Background: Pressure injuries (PIs) are a significant issue in nursing homes (NHs) that affect residents’ physical, psychological, and financial well-being. Despite advancements in prevention and management, PIs remain a critical challenge requiring a comprehensive analysis of research trends to guide future efforts. Methods: We analyzed 1,857 research abstracts published up to December 2023 using text network analysis and topic modeling. Keyword frequency, co-occurrence patterns, and centrality metrics were examined to identify the key terms. Latent Dirichlet allocation was employed for topic modeling, and trends were analyzed over decades to explore the evolution of research priorities. Results: The most frequent keywords were “patient,” “care,” and “wound,” emphasizing the central themes of patient care and wound management. Four main topics were identified: Managing PI Complications, Preventing PIs and Maintaining Skin Integrity, Improving Organizational Strategies for PI Care, and Managing Systemic Conditions in PI Care. Trends revealed a decline in studies on post-injury management, while prevention and organizational strategies have gained prominence. Patient-specific risk factors have consistently attracted attention over the decades, highlighting the importance of individualized care. Conclusion This study underscores the shift from reactive post-injury management to proactive prevention and organizational strategies in PI research. These findings emphasize the need for integrated approaches that combine patient-centered care with systemic and preventive measures to improve outcomes in NHs.

Background: This study focuses on the development of a hydrogel wound patch incorporating natural extracts, designed to function as a sun patch. By maintaining a moist environment and delivering bioactive compounds, the patch promotes wound healing while also providing cooling and ultraviolet (UV) protection. This dual-purpose approach enhances skin recovery and shields damaged areas from external stressors. The study aims to optimize the formulation and evaluate its efficacy for both therapeutic and cosmetic applications. Methods: Hydrogel solutions prepared using acrylamide, glycerol, and carboxymethyl cellulose were enriched with extracts from Saururus chinensis, Styrax japonicus, and Centella asiatica. The enriched solutions were processed into patches and tested for their adhesion, cooling effects, and UV protective abilities. Additionally, the wound healing efficacy was evaluated in a mouse model. Results: The hydrogel patches demonstrated comparable adhesion properties, effective skin cooling, and high UV protection rates similar to those of commercially available products. In the mouse model, the patches significantly improved wound closure and tissue regeneration in the experimental group as compared to the control group. Conclusion The study confirms that hydrogel sun patches enriched with natural extracts have the ability to effectively promote wound healing and offer substantial UV protection and cooling benefits, demonstrating their potential medical and cosmetic applications.

Background: Burn injuries are a major global health issue, causing significant morbidity and mortality. Negative-pressure wound therapy (NPWT) is a common treatment that aids fluid drainage and enhances blood flow, thereby promoting wound healing. However, its effects on wound healing parameters like fibroblast growth factor-2 (FGF2) and platelet-derived growth factor (PDGF) in deep dermal burns are not fully elucidated. This study aimed to compare NPWT with conventional treatments, namely 0.9% sodium chloride (NaCl) and silver sulfadiazine (SSD), in terms of their effects on FGF2 and PDGF levels in burn wounds. Methods: Seventy-two fresh tissue samples from Yorkshire pig deep dermal burn models were divided into three treatment groups: NPWT, NaCl, and SSD. Wounds were photographed and observed macroscopically. Tissue samples were collected on days 3, 7, 14, and 21 and analyzed using enzyme-linked immunosorbent assay for further statistical analysis. Results: Macroscopic observation indicated better epithelialization and granulation in the NPWT group, with minimal wound contraction. Although differences across the treatment groups were insignificant, NPWT maintained higher and more stable FGF2 levels, peaking on days 7 and 21 (780.62±353.88 ng/mL and 504.31±254.25 ng/mL), with significant delta (Δ) value increases in the later stages (P=0.042), which were not observed in the NaCl and SSD groups. PDGF concentrations showed insignificant differences across all treatment groups, with notable delta changes in the SSD group (P=0.018). Conclusion NPWT demonstrated superior wound healing performance compared to conventional treatments. In addition to favorable macroscopic findings, NPWT potentially maintained FGF2 levels throughout the wound healing process.

Background: Fournier’s gangrene (FG) is a rare, rapidly progressing necrotizing fasciitis affecting the perineum and external genitalia, characterized by polymicrobial infection, obliterative endarteritis, and subcutaneous arterial thrombosis. This study compares the impact of vacuum-assisted closure (VAC) and non-VAC wound care on the length of hospital stay in FG patients treated at a tertiary hospital in Surabaya, Indonesia. Methods: A retrospective, cross-sectional study analyzed secondary data from 12 FG patients treated by the plastic reconstructive and aesthetic surgery department at a tertiary hospital in Surabaya, Indonesia, between May 2017 and April 2021. Results: The study included patients aged 16 to 60 years (66.7%), with a mean age of 50.25 years. Diabetes mellitus was the most prevalent comorbidity (83.2%), followed by hypertension and hepatitis. Wound care included VAC in 83.2% of cases, with the remainder treated using non-VAC methods. Surgical interventions involved flap advancement (50.0%), bilateral medial thigh flap (33.3%), and skin grafts (16.7%). The mean hospital stay was 40.5 days. Mann-Whitney U test analysis revealed no significant correlation between the type of wound care (VAC or non-VAC) and hospital stay length (P<0.05). Conclusion There is no significant correlation between wound care type and length of hospital stay in FG patients treated at a tertiary hospital, suggesting other factors may more strongly influence hospitalization duration.

Managing crush injuries of upper extremities with severe devitalization of surrounding tissues is often complicated by limited covering options. A 46-year-old male patient presented 4 days after sustaining a crush injury, for which he had undergone vascular repair at another hospital. The patient had extensive necrosis of forearm muscles, with uncertain vascularity of the hand. Debridement of the wound exposed the brachial artery; viability of the hand was still uncertain. Lacking healthy surrounding tissue for coverage, and also to minimize donor site morbidity in a limb with an uncertain prognosis, a dermal substitute was utilized to protect the exposed brachial artery. After the progressive necrosis had stabilized and the dermal substitute had successfully integrated, skin grafting was performed. The patient experienced an uneventful recovery and is now scheduled for functional restoration procedures in the near future. The dermal substitute was instrumental in managing this difficult situation.

Fournier’s gangrene (FG) is a rapidly progressive necrotizing fasciitis affecting the perineal, genital, or perianal regions. It is a rare but potentially life-threatening condition that predominantly affects immunocompromised individuals, including those infected with the human immunodeficiency virus (HIV). Recent findings have highlighted the benefits of sodium-glucose cotransporter 2 inhibitors (SGLT2i) for patients with diabetes mellitus, such as prevention and treatment of cardiovascular disease, heart failure, and kidney disease. This supports both the expansion of their indications and the development of drug combinations with first-line medications. However, the increased risk of genitourinary infections is a well-known side effect of SGLT2i. This report describes the case of a 62-year-old man with well-controlled HIV infection, hypertension, and diabetes mellitus, who was using an SGLT2i and presented with FG. The patient underwent prompt surgical debridement, antibiotic therapy, and discontinued the SGLT2i, followed by wound reconstruction using a local transposition flap. This resulted in a successful outcome, with no further wounds observed for 3 months. This case underscores the potential synergistic risk factors of SGLT2i use and HIV infection in the development of FG and highlights the critical importance of prompt surgical intervention.

Background: The use of acellular dermal matrix (ADM) in breast reconstruction can inhibit capsular contracture, increasing the success rate of surgery. Adipose-derived stem cells (ADSCs) can effectively suppress foreign body reaction, which is a major cause of capsular contracture. This study aimed to elucidate the synergistic effects of combining ADSCs with ADM on capsule formation, utilizing a rat model. Methods: The study utilized 12 rats, equally divided into two experimental groups. Group A received silicone implants covered with ADM, while Group B was implanted with silicone prostheses wrapped in ADM, pre-seeded with ADSCs. Capsule formation was assessed through visual examination, histological analysis, and reverse transcription-polymerase chain reaction (RT-PCR) at 4 and 8 weeks post-implantation. Results: At 4 weeks, the mean capsular thickness was 177.16 μm in Group A and 170.76 μm in Group B; at 8 weeks, it was 196.69 μm in Group A and 176.10 μm in Group B. Statistical analysis showed no significant difference in capsule thickness between the groups (P>0.05). Histological findings indicated that Group A had more inflammatory cells and collagen fibers and reduced angiogenesis. RT-PCR showed that angiogenesis-promoting gene expression in Group B was 14% higher at 4 weeks and 156% higher at 8 weeks compared to Group A. Conclusion Although no statistically significant reduction in capsule thickness was observed, ADSC-seeded implants showed histological features associated with reduced inflammation and enhanced angiogenesis, suggesting potential benefits in capsule formation management.

Marjolin’s ulcers are rare aggressive conditions that arise from chronic skin lesions and diseases. Various cell types may be observed in these lesions; however, squamous cell carcinoma is the most common type. Squamous cell carcinoma due to Marjolin’s ulcer has a greater tendency to metastasize than squamous cell carcinoma due to other causes. This condition occurs primarily on the lower extremities, although a few cases have been reported of it occurring on the scalp. Moreover, cases of penetration of bone and dura mater are observed even more rarely. In this article, we present a rare case of a Marjolin’s ulcer that penetrated the scalp and invaded the bone and dura mater.

Exosomes are small extracellular vesicles released by a range of cells, including mesenchymal stromal/stem cells (MSCs), immune cells, cancerous cells, etc. These particles contain biomolecules such as DNA, microRNA, messenger RNA, protein, and lipid, and play a vital role in establishing cellular communication. After reaching the target cells, the particles cause changes in function, fate, morphology, differentiation, and growth. Exosomes released from a variety of sources have the ability to influence the behavior of cells involved in wound healing, enhance neovascularization, promote collagen deposition, reduce inflammation, and quicken the healing process. According to new research, endothelial cell adhesion, migration, proliferation, vascular repair, and angiogenesis are all accelerated during the wound healing process when deleted in malignant brain tumors 1 (DMBT1) is used as an active stimulant. This article will review DMBT1 protein as one of the major elements of exosomes from human urine-derived MSCs.

Background: Ablative oncologic procedures for colorectal or gynecologic malignancies can result in large skin or tissue volume defects. Although direct closure may be possible, such attempts can lead to postoperative complications such as wound breakdown, organ prolapse, chronic seroma, or infection. Various procedures, from flap surgery to local wound care, can be useful additions to improve patient outcomes. Methods: This study retrospectively reviews cases of patients with multiple comorbidities who had undergone concomitant interventions after pelvic ablative surgery. Various interventions after pelvic ablative surgery, from reconstructing the defect to managing postoperative complications, are described. Results: Careful planning and selection of the reconstruction method can significantly improve patient outcomes. The authors suggest using gluteal flaps for most reconstructive demands. Conclusion This case series emphasizes the utility of using various flaps, especially the gluteal flap, in reconstructing oncologic defects in the pelvic and perineal regions. The insights gained from this study will hopefully be of assistance to future research and clinical practice, ultimately improving patient outcomes.