Background: In some patients, diabetic foot ulcers may heal slowly despite tight control of blood glucose and normal limb circulation, implying the presence of multifactorial, unidentified factors to wound healing. Previous efforts to identify these factors using binary variables, such as amputation or specific healing timelines, inadequately reflect the complexities of wound healing capacity.

Aims: We aimed to identify factors associated with delayed diabetic foot ulcer healing.

Methods: Eight factors were assumed to affect diabetic foot ulcer healing; patient age, age at the onset of diabetes, sex, peripheral arterial disease (PAD), HbA1c, smoking as measured by the Brinkman index (BI), dialysis and bone infection. They were analysed using linear regression and multivariable analysis against three healing indices: total healing period (THP), granulation time (GT) and time to contraction onset (TCO).

Results: PAD and BI correlated positively with all three indices. Patients with PAD exhibited significantly extended THP, GT and TCO. An increase of 100 in BI corresponded with a 1.53 day increase in GT. Conclusion: PAD was associated with delayed healing according to every measure analysed, while BI was linked with slower granulation. Besides THP, the measurements of GT — and possibly TCO — could evaluate some aspects of healing capacity of diabetic ulcers.

Kazufumi Tachi

Senior Lecturer, Division of Plastic Surgery, Tohoku Medical and Pharmaceutical University, Sendai, Japan

Koichi Gonda

Professor, Division of Plastic Surgery, Tohoku Medical and Pharmaceutical University, Sendai, Japan

Takashi Kochi

Chief Surgeon, Department of Plastic Surgery, Sendai City Hospital, Sendai, Japan

Jyunya Niwa

Research Associate, Division of Plastic Surgery, Tohoku Medical and Pharmaceutical University, Sendai, Japan

Key words

Diabetic foot ulcer

New index of wound healing

Brinkman index

Declarations

All authors have no conflicts of interest to declare.

Surgical site infections of post-transplanted heart patients, as well as wound care, have little scientific evidence in Mexico, although adequate treatment in infected wounds with advanced wound dressings or cellulose membranes that allow us to clearly assess the incision can reduce hospital stay, pain, anxiety and the infection itself, together with appropriate antibiotic therapy. The aim of this case report is to describe the management and care of the surgical site infection (Gram-negative bacillus) following a heart transplant that includes the transparent cellulose membrane.

Dalila Diana Bautista Uribe

Nurse Specialised in Wounds, Stomata and Burns, Centro Médico Siglo XXI Cardiología, Mexico City, CDMX, Mexico

Key words

• Surgical site infection
• Bacterial cellulose membrane

• Heart transplant

This article is based on a presentation by Professor Steven Jeffery at the annual Wounds UK conference in Harrogate, on 7 November 2023. Professor Jeffery presented clinical studies on how a bioengineered wound therapy with a porcine urinary bladder matrix (UBM) may facilitate healing of chronic wounds.

Steven LA Jeffery

Medical Director Pioneer Wound Telehealth and Professor of Wound Study, Birmingham City University

John McRobert

Clinical Research Director, Pioneer Wound Telehealth

Key words

• Chronic diabetic wounds

• Urinary bladder matrix
• Macrophages
• Wound healing
• Meeting report
• Wound care services

This meeting report has been funded by an educational grant from Integra

Management, as well as prevention, of wound infection is key in the promotion of the healing process. In India, over one million people are moderately or severely burnt every year, and managing the challenging burn wounds is a daily reality for clinicians in the country. Silver has been used as an antimicrobial in burn wound management for decades and modern advanced dressings can provide safe prevention and management of infection in these cases. This article reports the cases of two adults, an infant and a child with burns, at risk of infection and managed with a Technology Lipido-Colloid non-adherent dressing with silver (TLC-Ag; UrgoTul Ag/Silver). The main benefits observed when using the evaluated dressing in these patients included rapid wound healing but also patient-related outcomes, such as decrease in pain and atraumatic removal.

Dr Venkateswaran

Plastic Surgeon, Jupiter Hospital, Mumbai, India

Dr Ravichander Rao A

Plastic Surgeon, Care Hospital, Hyderabad, India

Dr Krishna Kumar

Plastic, Aesthetics, Burns, Hand and Reconstructive Microsurgeon, Kovai Medical Centre & Hospital, Coimbatore, India

Dr Sankamithra

Consultant Plastic Surgeon, Lakshmi Medical center, Pollachi, India

Key words

• Burns
• Lipido-colloid non-adherent dressing

• Silver

Declarations

All authors have no particular conflicts of interest to declare regarding these cases.