Search Our Scientific Publications & Authors

J Wound Care 2021 May;30(Sup5):S32-S36

The SerenaGroup Research Foundation, Cambridge, MA, US.

Objective: Debridement, the removal of nonviable tissue, forms the foundation of wound care practice. Clinicians have a variety of debridement methods at their disposal: sharp, biologic, enzymatic, autolytic and mechanical. The choice of debridement technique depends on the patient care setting, ulcer type and the clinician's experience, training, comfort level and licensure. Read More

Cochrane Database Syst Rev 2021 May 10;5:CD013620. Epub 2021 May 10.

Nursing Research Institute, St Vincent's Health Australia Sydney, St Vincent's Hospital Melbourne & Australian Catholic University, Fitzroy, Melbourne, Australia.

Background: Pressure ulcers (also known as pressure injuries, pressure sores, decubitus ulcers and bed sores) are localised injuries to the skin or underlying soft tissue, or both, caused by unrelieved pressure, shear or friction. Alternating pressure (active) air surfaces are widely used with the aim of preventing pressure ulcers.

Objectives: To assess the effects of alternating pressure (active) air surfaces (beds, mattresses or overlays) compared with any support surface on the incidence of pressure ulcers in any population in any setting. Read More

Cochrane Database Syst Rev 2021 May 10;5:CD013624. Epub 2021 May 10.

Nursing Research Institute, St Vincent's Health Australia Sydney, St Vincent's Hospital Melbourne & Australian Catholic University, Fitzroy, Melbourne, Australia.

Background: Pressure ulcers (also known as pressure injuries, pressure sores, decubitus ulcers and bed sores) are localised injuries to the skin or underlying soft tissue, or both, caused by unrelieved pressure, shear or friction. Beds, overlays or mattresses are widely used with the aim of treating pressure ulcers.

Objectives: To assess the effects of beds, overlays and mattresses on pressure ulcer healing in people with pressure ulcers of any stage, in any setting. Read More

Int J Surg Case Rep 2021 Apr 29;82:105931. Epub 2021 Apr 29.

Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran. Electronic address:

Introduction And Importance: Diabetic foot ulcers (DFUs), as one of the most debilitating complications of diabetes, can lead to amputation. Treatment and management of d DFUs are among the most critical challenges for the patients and their families.

Case Presentation: The present case report is of a 63-year-old man with a 5-year history of uncontrolled type 2 diabetes who has had DFU for the past three years on three sites of the left external ankle in the form of two deep circular ulcers with sizes of 6 × 4 cm and 6 × 8 cm, the sole as a superficial ulcer with a size of 6 × 3 cm, and the left heel as a deep skin groove. Read More

J Wound Ostomy Continence Nurs 2021 May-Jun 01;48(3):239-250

Manuel Rodríguez-Palma, PhD, MSN, RN, Nursing Home "José Matía Calvo," Cádiz, Spain; and Executive Member of Spanish Pressure Ulcer Advisory Panel.

Incontinence-associated dermatitis (IAD) has been studied over the last decades, but gaps in the knowledge related to its identification, etiological agents, and risk factors remain. We carried out a scoping review about IAD that included systematic reviews, experimental, and observational studies about IAD and its potential risk factors. We retrieved 24 articles that described 100 potential risk factors and which were synthesized by the authors and proposed to a panel of experts. Read More

Int Wound J 2021 May 5. Epub 2021 May 5.

German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.

Patients with chronic leg ulcer, pressure ulcer, or diabetic foot ulcer suffer from significant disease burden. With a view to improving healthcare provision sustainably, a predictive model of time to closure (time-to-event analysis) based on claims data was developed. To identify potential predictors of wound closure, clinical information absent from statutory health insurance (SHI) data was modelled. Read More

Int Wound J 2021 May 4. Epub 2021 May 4.

Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.

The objectives of this study were to examine the knowledge and attitude of Indonesian community nurses regarding Pressure Injury (PI) prevention. A cross-sectional design was used and included the community nurses permanently working in the Public Health Center (Puskemas) in Bandung, West Java Indonesia. Knowledge was measured using the Pressure Ulcer Knowledge Assessment Tool (PUKAT 2. Read More

Int Wound J 2021 May 3. Epub 2021 May 3.

Charite Center for Health and Human Sciences, Charité - Universitätsmedizin Berlin, Berlin, Germany.

Pressure ulcers/injuries are caused by sustained loading and deformation of skin and underlying soft tissues. Prophylactic dressings are recommended as an adjunct to other preventive measures such as repositioning and offloading. The aim of this study was to investigate the effects of prophylactic soft silicone multi-layered foam dressings on the skin structure and function of the two most common pressure areas, sacrum and heel, with and without loading. Read More

Int J Low Extrem Wounds 2021 Apr 29:15347346211002334. Epub 2021 Apr 29.

6684Oregon Health & Science University, Portland, OR, USA.

Ulcers of mixed etiology are diagnostically elusive and challenging to treat, especially when rare conditions are superimposed. Pyoderma gangrenosum (PG) is an autoinflammatory, ulcerative skin disease that is difficult to diagnose. Diagnostic criteria exist but there are no specific clinical tests to identify it. Read More

Front Immunol 2021 9;12:648554. Epub 2021 Apr 9.

Department of Health Sciences, Carleton University, Ottawa, ON, Canada.

Delayed wound healing can cause significant issues for immobile and ageing individuals as well as those living with co-morbid conditions such as diabetes, cardiovascular disease, and cancer. These delays increase a patient's risk for infection and, in severe cases, can result in the formation of chronic, non-healing ulcers (e.g. Read More

Wounds 2021 Apr;33(4):86-90

Wound Care Team Director, UC Davis Medical Center, Sacramento, California.

Introduction: Hospital-acquired pressure ulcer/injury (HAPU/I) often occurs postoperatively despite preventative interventions. The authors recently found an increasing incidence of HAPU/I in patients having prolonged operating room (OR) procedures in both the bent knee and lithotomy positions.

Objective: The aim of this study was to measure and compare 2 different OR surfaces in both the supine with bent knees position and the supine in lithotomy position. Read More

Adv Skin Wound Care 2021 Apr 16. Epub 2021 Apr 16.

In the Department of Plastic and Reconstructive Surgery, University Hospital Brussels, Belgium, Rania Elkhatib, MD, is Attending Physician; Gabriele Giunta, MD, FEBOPRAS, is Consultant; Valerie Hanssens, MSc, is Nurse Specialist; Ayush Kapila, MD, MRCS, is Resident; Randy De Baerdemaeker, MD, FEBOPRAS, is Consultant; Assaf Zeltzer, MD, PhD, is Consultant; and Moustapha Hamdi, MD, PhD, is Head of Department. The authors have disclosed no financial relationships related to this article. Submitted September 2, 2020; accepted in revised form October 28, 2020.

Abstract: With the continuous spread of the COVID-19 pandemic, an increasing number of patients have been admitted to the ICU with severe respiratory complications requing prolonged supine positioning. Recently, many case reports have been published regarding dermatological manifestations associated with the COVID-19 disease. Yet, there is little information about the clinical features. Read More

J Wound Care 2021 Apr;30(Sup4):S42-S52

International Medical Director, Urgo Education and Training Alliance, Singapore.

Objective: Management of chronic wounds remains one of the major challenges for health professionals and patients. An evidence-based decision is important to ensure that patients are receiving the best treatment proven to reduce healing time and improve outcomes, including economic benefits and patients' health-related quality of life (HRQoL). Due to recent restrictions because of the COVID-19 pandemic, including closure of wound care centres within hospitals and a drop in patient volume, chronic wound management needs simple-to-use dressings which are still effective and evidence-based solutions. Read More

J Wound Care 2021 Apr;30(Sup4):S38-S40

Department of Burns and Plastic Surgery, Tangshan Gongren Hospital, China.

Objective: Hard-to-heal wounds are a surgical challenge, and diabetic foot ulcers (DFUs) are one of the most common and severe varieties. Previous studies have shown that autologous fat grafting (AFG) and negative pressure wound therapy (NPWT) have the potential to promote wound healing. This case study describes how these two methods together helped in the healing of a serious DFU. Read More

J Wound Care 2021 Apr;30(4):304-310

Institute of Physics, USP, São Carlos, SP, Brazil.

Objective: A pressure ulcer (PU) is an area of tissue trauma caused by continuous and prolonged pressure, often associated with hospitalised patients immobilised due to neurological problems, negatively affecting their quality of life, and burdening the public budget. The aim of this study was to report the follow-up, for 45 weeks, of three patients with neurological lesions due to trauma who subsequently developed PUs, and who were treated with a combination of photodynamic therapy (PDT), low level laser therapy (LLLT) and cellulose membrane (CM).

Method: PDT was mediated by the photosensitiser curcumin on a 1. Read More

Adv Skin Wound Care 2021 May;34(5):1-6

At the Ajou University School of Medicine, Suwon, Republic of Korea, Hyung Min Hahn, MD, is Assistant Professor; Dong Hwan Lee, MD, is a Resident; Il Jae Lee, MD, PhD, is Associate Professor, Department of Plastic and Reconstructive Surgery. Acknowledgments: The authors thank Editage (www.editage.co.kr) for English language editing. This research was supported by a Korea Health Industry Development Institute grant to Ajou University Medical Center. The authors have disclosed no other financial relationships related to this article. Submitted May 28, 2020; accepted in revised form September 3, 2020.

Objective: To examine and report clinical outcomes of a ready-to-use micronized dermal matrix for diabetic foot ulcers (DFUs) and compare it to treatment with conventional negative-pressure wound therapy (NPWT) only.

Methods: The researchers randomly allocated 30 DFUs Wagner grade 2 or higher from 30 adult patients into two groups. The control group (n = 15) was treated with conventional NPWT, and the experimental group (n = 15) was treated with micronized dermal matrix and NPWT. Read More

J Plast Reconstr Aesthet Surg 2021 Apr 1. Epub 2021 Apr 1.

Imperial College London, 46 Baston Road, Hayes BR2 7BE, Kent, UK. Electronic address:

In this response to 'The impact of COVID-19 on medical electives in plastic surgery - A medical students' perspective' by U. Singh, I highlight the invaluable learning opportunities provided by an elective placement in plastic surgery as a senior medical student, particularly regarding wound care and dressing. Such exposure to wound care on a plastic surgery placement in medical school may increase the confidence of junior doctors entering the hospital workplace. Read More

Arch Osteoporos 2021 04 8;16(1):63. Epub 2021 Apr 8.

Department of Trauma Surgery, Ziekenhuisgroep Twente, Almelo-Hengelo, The Netherlands.

Individual process indicators often do not enable the benchmarking of hospitals and often lack an association with outcomes of care. The composite hip fracture process indicator, textbook process, might be a tool to detect hospital variation and is associated with better outcomes during hospital stay.

Purpose: The aim of this study was to determine hospital variation in quality of hip fracture care using a composite process indicator (textbook process) and to evaluate at patient level whether fulfilment of the textbook process indicator was associated with better outcomes during hospital stay. Read More

Wound Repair Regen 2021 Apr 5. Epub 2021 Apr 5.

Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.

Advances in patient care for pressure injuries (PIs) have reduced the prevalence of PIs in Japan, although not in recent years. Several single-nucleotide polymorphisms (SNPs) have been identified in genes potentially associated with PIs. However, individual variance among PI risks require targeted investigations that may lead to the identification of PI susceptibilities or preventive care options that directly influence PI development pathways. Read More

Wounds 2021 Mar;33(3):77-80

Wright State University School of Medicine, Dayton, Ohio; Jobst Vascular Institute/ProMedica Health system, Toledo, Ohio.

Introduction: Management of patients with pressure wounds often may entail the administration of vitamins A and C, zinc, and arginine. Supplementing these nutrients as part of a standard wound care protocol may increase the risk for toxicity and unnecessarily increase the cost of health care.

Objective: This study aimed to correlate the nutritional status represented by albumin and prealbumin levels with aforementioned nutrient levels. Read More

Wound Manag Prev 2021 Mar;67(3):30-35

Qazvin University of Medical Sciences, Qazvin, Iran.

Background: Medical device-related pressure ulcers/injuries (MDRPU/Is) are a serious concern in health care.

Purpose: To develop and assess the psychometric testing of a questionnaire to measure nursing students' attitudes about the care and prevention of MDRPU/Is.

Methods: Based on a review of the literature, a 26-item questionnaire was developed; face validity was assessed by ten (10) nursing students. Read More

Ann Vasc Dis 2021 Mar;14(1):46-51

Department of Plastic and Reconstructive Surgery, Juntendo University School of Medicine, Sapporo, Hokkaido, Japan.

Venous leg ulcers (VLUs) caused by chronic venous insufficiency are difficult to treat. Outcomes after compression therapy and the current standard of care often used in conjunction with other options vary widely. We examined the effects of foam inserts on sub-bandage pressures in patients with VLUs and compared use of foam inserts in elastic and inelastic compression bandaging. Read More

J Vasc Surg Cases Innov Tech 2021 Mar 27;7(1):159-163. Epub 2020 Oct 27.

Department of Vascular Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pa.

Angiosome-directed endovascular therapy for the treatment of chronic limb-threatening ischemia (CLTI) remains controversial owing to the overlap of wound angiosomes. Angiographic grading of success has limitations and translesional pressure assessments are seldom performed in the infrapopliteal vessels. Objective criteria to determine revascularization success in tibiopedal vessels have not been well described. Read More

Adv Wound Care (New Rochelle) 2021 05;10(5):281-292

Department of Surgery, Indiana University Health Comprehensive Wound Center, Indianapolis, Indiana, USA.

Chronic wounds impact the quality of life (QoL) of nearly 2.5% of the total population in the United States and the management of wounds has a significant economic impact on health care. Given the aging population, the continued threat of diabetes and obesity worldwide, and the persistent problem of infection, it is expected that chronic wounds will continue to be a substantial clinical, social, and economic challenge. Read More

J Wound Care 2021 Mar;30(3):198-208

St. Helens Medical Centre, Isle of Wight, UK.

Objective: The presence of sub-epidermal moisture (SEM) over a bony prominence is indicative of incipient pressure ulcer (pressure injury/decubitus/bedsore) (PU). Early identification of patients at increased risk of PU can prompt interventions that reduce the incidence and severity of hospital (or community)-acquired PUs (HAPUs). This study evaluated the clinical utility of a SEM Scanner device in HAPU management. Read More

Int Wound J 2021 Mar 16. Epub 2021 Mar 16.

Nursing School, MSN Aspen University, Denver, Colorado, USA.

Hospital-acquired pressure ulcers (HAPUs) negatively affect patients during hospitalisation, putting patients at risk for further complications. HAPUs are one of the hospital quality key performance indicators (KPIs) that necessitate quality initiatives and/or programmes to minimise its occurrence and consequences. When quality initiatives are put into place and proven effective, the next important focus is sustainability of the effects. Read More

BMC Geriatr 2021 03 15;21(1):182. Epub 2021 Mar 15.

Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.

Background: Energy inadequacy has a great impact on health outcomes in older adult patients; however, it is difficult to evaluate energy adequacy in these patients, especially in home-care settings. We recently reported that temporal muscle thickness can be an indicator of nutritional status. The present study aims to examine whether a change in temporal muscle thickness is directly correlated with energy adequacy and, if so, to determine the cutoff value of a change in temporal muscle thickness to detect energy inadequacy. Read More

Diabetes Res Clin Pract 2021 Mar 10;175:108733. Epub 2021 Mar 10.

Program in Physical Therapy and Department of Radiology, Washington University School of Medicine in St Louis, St. Louis, MO 63108, USA. Electronic address:

Physical activity is an essential part of general health and diabetes management. However, recommending weight-bearing physical activity for people with plantar diabetic foot ulcers is controversial, even when gold standard offloading devices are used, as it is commonly thought to delay healing. We aimed to narratively review relevant studies investigating the relationship between plantar diabetic foot ulcer healing and weight-bearing activity, plantar pressure and device adherence. Read More

BMJ Open 2021 Mar 12;11(3):e043042. Epub 2021 Mar 12.

Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.

Introduction: Pressure ulcers are serious and potentially life-threatening problems across all age groups and across all medical specialties and care settings. The hospitalised elderly population is the most common group to develop pressure ulcers. This study aims to systematically review studies implementing pressure ulcer prevention strategies recommended in the Pressure Ulcer Prevention Practice Guidelines for the prevention of pressure ulcers among hospitalised elderly patients globally. Read More

J Wound Ostomy Continence Nurs 2021 Mar-Apr 01;48(2):115-123

Charlotte Raepsaet, Skin Integrity Research Group (SKINT), Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.

Purpose: We studied pressure injury (PI) stage II-IV cumulative incidence and the change of PI status in the sacral area of nursing home residents associated with the use of a fully automated pulsating support system air mattress in use for 30 days. We also assessed caregivers', residents', and their family members' experiences and perceptions of mattress comfort and other factors such as pain.

Design: Multicenter cohort study. Read More