An explorative study on the validity of various definitions of a 2 ·2°C temperature threshold as warning signal for impending diabetic foot ulceration
Abstract Home monitoring of skin temperature is effective to prevent diabetic foot ulceration. We explored the validity of various definitions for the>2·2°C left‐to‐right threshold used as a warning signal for impending ulceration. Twenty patients with diabetes and peripheral neuropathy monitored their skin temperature with an infrared thermometer at the plantar hallux, metatarsal heads, midfoot and heel four times a day for 6 consecutive days. Environmental temperature and walking activity were monitored and associated with foot temperature. The average temperature difference between feet was 0·65...
Source: International Wound Journal - October 1, 2017 Category: Surgery Authors: Anke M Wijlens, Samantha Holloway, Sicco A Bus, Jaap J van Netten Tags: ORIGINAL ARTICLE Source Type: research

The contribution of a directional preference of stiffness to the efficacy of prophylactic sacral dressings in protecting healthy and diabetic tissues from pressure injury: computational modelling studies
The objective of this study has been to expand our previous work regarding the modes of action and biomechanical efficacy of prophylactic dressings in protecting the soft tissues adjacent to the sacrum by specifically examining the role of a directional stiffness preference (anisotropy) of the dressing while further accounting for diabetic tissue conditions. Multiple three‐dimensional anatomically detailed finite element (FE) model variants representing diabetic tissue conditions were used, and tissue loading state data were compared with healthy tissue simulations. We specifically compared soft tissue exposures to eleva...
Source: International Wound Journal - September 28, 2017 Category: Surgery Authors: Ayelet Levy, Dafna Schwartz, Amit Gefen Tags: ORIGINAL ARTICLE Source Type: research

Calendar
(Source: International Wound Journal)
Source: International Wound Journal - September 27, 2017 Category: Surgery Tags: CALENDAR OF EVENTS Source Type: research

News and views
(Source: International Wound Journal)
Source: International Wound Journal - September 27, 2017 Category: Surgery Tags: NEWS Source Type: research

Society news
(Source: International Wound Journal)
Source: International Wound Journal - September 27, 2017 Category: Surgery Tags: NEWS Source Type: research

Guidelines for Ethical Publishing
(Source: International Wound Journal)
Source: International Wound Journal - September 27, 2017 Category: Surgery Authors: Keith Harding, Douglas Queen Tags: EDITORIAL Source Type: research

Issue Information
(Source: International Wound Journal)
Source: International Wound Journal - September 27, 2017 Category: Surgery Tags: ISSUE INFORMATION Source Type: research

Self ‐medication garlic‐induced irritant skin lesions – case series
(Source: International Wound Journal)
Source: International Wound Journal - September 25, 2017 Category: Surgery Authors: Anca Chiriac, Anca E Chiriac, Adrian Naznean, Cristian Podoleanu, Simona Stolnicu Tags: LETTER TO THE EDITOR Source Type: research

The exquisitely painful fingertip – subungual glomus tumours
(Source: International Wound Journal)
Source: International Wound Journal - September 25, 2017 Category: Surgery Authors: Shetha Naji, Charles Yuen Yung Loh, Makarand Tare Tags: LETTER TO THE EDITOR Source Type: research

Medications affecting healing: an evidence ‐based analysis
Abstract The purpose of this arm of the study was to investigate the impact of medication on healing times of the various wound types, including acute wounds and leg ulcers. A prospective longitudinal study design was used, with de‐identified data collected using an electronic mobile wound care database system. Three main categories of data were collected, including patients' demographics, wounds types and treatment characteristics. For acute wounds, there was a total of 1732 patients with 2089 acute wounds. The average healing time was about 35 days. The only significant association was with chemotherapy, which i...
Source: International Wound Journal - September 25, 2017 Category: Surgery Authors: Hanan Khalil, Marianne Cullen, Helen Chambers, Matthew McGrail Tags: ORIGINAL ARTICLE Source Type: research

Prognostic factors and treatment outcomes for patients with Fournier's gangrene: a retrospective study
Abstract Fournier's gangrene is a gas‐forming, necrotising soft tissue infection affecting the perineum. It spreads rapidly along the deep fascial planes and is associated with a high mortality rate. With a growing elderly population with comorbidities, the frequency of severe cases of Fournier's gangrene is expected to increase. We retrospectively reviewed 20 patients diagnosed with Fournier's gangrene at our institution from 2003 to 2014 and analysed data. Thirteen patients had diabetes mellitus, two had been diagnosed with liver cirrhosis, and four were chronic alcoholics. Of 15 patients admitted to an intensive care ...
Source: International Wound Journal - September 25, 2017 Category: Surgery Authors: Kyung Sook Hong, Hee Jung Yi, Ryung ‐Ah Lee, Kwang Ho Kim, Soon Sup Chung Tags: ORIGINAL ARTICLE Source Type: research

Citric acid treatment of non ‐healing sinus of neck in a patient treated with anti‐Koch therapy
(Source: International Wound Journal)
Source: International Wound Journal - September 25, 2017 Category: Surgery Authors: Basavraj S Nagoba, Milind S. Davane Tags: LETTER TO THE EDITOR Source Type: research

Self ‐medication garlic‐induced irritant skin lesions – case series
(Source: International Wound Journal)
Source: International Wound Journal - September 25, 2017 Category: Surgery Authors: Anca Chiriac, Anca E Chiriac, Adrian Naznean, Cristian Podoleanu, Simona Stolnicu Tags: LETTER TO THE EDITOR Source Type: research

Enhanced wound ‐healing performance of a phyto‐polysaccharide‐enriched dressing – a preclinical small and large animal study
In conclusion, a polysaccharide‐enriched dressing outperformed a traditional dressing in reducing wound size, minimising hypertrophic scar formation, regulating cytokines and maximising antimicrobial effects. (Source: International Wound Journal)
Source: International Wound Journal - September 21, 2017 Category: Surgery Authors: Chih ‐Hsin Wang, Shu‐Jen Chang, Yuan‐Sheng Tzeng, Yu‐Jen Shih, Chang Adrienne, Shyi‐Gen Chen, Tim‐Mo Chen, Niann‐Tzyy Dai, Juin‐Hong Cherng Tags: ORIGINAL ARTICLE Source Type: research

Deep tissue loads in the seated buttocks on an off ‐loading wheelchair cushion versus air‐cell‐based and foam cushions: finite element studies
Abstract For wheelchair users, a common injury is a sitting‐acquired pressure ulcer (PU) which typically onsets near the interface between the ischial tuberosity (IT) and the overlying soft tissues. The risk of developing PUs can be reduced considerably if an adequate cushion is placed on the wheelchair in order to protect tissues from PUs by minimising interface mechanical loads between the body and cushion and also, exposure to internal soft tissue loads. In this work, we studied the biomechanical performances of an off‐loading (OL) cushion with limited adjustability, in comparison to a standard foam cushion and a fu...
Source: International Wound Journal - September 6, 2017 Category: Surgery Authors: Lea Peko Cohen, Amit Gefen Tags: ORIGINAL ARTICLE Source Type: research

Quantum molecular resonance technology in hard ‐to‐heal extremity wounds: histological and clinical results
Abstract Chronic wounds are commonly associated with high morbidity rates due to the patient's need of frequent dressing changes and repeated visits to the outpatient wound clinic. Furthermore, chronic wounds are often characterised by severe pain, which can cause significant disability to the patient. New technologies aim to develop an optimal device to reduce discomfort of the patient and to heal wounds. The device Rexon‐age® is introduced for the first time in wound healing, and preliminary data on clinical and histological results are shown. From April 2014 to April 2015, 11 patients – 7 females and 4 males...
Source: International Wound Journal - August 30, 2017 Category: Surgery Authors: Marco Fraccalvieri, Marco Salomone, Claudia Di Santo, Erind Ruka, Umberto Morozzo, Stefano Bruschi Tags: ORIGINAL ARTICLE Source Type: research

Reply to: Effectiveness of a multi ‐layer foam dressing in preventing sacral pressure ulcers in the early acute care of patients with a traumatic spinal cord injury: comparison with the use of a gel mattress by Gefen and Santamaria
(Source: International Wound Journal)
Source: International Wound Journal - August 10, 2017 Category: Surgery Authors: Andr éane Richard‐Denis, Cynthia Thompson, Jean‐Marc Mac‐Thiong Tags: LETTER TO THE EDITOR Source Type: research

Wood's lamp for vitiligo disease stability and early recognition of initiative pigmentation after epidermal grafting
Abstract The prerequisite for a successful vitiligo epidermal grafting surgery is the stable status of the disease. We used Wood's lamp to assess vitiligo activity to determine the disease stability, surgical grafting timing and the early recognition of re‐pigmentation after grafting. Amelanotic lesions with sharply demarcated borders are typically stable and are good candidates for grafting. The re‐pigmentation was first recognised under Wood's lamp as hypochromic islands, which progressed to normally pigmented islands. For patients more prone to relapse, follow up with Wood's lamp also provides more accurate surveill...
Source: International Wound Journal - August 10, 2017 Category: Surgery Authors: Yen ‐Jen Wang, Chang‐Cheng Chang, Kun‐Lin Cheng Tags: CASE REPORT Source Type: research

Chitin and chitosan: biopolymers for wound management
Abstract Chitin and chitosan are biopolymers with excellent bioactive properties, such as biodegradability, non‐toxicity, biocompatibility, haemostatic activity and antimicrobial activity. A wide variety of biomedical applications for chitin and chitin derivatives have been reported, including wound‐healing applications. They are reported to promote rapid dermal regeneration and accelerate wound healing. A number of dressing materials based on chitin and chitosan have been developed for the treatment of wounds. Chitin and chitosan with beneficial intrinsic properties and high potential for wound healing are attractive ...
Source: International Wound Journal - August 10, 2017 Category: Surgery Authors: Rita Singh, Kirti Shitiz, Antaryami Singh Tags: ORIGINAL ARTICLE Source Type: research

Cross ‐cultural adaptation, reproducibility and validation of the Italian version of the Patient and Observer Scar Assessment Scale (POSAS)
This study confirmed that POSAS‐I can be used to assess patients with surgical scars in the Italian population. OSAS‐I is useful for clinical and research purposes, while PSAS‐I should be better used to capture patients' own opinions and symptoms in clinical settings. (Source: International Wound Journal)
Source: International Wound Journal - August 6, 2017 Category: Surgery Authors: Stefano Vercelli, Giorgio Ferriero, Elisabetta Bravini, Valeria Stissi, Matteo Ciceri, Sara Rossetti, Sara Bianchi, Francesco Sartorio Tags: ORIGINAL ARTICLE Source Type: research

Evaluation of a muscle pump ‐activating device for non‐healing venous leg ulcers
ABSTRACT This evaluation involves an innovative muscle pump‐activating device (geko™) as an adjunctive therapy with best practices for non‐healing venous leg ulcers (VLUs). Stimulating the common peroneal nerve (at the fibular head), the geko™ device creates a response that acts as foot and calf muscle pumps, increasing venous, arterial and microcirculatory flow. The aim was to evaluate and determine if the geko™ is effective in this population and if it should be added to the medical supply formulary. In all, 12 patients with 18 recalcitrant VLUs (defined as less than 30% reduction in wound size in 3...
Source: International Wound Journal - August 2, 2017 Category: Surgery Authors: Connie Harris, Rochelle Duong, Gwen Vanderheyden, Beth Byrnes, Renee Cattryse, Ava Orr, David Keast Tags: ORIGINAL ARTICLE Source Type: research

The exquisitely painful fingertip  – subungual glomus tumours
(Source: International Wound Journal)
Source: International Wound Journal - August 1, 2017 Category: Surgery Authors: Shetha Naji, Charles Yuen Yung Loh, Makarand Tare Tags: LETTER TO THE EDITOR Source Type: research

Enhanced wound ‐healing performance of a phyto‐polysaccharide‐enriched dressing – a preclinical small and large animal study
In conclusion, a polysaccharide‐enriched dressing outperformed a traditional dressing in reducing wound size, minimising hypertrophic scar formation, regulating cytokines and maximising antimicrobial effects. (Source: International Wound Journal)
Source: International Wound Journal - August 1, 2017 Category: Surgery Authors: Chih ‐Hsin Wang, Shu‐Jen Chang, Yuan‐Sheng Tzeng, Yu‐Jen Shih, Chang Adrienne, Shyi‐Gen Chen, Tim‐Mo Chen, Niann‐Tzyy Dai, Juin‐Hong Cherng Tags: ORIGINAL ARTICLE Source Type: research

Preliminary result with incisional negative pressure wound therapy and pectoralis major muscle flap for median sternotomy wound infection in a high ‐risk patient population
ABSTRACT Deep sternal wound infection (DSWI) represents a dangerous complication that can follow open‐heart surgery with median sternotomy access. Muscle flaps, such as monolateral pectoralis major muscle flap (MPMF), represent the main choices for sternal wound coverage and infection control. Negative pressure incision management system has proven to be able to reduce the incidence of these wounds' complications. PrevenaTM represents one of these incision management systems and we aimed to evaluate its benefits. A total of 78 patients with major risk factors that presented post‐sternotomy DSWI following cardiac surger...
Source: International Wound Journal - August 1, 2017 Category: Surgery Authors: Federico Lo Torto, Ambra Monfrecola, Juste Kaciulyte, Pedro Ciudad, Donato Casella, Diego Ribuffo, Bruno Carlesimo Tags: ORIGINAL ARTICLE Source Type: research

Quality ‐of‐life evaluation in chronic wounds: comparative analysis of three disease‐specific questionnaires
Abstract The study directly compared the feasibility and performance of three instruments measuring health‐related quality of life (HRQoL) in chronic ulcers: the Freiburg Life Quality Assessment for wounds (FLQA‐w), the Cardiff Wound Impact Schedule (CWIS) and the Würzburg Wound Score (WWS). The questionnaires were evaluated in a randomly assigned order in a longitudinal observational study of leg ulcer patients. Psychometric properties (internal consistency, responsiveness and construct validity) were analysed. Patient acceptance was recorded. Analysis of n = 154 patients revealed good internal cons...
Source: International Wound Journal - August 1, 2017 Category: Surgery Authors: Matthias Augustin, Katrin Baade, Kristina Heyer, Patricia E Price, Katharina Herberger, Thomas Wild, Michael Engelhardt, Eike S Debus Tags: ORIGINAL ARTICLE Source Type: research

Non ‐adherence to treatment of chronic wounds: patient versus professional perspectives
This study explored intentional and unintentional non‐adherence to treatment from patient/carer and health care professional perspectives. Patients with wounds receiving ALLEVYN Life dressings (n = 20) and patients not receiving ALLEVYN Life dressings who were deemed to be non‐adherent to treatment regimes (n = 6) took part in semi‐structured interviews to explore their experiences of living with a wound, treatment and intentional and unintentional non‐adherence. Three focus groups of health care professionals explored issues surrounding non‐adherence to treatment regimes. Groups inclu...
Source: International Wound Journal - August 1, 2017 Category: Surgery Authors: Christine Moffatt, Susie Murray, Vaughan Keeley, Aimee Aubeeluck Tags: ORIGINAL ARTICLE Source Type: research

Healing of chronic venous ulcer with topical sevoflurane
Abstract The present study assesses the efficacy and safety of topical sevoflurane in chronic venous ulcers and its impact on analgesia and healing. This retrospective study included 30 patients older than 65 years with painful refractory chronic venous ulcers. Patients were treated with topical sevoflurane prior to the usual ulcer cleaning every 2 days for a period of 1 month. Treatment was initiated with a saline solution, followed by direct irrigation of 1 ml of liquid sevoflurane over the wound size, which was measured as cm2. Sevoflurane had a fast, intense and long‐lasting analgesic effect. Latency time ranged from...
Source: International Wound Journal - August 1, 2017 Category: Surgery Authors: Adrian Imbernon ‐Moya, Francisco Javier Ortiz‐de Frutos, Mónica Sanjuan‐Alvarez, Isabel Portero‐Sanchez, Raúl Merinero‐Palomares, Victoria Alcazar Tags: ORIGINAL ARTICLE Source Type: research

Reply: to Effectiveness of a multi ‐layer foam dressing in preventing sacral pressure ulcers in the early acute care of patients with a traumatic spinal cord injury: comparison with the use of a gel mattress by Gefen and Santamaria
(Source: International Wound Journal)
Source: International Wound Journal - August 1, 2017 Category: Surgery Authors: Andr éane Richard‐Denis, Cynthia Thompson, Jean‐Marc Mac‐Thiong Tags: LETTER TO THE EDITOR Source Type: research

How and why patients self ‐treat chronic wounds
ABSTRACT The aim of this study was to investigate how people self‐treat chronic wounds, why they self‐treat and the assistance and support that they receive. The increasing emphasis on self‐management of chronic conditions, the potential benefits of self‐treatment to the health care consumer and competing demands on health care funding are good reasons to investigate self‐treatment of chronic wounds as we have little data on this group of individuals. A survey study was conducted in Australia. A non‐random sample of 100 participants was recruited. Participants were aged 18 years or older and currently or previo...
Source: International Wound Journal - August 1, 2017 Category: Surgery Authors: Suzanne Kapp, Nick Santamaria Tags: ORIGINAL ARTICLE Source Type: research

A PEGylated fibrin hydrogel ‐based antimicrobial wound dressing controls infection without impeding wound healing
In this study, we have evaluated the antimicrobial and wound healing efficacy of SSD‐CSM‐FPEG using a full‐thickness porcine wound infected with Pseudomonas aeruginosa. Infected wounds treated with a one‐time application of the SSD‐CSM‐FPEG wound dressing demonstrated significantly reduced bacterial bioburden over time (99·99% of reduction by day 11; P 
Source: International Wound Journal - August 1, 2017 Category: Surgery Authors: Joel Gil, Shanmugasundaram Natesan, Jie Li, Jose Valdes, Andrew Harding, Michael Solis, Stephen C. Davis, Robert J. Christy Tags: ORIGINAL ARTICLE Source Type: research

Adherence to evidence ‐based pressure injury prevention guidelines in routine clinical practice: a longitudinal study
Abstract The aim of this longitudinal study was to describe adherence to evidence‐based pressure injury (PI) prevention guidelines in routine clinical practice in Australian hospitals. Data were analysed from four control sites of a larger‐cluster randomised trial of a PI intervention. The sample of 799 included 220 (27·5%) Not at risk, 344 (43·1%) At risk and 110 (13·8%) At high risk patients. A total of 84 (10·5%) patients developed a PI during the study: 20 (9·0% of 220) in the Not at risk group, 45 (13·1% of 344) in the At risk group, 15 (13·6% of 110) in the At high...
Source: International Wound Journal - July 26, 2017 Category: Surgery Authors: Wendy Chaboyer, Tracey Bucknall, Brigid Gillespie, Lukman Thalib, Elizabeth McInnes, Julie Considine, Edel Murray, Paula Duffy, Michelle Tuck, Emma Harbeck Tags: ORIGINAL ARTICLE Source Type: research

Compression therapy – cross‐sectional observational survey about knowledge and practical treatment of specialised and non‐specialised nurses and therapists
This study compares knowledge and practical skills of participants with further training with those who had no training. This comparison provides information on whether further qualifications have an impact on knowledge and practical skills. In seminars for compression therapy, data on specific and non‐specific expertise were acquired. A practical test determined the participants' skills for creating a compression bandage in a pressure value range of 50–60 mmHg. In total, 1338 participants with specific expertise and 138 participants with non‐specific expertise took part. Knowledge evaluation showed that 7·...
Source: International Wound Journal - July 25, 2017 Category: Surgery Authors: Kristina Heyer, Kerstin Protz, Matthias Augustin Tags: ORIGINAL ARTICLE Source Type: research

Can a Morel ‐Lavallée lesion be misdiagnosed as a mass like lesion?
ABSTRACT The Morel‐Lavallée lesion (MLL) is a post‐traumatic closed soft tissue degloving injury. Common complaints of MLL patients are a haematoma or fluid collection on the trunk or the lower extremity. However, the authors introduce unique cases of MLL that present an atypical appearance. The fluid collection was not apparent, and the capsule formation was not detected on preoperative image study. The main complaint of patients was the uncomfortable mass‐like lesion that was regarded as a simple benign lump. The purpose of this case study is to introduce the atypical cases of MLL and to help other physician...
Source: International Wound Journal - July 25, 2017 Category: Surgery Authors: Yoon Jae Lee, Jun Hyeok Kim, Ji Young Kim, Hyun Ho Han Tags: ORIGINAL ARTICLE Source Type: research

Compression therapy  – cross‐sectional observational survey about knowledge and practical treatment of specialised and non‐specialised nurses and therapists
This study compares knowledge and practical skills of participants with further training with those who had no training. This comparison provides information on whether further qualifications have an impact on knowledge and practical skills. In seminars for compression therapy, data on specific and non‐specific expertise were acquired. A practical test determined the participants' skills for creating a compression bandage in a pressure value range of 50–60 mmHg. In total, 1338 participants with specific expertise and 138 participants with non‐specific expertise took part. Knowledge evaluation showed that 7...
Source: International Wound Journal - July 25, 2017 Category: Surgery Authors: Kristina Heyer, Kerstin Protz, Matthias Augustin Tags: ORIGINAL ARTICLE Source Type: research

The detrimental impact of extracellular bacterial proteases on wound healing
Abstract In addition to clinical signs of infection (e.g. inflammation, purulence and pain), a microbial count of ≥105 colony‐forming units/g has historically been used to define wound infection. However, it is increasingly recognised that, rather than a high bioburden level alone being detrimental to wound healing, it is the virulence of the invading microorganism and the host's immune status that can affect clinical outcomes. Bacteria, such as Pseudomonas aeruginosa, Staphylococcus aureus and Staphylococcus epidermidis, have developed a range of virulence factors to help them overcome host defences and proliferate w...
Source: International Wound Journal - July 25, 2017 Category: Surgery Authors: Sharon Lindsay, Angela Oates, Katie Bourdillon Tags: ORIGINAL ARTICLE Source Type: research

Topical sevoflurane for chronic venous ulcers infected by multi ‐drug‐resistant organisms
We present three cases of a chronic venous ulcer infected by multi‐resistant bacteria refractory to conventional systemic antibiotics, including Pseudomonas aeruginosa and methicillin‐resistant Staphylococcus aureus (MRSA). Treatment with topical sevoflurane was performed for 1 month without systemic antibiotics. Patients with an MRSA infection showed progressive improvement with negative culture at the end of the treatment. Multi‐drug‐resistant P. aeruginosa infection persisted at the end of treatment with positive culture. The local adverse events were mild and transient, including heat, pruritus and erythema. To...
Source: International Wound Journal - July 24, 2017 Category: Surgery Authors: Adri án Imbernón‐Moya, Francisco Javier Ortiz‐de Frutos, Mónica Sanjuan‐Alvarez, Isabel Portero‐Sanchez, Raúl Merinero‐Palomares, Victoria Alcazar Tags: CASE REPORT Source Type: research

Intraoperative indocyanine green fluorescent angiography ‐assisted modified superior gluteal artery perforator flap for reconstruction of sacral pressure sores
In this report, we describe the procedure and outcomes for 19 patients with grades III and IV sacral pressure sores who underwent the operation between September 2015 and November 2016. All flaps survived, and two experienced wound‐edge partial dehiscence. With the assistance of this imaging device, we were able to acquire a reliable superior gluteal artery perforator flap and perform modified operations with it that are safe, easy to learn and associated with fewer complications than are traditional. (Source: International Wound Journal)
Source: International Wound Journal - July 23, 2017 Category: Surgery Authors: Chun ‐Kai Chang, Chien‐Ju Wu, Chun‐Yu Chen, Chi‐Yu Wang, Tzi‐Shiang Chu, Kuo‐Feng Hsu, Han‐Ting Chiu, Hung‐Hui Liu, Chang‐Yi Chou, Chih‐Hsin Wang, Chin‐Ta Lin, Niann‐Tzyy Dai, Yuan‐Sheng Tzeng Tags: ORIGINAL ARTICLE Source Type: research

Comparing the reported burn conditions for different severity burns in porcine models: a systematic review
Abstract There are many porcine burn models that create burns using different materials (e.g. metal, water) and different burn conditions (e.g. temperature and duration of exposure). This review aims to determine whether a pooled analysis of these studies can provide insight into the burn materials and conditions required to create burns of a specific severity. A systematic review of 42 porcine burn studies describing the depth of burn injury with histological evaluation is presented. Inclusion criteria included thermal burns, burns created with a novel method or material, histological evaluation within 7 days post...
Source: International Wound Journal - July 23, 2017 Category: Surgery Authors: Christine J Andrews, Leila Cuttle Tags: ORIGINAL ARTICLE Source Type: research

Changes in the extracellular matrix surrounding human chronic wounds revealed by 2 ‐photon imaging
Abstract Chronic wounds are a growing problem worldwide with no effective therapeutic treatments available. Our objective was to understand the composition of the dermal tissue surrounding venous leg ulcers and diabetic foot ulcers (DFU). We used novel 2‐photon imaging techniques alongside classical histology to examine biopsies from the edges of two common types of chronic wound, venous leg ulcers and DFU. Compared to normal intact skin, we found that collagen levels are significantly reduced throughout the dermis of venous leg ulcer biopsies and DFU, with a reduction in both fibril thickness and abundance. Both wound t...
Source: International Wound Journal - July 21, 2017 Category: Surgery Authors: Jessica E.S. Sutcliffe, Christopher Thrasivoulou, Thomas E Serena, Leigh Madden, Toby Richards, Anthony R.J. Phillips, David L Becker Tags: ORIGINAL ARTICLE Source Type: research

Risk factors for amputation in patients with diabetic foot infection: a prospective study
In this study, we aimed to evaluate the independent risk factors for osteomyelitis, amputation and major amputation in patients with DFI using standard scoring procedures. We prospectively studied 379 patients with DFI. The variables were analysed using logistic analysis. A total of 126 cases (33·2%) underwent amputation. The odds ratios in the amputation model were 3·09 for osteomyelitis (P  15 mm (P 
Source: International Wound Journal - July 19, 2017 Category: Surgery Authors: Serhat Uysal, Bilgin Arda, Meltem I Ta şbakan, Şevki Çetinkalp, Ilgın Y Şimşir, Anıl M Öztürk, Ayşe Uysal, İlgen Ertam Tags: ORIGINAL ARTICLE Source Type: research

A simple concept for covering pressure sores: wound edge ‐based propeller perforator flap
We present a new surgical modification to allow propeller perforator flaps to cover pressure sores at various locations. We used a propeller perforator flap concept based on the detection of newly formed perforator vessels located 1 cm from the wound margin and stimulated by the chronic inflammation process. Between January 2009 and January 2017, 33 wound edge‐based propeller perforator flaps were used to cover pressure sores at various locations in 28 patients. In four cases more than one flap was used on the same patient. The patients comprised 18 males and 10 females with a mean age of 41·25 (range, 16–70...
Source: International Wound Journal - July 14, 2017 Category: Surgery Authors: Osman Kelahmetoglu, Koenraad Van Landuyt, Caglayan Yagmur, Casper E Sommeling, Musa K Keles, Volkan Tayfur, Tekin Simsek, Yener Demirtas, Ethem Guneren Tags: ORIGINAL ARTICLE Source Type: research

Differences in the daily activity of patients with diabetic foot ulcers compared to controls in their free ‐living environments
We examined daily activity outcomes of 30 patients with DFU, 23 DPN and 20 DM. All patients wore a validated multi‐sensor device for > 5 days (>22 hours per day) to measure their daily activity outcomes: steps, energy expenditure (kJ), average metabolic equivalent tasks (METs), physical activity (>3·0 METs) duration and energy expenditure, lying duration, sleep duration and sleep quality. We found that DFU patients recorded fewer median (interquartile ranges, IQR) daily steps [2154 (1621–4324)] than DPN [3660 (2742–7705)] and DM [5102 (4011–7408)] controls (P 
Source: International Wound Journal - July 13, 2017 Category: Surgery Authors: Helen Sheahan, Kimberley Canning, Nishka Refausse, Ewan M Kinnear, Greg Jorgensen, James R Walsh, Peter A Lazzarini Tags: ORIGINAL ARTICLE Source Type: research

Calendar
(Source: International Wound Journal)
Source: International Wound Journal - July 11, 2017 Category: Surgery Tags: CALENDAR OF EVENTS Source Type: research

News and views
(Source: International Wound Journal)
Source: International Wound Journal - July 11, 2017 Category: Surgery Tags: NEWS Source Type: research

Society news
(Source: International Wound Journal)
Source: International Wound Journal - July 11, 2017 Category: Surgery Tags: NEWS Source Type: research

The top five challenges in wound care
(Source: International Wound Journal)
Source: International Wound Journal - July 11, 2017 Category: Surgery Authors: Douglas Queen Tags: EDITORIAL Source Type: research

Issue Information
(Source: International Wound Journal)
Source: International Wound Journal - July 11, 2017 Category: Surgery Tags: ISSUE INFORMATION Source Type: research

The posterior thigh flap for defect coverage of ischial pressure sores – a critical single‐centre analysis
ABSTRACT The development of pressure sores is still not only an enormous economical but also a medical burden. Especially in the ischial region, the local defect coverage remains demanding as it is the main weight‐bearing area in wheelchair‐mobilised patients and is prone to high mobility. The purpose of our study was to report our long‐time experience with the reconstruction of ischial pressure ulcers with the medially based posterior thigh flap. A retrospective analysis of all primary pressure sores grade III–IV in the ischial area, which were covered with a medially based posterior thigh flap between January...
Source: International Wound Journal - June 29, 2017 Category: Surgery Authors: Gabriel Djedovic, Evi M Morandi, Julia Metzler, Anna Wirthmann, Johannes Matiasek, Thomas Bauer, Ulrich M Rieger Tags: ORIGINAL ARTICLE Source Type: research

Microscopy visualisation confirms multi ‐species biofilms are ubiquitous in diabetic foot ulcers
ABSTRACT Increasing evidence within the literature has identified the presence of biofilms in chronic wounds and proposed that they contribute to delayed wound healing. This research aimed to investigate the presence of biofilm in diabetic foot ulcers (DFUs) using microscopy and molecular approaches and define if these are predominantly mono‐ or multi‐species. Secondary objectives were to correlate wound observations against microscopy results in ascertaining if clinical cues are useful in detecting wound biofilm. DFU tissue specimens were obtained from 65 subjects. Scanning electron microscopy (SEM) and peptide nuclei...
Source: International Wound Journal - June 23, 2017 Category: Surgery Authors: Khalid Johani, Matthew Malone, Slade Jensen, Iain Gosbell, Hugh Dickson, Honhua Hu, Karen Vickery Tags: ORIGINAL ARTICLE Source Type: research

The financial and quality ‐of‐life cost to patients living with a chronic wound in the community
This study found that chronic wounds present a significant financial cost to individuals who must self‐fund their wound dressings and other wound treatment related expenses. Participants who had access to wound product subsidisation also experienced personal financial costs. People who have chronic wounds experience sub‐optimal quality of life therefore this condition is also costly to the individual's well‐being. The quality of life of younger people has not received adequate attention and requires further consideration given the many years that younger people may have to live with this debilitating and often recurr...
Source: International Wound Journal - June 20, 2017 Category: Surgery Authors: Suzanne Kapp, Nick Santamaria Tags: ORIGINAL ARTICLE Source Type: research