions. These recommendations provide a foundation for the development of guidelines to support timely and informed collaborative decisions in the future.

The aim of this clinical trial was to evaluate the performance and local tolerance of an innovative mesh-free contact layer (healing matrix) made of lipidocolloid technology (TLC) in the management of various wounds. This dressing is made highly flexible by the absence of textile mesh in its core. A four-week, prospective, multicentre clinical trial was conducted on the evaluated dressing (UrgoFit, Laboratoires Urgo, France) in 23 centres in France. Eligible patients were adults with a cutaneous wound of acute or chronic origin or due to epidermolysis bullosa (EB) in the granulation stage. The primary endpoint was the relative wound area reduction (RWAR) at week 4. Secondary endpoints included wound closure rate and time-to-heal, as well as dressing change frequency, pain at dressing removal, local tolerance and acceptability of the dressing. A total of 78 adult patients (23-95 years old) were treated with the dressing over a period of 24±8 days. Wound aetiologies included: postoperative or traumatic finger wounds; skin graft donor sites; dermabrasions/skin tears; burns; leg ulcers (LUs) of predominantly venous origin; a stage 3 pressure injury; and EB lesions. The median RWAR at week 4 was 98.2% (ranging between 61.5-100.0%, depending on wound types). Complete closure was achieved in 49% of patients (59% in acute wounds, 60% in EB lesions and 16% in chronic wounds) with a median time-to-heal of 16.5 days (ranging between 14.5-27.0 days, depending on wound types). Half of LUs reached a RWAR ≥40% at week 4, a predictive indicator of complete wound healing at week 24. Dressings were changed every 2±1 days on average (and left in place for a maximum of 10 days). Since the first application, the dressing was judged by healthcare professionals (HCPs) to be 'very easy' or 'easy' to apply on 96% of wounds, with a 'very good' or 'good' conformability to 94% of wound beds. Similar results were reported in cases of finger/hand wounds. Since the first week of treatment, the dressing removal was also judged 'very easy' or 'easy' in 95-98% of the cases, protecting and preserving newly formed tissue in 100% of cases. At the first follow-up visit, patients reported the dressing changes to be painless in 95% of cases. This represented a significant improvement over the previous dressings they received (p<0.0001). In all, seven non-serious adverse events related to the dressing were reported during the study period. In this clinical trial, the innovative mesh-free TLC dressing was shown to promote wound healing, to be well tolerated and well accepted by patients and HCPs, in line with the evidence available on other TLC dressings; however, its enhanced conformability may provide an additional benefit for the management of wounds.

Mechanistic study of unoxidized tannic acid crosslinked gelatin-CMC electrospun matrices for combating antibacterial resistance in infected wounds.

Multifunctional nanozyme-embedded hydrogels for advanced diabetic wound management.

A closed-loop thermoelectric patch for autonomous management of MRSA-infected chronic wounds

Application of bacterial cellulose film as a wound dressing in varicose vein surgery: A randomized clinical trial.