AI in Wound Assessment: Transforming Chronic Wound Care

Artificial intelligence (AI) is revolutionizing wound care by transforming how clinicians assess and manage chronic wounds. By automating measurements, enhancing diagnostic precision, and enabling remote monitoring, AI-powered tools address the shortcomings of traditional manual assessments, which are often subjective, time-consuming, and variable. From smartphone-based imaging to deep learning algorithms, AI delivers data-driven insights that improve treatment planning and patient outcomes for conditions like diabetic ulcers, pressure injuries, and venous leg ulcers. This article delves into AI’s impact on wound assessment, offering wound care professionals a glimpse into a technology poised to redefine clinical practice.

The Need for AI in Wound Assessment

Chronic wounds affect over 6 million Americans, costing healthcare systems billions annually. Accurate assessment is crucial to guide treatments, prevent infections, and accelerate healing. Yet, traditional methods—ruler measurements, visual inspections—rely on clinician experience, leading to inconsistencies. AI overcomes these barriers with standardized, objective analysis. Tools like Healthy.io’s Minuteful for Wound use smartphone cameras with calibration markers to capture high-resolution images, instantly measuring wound dimensions and classifying tissue types (granulation, necrotic, epithelialization). Such automation saves time, reduces errors, and allows clinicians to focus on patient care rather than documentation.

Key Highlights:

• Automated Precision: AI systems like eKare’s inSight measure wound size and tissue composition with 94% accuracy, outperforming manual methods. Deep learning models, such as U-Net, segment wound areas precisely, ensuring reliable data for clinical decisions.
• Advanced Diagnostics: AI tools, including Spectral AI’s DeepView SnapShot, predict healing potential and identify infection risks early. These capabilities enable proactive interventions, improving outcomes for complex wounds.
• Telemedicine Integration: AI apps facilitate remote monitoring, allowing patients to upload wound images for real-time clinician review. This enhances access for rural or bedbound patients, reducing hospital visits.
• Future Potential: AI could integrate with wearables and predictive analytics to forecast complications like amputations. Research continues to address challenges like limited datasets and tissue segmentation accuracy.

Clinical and Economic Benefits

AI’s precision in wound assessment drives significant clinical and economic advantages. By detecting subtle changes in wound characteristics—such as early signs of infection or delayed healing—AI supports tailored treatments, from selecting optimal dressings to initiating therapies like negative pressure wound therapy. Early intervention reduces infection rates and hospital readmissions, critical given chronic wounds’ $20–$30 billion annual U.S. cost. AI’s telemedicine capabilities also empower patients, improving adherence and satisfaction. For clinicians, AI tools integrate into workflows, enhancing documentation for reimbursement and freeing time for patient interaction. A 2024 review notes AI’s potential to standardize care across settings, from hospitals to home care.

Challenges to Overcome

Despite its promise, AI in wound assessment faces obstacles. Limited public datasets hinder model training, especially for complex tissues like necrotic areas, which vary in appearance. Regulatory approval, such as FDA clearance, is essential for credibility, but not all apps meet these standards. Clinicians must balance AI insights with clinical judgment to account for patient-specific factors, avoiding over-reliance. The PMC review emphasizes the need for robust clinical validation and diverse datasets to ensure AI tools perform reliably across populations, particularly for underrepresented groups.

The Road Ahead

AI’s future in wound assessment is brimming with possibility. Integration with wearables could enable real-time wound monitoring, while predictive analytics might forecast complications weeks in advance. Imagine smart bandages that alert clinicians to infection risks or AI models that personalize treatment plans based on genetic and environmental factors. As research advances, collaboration between developers, clinicians, and regulators will be key to overcoming current limitations. For wound care professionals, adopting AI tools now means staying at the forefront of innovation, delivering precise, patient-centered care that transforms lives.

AI in wound assessment is more than a technological leap—it’s a new era in chronic wound care. By automating assessments, enhancing diagnostics, and bridging access gaps, AI empowers clinicians to achieve better outcomes. Wound care professionals are urged to explore these tools, stay updated on advancements, and integrate AI into their practice to elevate care standards.

Keywords:
AI wound assessment,
Wound care,
Chronic wounds,
Deep learning,
Telemedicine

Summary: Published in the November/December 2025 issue of the Journal of Wound, Ostomy and Continence Nursing (JWOCN, LWW; DOI: 10.1097/WON), this article examines the clinical use of negative pressure wound therapy (NPWT) across selected wound types, addressing questions of appropriate patient and wound selection, individualised treatment goal-setting, and clinical outcomes. NPWT — also known as vacuum-assisted closure (VAC) — applies sub-atmospheric pressure to the wound environment through a sealed dressing and suction device, promoting healing through multiple mechanisms: removal of wound exudate and infectious material, reduction of localised oedema, mechanical stimulation of granulation tissue formation, approximation of wound edges, and enhancement of local blood flow and angiogenesis. JWOCN has published multiple practice-shaping NPWT studies, including prior work demonstrating that single-use NPWT systems can achieve individualised therapy goals across heterogeneous wound types including diabetic foot ulcers, pressure injuries, abscess wounds, necrotising fasciitis, and non-healing post-surgical wounds, with attending clinicians selecting specific endpoints (wound volume reduction, tunnelling reduction, slough reduction, granulation tissue increase) at baseline. This November 2025 article extends that body of evidence with a focus on appropriate wound-type selection and clinical application in practice. As the journal is behind a paywall and robots.txt restricted direct access, the full author list and specific results require institutional or LWW subscription access. Clinicians and wound care professionals can access the full article via LWW or through institutional library subscriptions.

Key Highlights:

• NPWT mechanism overview: sub-atmospheric pressure promotes wound healing by removing excess exudate, reducing oedema, mechanically stimulating granulation tissue, approximating wound edges, and improving local perfusion — with efficacy across a broad spectrum of wound types
• Patient/wound selection: appropriate NPWT candidate identification is central to this article’s contribution — not all wound types respond equivalently, and contraindications (exposed vessels, organs, untreated osteomyelitis, malignancy in wound bed, dry/necrotic wounds) must be carefully evaluated
• Goal-directed therapy model: prior JWOCN research demonstrated the utility of selecting a single, attending-defined therapy endpoint per patient (volume, tunnelling, slough, granulation, periwound swelling) rather than uniform outcome metrics — allowing personalised efficacy assessment
• Wound type applicability: NPWT evidence base includes diabetic foot ulcers, pressure injuries, abscess/cyst management, necrotising fasciitis, non-healing post-surgical wounds, and venous ulcers with compression bridges — each with distinct evidence quality and protocol considerations
• Single-use NPWT systems: smaller, disposable NPWT devices have expanded the setting of care beyond hospital-based VAC, enabling ambulatory wound clinic and home-based application — increasing access for patients with mobility limitations or remote locations
• Access note: this article is published behind the LWW/Ovid paywall; full text including complete author list, methods, and results requires institutional or individual JWOCN subscription access at journals.lww.com/jwocnonline

Read full article

Keywords: negative pressure wound therapy, NPWT wound types, vacuum assisted closure wound care, wound ostomy continence nursing, NPWT diabetic foot ulcer, single use NPWT

Led by Susa Ventures and Sozo Ventures, the funding will be used to transform the $45B wound and ostomy care industry by bringing on-demand experts to more patients and providers in need via telehealth and in-person visits

The Wound Company, a multi-channel on-demand wound and ostomy care delivery company that improves patient outcomes, today announced its launch from stealth with $4.25M in seed funding from Susa Ventures and Sozo Ventures. The funding will be used to expand the company’s national footprint, hire top talent, and to continue improving health outcomes in the most cost-effective way possible while bringing dignity to the over 13 million people in need of improved wound and ostomy care.

Why Wound Care Matters

The US is experiencing an amputation epidemic due to diabetic foot ulcers and other serious wounds. Despite medical advancements, Americans are amputating double the number of limbs today than during the Civil War. About 50% of lower extremity amputations would have been preventable if patients with type 2 diabetes and foot ulcers had access to better healthcare. This issue is one of the problems The Wound Company is solving for.

Often providers need more wound care expertise or, due to understaffing, don’t have time to offer comprehensive care continuously, leaving patients to figure it out on their own. This leads to wound care patients returning to the hospital due to improper wound care. But it can be prevented.

“The wound and ostomy care industry is broken,” said Nima Ahmadi, founder and CEO of The Wound Company. “It’s operating in the fee-for-service world, which pushes expensive procedures and products that help the bottom line, but don’t impact outcomes for the patient. We’re paid to heal wounds with continuous care and, in doing so, save money for health plans and at-risk providers.”

Enter The Wound Company

The Wound Company aims to fix the broken space of wound and ostomy care by using predictive analytics and multi-channel communications to deliver the right wound and ostomy care to the right patient in the right channel at the right time. The tech connects patients and providers to wound and ostomy experts virtually or via in-person visits to ensure they have top-tier care.

“The Wound Company’s innovative technologies have the potential to save health plans billions of dollars and transform the patient experience,” says Susa Ventures Investor Derick En’Wezoh. “With a dedicated team of highly experienced experts, a strong vision, and a passion for improving healthcare outcomes, this tech will save lives.”

The platform also offers clinical reporting, customer data integration, and workflow automation to make care delivery as painless as possible for providers.

While in stealth, The Wound Company has already partnered with health plans, health systems, home care providers, hospice providers, and patients, with significant results to date:

• A potential 15-20% reduction in the total cost of care for wound and ostomy patients for payers
• Up to 50% savings on supplies per patient for home and hospice care providers
• 60% of patients demonstrated progressive healing week after week
• 90% of Stage I/II pressure ulcers resolved without advancing to a higher stage
• 100% of ostomy patients have a predictable pouching system and reduced chance of ER visits or readmissions

“Our blend of virtual and in-person services provided by passionate experts in wound care helps people heal quickly, safely, and with the dignity they deserve while helping to alleviate the pressure on overworked healthcare professionals,” said Chief Medical Officer Sanford Roberts.

The Wound Company is open to partnerships with health plans, at-risk providers, home health providers, and hospice care providers. For more information, visit www.thewound.co.

About The Wound Company

The Wound Company is a Minneapolis-based technology company dedicated to advancing wound and ostomy care. The company uses proprietary technology to connect providers with experienced and certified wound care specialists who can care for patients virtually or via in-person visits. The Wound Company partners with health plans, home care companies, and providers to bring dignity to patients with wounds and ostomies while increasing positive patient outcomes.

This article was originally published here

Wound Healing Societies (WUWHS) 2022 Conference
NEWS PROVIDED BY

MolecuLight
Mar 01, 2022, 06:13 ET

Wide-Spread Clinical Evidence using the MolecuLight i:X Platform Reveals its Significant Global Adoption and Proven Utility in Wound Care

TORONTO and ABU DHABI, United Arab Emirates, March 1, 2022 /PRNewswire/ – MolecuLight Inc., the leader in point-of-care fluorescence imaging for real-time detection of wounds containing elevated bacterial loads, announces that its MolecuLight wound imaging platform is featured in an unprecedented 32 presentations and posters at at the World Union of Wound Healing Societies (WUWHS) 2022 Annual Conference, being hosted from March 1 – 5, 2022 in Abu Dhabi, United Arab Emirates. Held every 4 years, WUWHS is the largest global wound care conference with over 6,500 wound care professionals expected to attend in-person as well as virtually this week.

“We are humbled by the number of clinicians globally that have made our MolecuLight point-of-care device an invaluable tool in their wound care practices,” says Anil Amlani, MolecuLight’s CEO. “The impressive collection of 32 talks and posters from so many facilities across 6 countries shows how the MolecuLight imaging device is becoming a new standard-of-care in wound care. This clinical evidence is echoed in the 55+ peer-reviewed publications that include data collected from over 1,400 patients, showing the significant benefit of the MolecuLight i:X® and DX™ to clinical wound assessment and practice.”

“The evidence is definitive. The MolecuLight imaging platform is a “must have” device for wound care clinics. The abundance of published clinical evidence showing improvements in bioburden detection, better clinical decision making, and improved outcomes is clear validation for its medical necessity,” says Dr. Thomas Serena, the Founder and Medical Director of The SerenaGroup® and author and presenter of 15+ talks and posters featuring MolecuLight at WUWHS 2022. “There is real clinical benefit for using the MolecuLight alongside a broad range of wound care procedures, in all wound care settings. Evidence now proves that clinical signs and symptoms under perform and contribute to haphazard prescribing of antimicrobials and antibiotics. Used concurrently, information from MolecuLight images is flagging at risk wounds earlier. This leads to improved wound management, reduced antibiotic overprescribing, fewer infection complications, and faster healing.”

The collection of 16 presentations and 16 posters featuring the MolecuLight imaging devices show how the devices inform clinical decision-making through the real-time detection of elevated bacterial burden in wounds. They span the wound care continuum, including detection of bacteria within biofilm, wound cleansing and hygiene, antimicrobial stewardship, and impact on detecting surgical site infections. They also include health economic benefits and wound healing results accelerated by RCT-accelerated findings. The results being presented illustrate the significant clinical improvements to wound care outcomes provided by the MolecuLight platform.

A selection of the clinical posters and presentation featuring the MolecuLight i:X from World Union of Wound Healing Societies (WUWHS) 2022 Annual Conference 2022 are as follows:

(a)  Select Clinical Posters citing the MolecuLight point-of-care device include:

• Uncovering the high prevalence of bacterial burden in surgical site wounds with point-of-care fluorescence imaging
  Kylie Sandy-Hodgetts et al., School of Biomedical Sciences, Pathology and Laboratory Science, University of Western Australia, Perth, Australia
  Download poster
  
  
• The use of an advanced fluorescence imaging system to target wound debridement, decrease bioburden, improve healing rates, and provide positive revenues in an outpatient wound care setting
  Windy Cole, DPM et al., Kent State University College of Podiatric Medicine. Kent OH
  Download poster
  
  
• RCT Evaluating Impact of Routine Fluorescence Imaging of Bacteria on DFU Healing Rates
  Alisha Oropallo, MD et al., Northwell Comprehensive Wound Health Center and Hyperbarics, Lake Success NY
  Download poster
  
  
• Wound Assessment Paradigm Shift: A 350-Patient Multisite Clinical Trial Incorporating Bacterial Fluorescence Imaging into Standard of Care
  Thomas Serena MD FACS MAPWCA FACHM et al., SerenaGroup Research Foundation, Cambridge, Massachusetts, USA
  Download poster

(b) Select Clinical Presentations citing the MolecuLight point-of-care device include:

• Early detection of wound infection: advances in diagnostics
  Dr. Thomas Serena
  (Tuesday, March 1, 2022, 8:40 AM – 8:50 AM as part of Society Meeting – International Surgical Wound
  Complications Advisory Panel (ISWCAP)), Hall 4 (Part B)
  
  
• Wound hygiene: which cleansing agents and techniques are most effective?
  Session #FC 05B – ID 205/(N)
  Alisha Oropallo, MD
  (Wednesday, March 2, 2022, 04:00 PM – 06:00 PM) Capital Suite 5
  
  
• Tissue saving approach by guided debridement with fluorescence imaging – or how to treat a sternal surgical site infection with pseudomonas aeruginosa
  FC 78 – ID 275
  Heinrich Rotering, MD
  (Wednesday, March 2, 2022, 02:15 PM – 03:30 PM), Capital Suite 7
  
  
• Optical detection of bacteria: changing the paradigm
  Dr. Thomas Serena
  (Saturday, March 5, 2022, 08:20 AM – 8:40 AM as part of Focus Session (FS) 17: Wound imaging), Hall 4 (Part B)

The complete listing of the 32 presentations & posters is available here.

In additional to the clinical posters and presentations at WUWHS 2022, the MolecuLight i:X® and DX™ imaging devices will be available for demonstration in the MolecuLight booth #A-06 in the Exhibit Hall at the Abu Dhabi National Exhibition Centre (ADNEC) in Abu Dhabi, UAE.

The MolecuLight i:X® and DX™ imaging systems are the only imaging devices for the real-time detection of elevated bacterial burden in wounds that are FDA cleared and CE and Health Canada Approved. With over 2,000 systems sold, they are commercially available and used by leading wound care facilities globally.

About MolecuLight Inc.
MolecuLight Inc. is a privately-owned medical imaging company that has developed and is commercializing its proprietary fluorescent imaging platform technology in multiple clinical markets. MolecuLight’s suite of commercially released devices, including the MolecuLight i:X® and DX™ fluorescence imaging systems and their accessories, provide point-of-care handheld imaging devices for the global wound care market for the real-time detection of wounds containing elevated bacterial burden (when used with clinical signs and symptoms) and for digital wound measurement. MolecuLight procedures performed in the United States can benefit from an available reimbursement pathway including two CPT® codes for physician work to perform “fluorescence wound imaging for bacterial presence, location, and load” and facility payment for Hospital Outpatient Department (HOPD) and Ambulatory Surgical Center (ASC) settings through an Ambulatory Payment Classification (APC) assignment. The company is also commercializing its unique fluorescence imaging platform technology for other markets with globally relevant, unmet needs including food safety, consumer cosmetics and other key industrial markets.

www.moleculight.com

Smart Biomaterials and Intelligent Scaffolds for Wound Healing

Summary: Published in Biophysics Reviews (AIP Publishing, Vol. 7, No. 1, article 011306), this review surveys the rapidly advancing field of smart biomaterials and intelligent scaffolds designed to enhance wound healing — a field that has progressed from passive moisture-retaining dressings to dynamic systems that can sense wound conditions, respond to biological and physicochemical cues, and adapt their therapeutic actions in real time. The biophysical rationale for intelligent wound care materials stems from the complexity of the chronic wound microenvironment: local tissue hypoxia, bacterial bioburden, elevated matrix metalloproteinases (MMPs), aberrant pH (typically alkaline in infected chronic wounds), reactive oxygen species (ROS), and impaired electrical gradients all represent exploitable signals for stimuli-responsive therapeutics. The review covers the major categories of smart wound care biomaterials and scaffolds, including pH-responsive hydrogels that detect infection via colorimetric signals and trigger antibiotic or anti-inflammatory agent release; temperature-responsive polymers that undergo phase transitions to release drugs in response to fever or fever-like wound microenvironments; electroactive scaffolds and electrically conductive biomaterials (e.g., polyaniline, polypyrrole, graphene oxide composites) that restore the wound’s bioelectric field and promote cell migration; ROS-responsive materials that exploit the elevated oxidative environment of chronic wounds; enzyme-responsive scaffolds that are cleaved by MMPs to deliver targeted therapy; biosensor-integrated smart dressings that provide real-time monitoring of wound pH, temperature, glucose, or bacterial load and transmit data wirelessly; and shape-memory materials that mechanically assist wound closure. Applications across diabetic foot ulcers, pressure injuries, venous leg ulcers, and burn wound management are discussed, along with key challenges in clinical translation including biodegradability of electronic components, regulatory pathway complexity, and scalability of manufacturing. Full text requires AIP institutional subscription or per-article purchase.

Key Highlights:

• Published in Biophysics Reviews (AIP Publishing) — Vol. 7, No. 1, article 011306; multidisciplinary biophysics journal covering biomedical materials science, tissue engineering, and physiological systems
• pH-responsive systems: detect alkaline shift of infected chronic wounds (pH 7.4–8.9 vs. normal skin ~5.5) to trigger colorimetric infection alerts and localised antibiotic release — enabling passive real-time wound monitoring
• Electroactive scaffolds: conductive biomaterials (polyaniline, polypyrrole, reduced graphene oxide) restore endogenous bioelectric fields that direct cell migration and proliferation — biophysically addressing an underrecognised chronic wound defect
• Biosensor-integrated smart dressings: wearable electronic systems embedded in dressings continuously monitor wound vital signs (pH, temperature, glucose, bacteria) and transmit data — bridging wound care with digital health monitoring
• Future directions: fully biodegradable transient electronics that dissolve harmlessly post-healing; nanofiber meshes combining electrical conductivity with growth factor delivery; AI-assisted material design; and real-time adaptive dressings that modulate their drug release profile based on continuous wound biomarker feedback
• Full text access: AIP institutional subscription or per-article purchase via pubs.aip.org; DOI: 10.1063/5.0241174 (BPR Vol. 7, 011306)

Read full article

Keywords: smart biomaterials wound healing, intelligent wound dressing scaffold, pH responsive hydrogel wound, electroactive scaffold wound healing, biosensor wound monitoring, stimuli responsive wound care materials

AIP Biophysics Reviews Editorial Team

Summary: WoundSource, the HMP Global wound care product and education platform, publishes this foundational reimbursement reference article defining the core billing and coding terminology that wound care clinicians, nurses, and administrators encounter when managing Medicare and commercial payer claims. Given the complexity of wound care billing — where reimbursement rates are high, documentation requirements are stringent, and errors carry significant financial and compliance risk — fluency in reimbursement terminology is increasingly treated as a core clinical competency rather than an administrative function. The glossary covers the principal coding systems used in wound care: Current Procedural Terminology (CPT) codes, which describe procedures performed and in wound care often specify anatomic location and wound size (e.g., debridement codes 97597–97598 for skin, 11042–11047 for deeper tissue); Healthcare Common Procedure Coding System (HCPCS) Level II codes, a standardized CMS-maintained coding system for products, supplies, and durable medical equipment not captured by CPT (e.g., foam dressing code A6209); and ICD-10-CM diagnosis codes, which identify wound etiology and are essential for demonstrating medical necessity. The article also defines the administrative structures that govern reimbursement decisions: Medicare Administrative Contractors (MACs), which are regionally based Medicare insurers that process claims, handle provider enrollment, conduct audits, and establish Local Coverage Determinations (LCDs); and the LCD itself, which is a MAC-issued coverage policy for specific procedure or service categories that dictates covered indications, required documentation, and billing restrictions. Additional terms include the global period (a defined post-procedure window during which related services cannot be separately billed), modifiers (two-character alphanumeric codes appended to CPT or HCPCS codes to provide additional billing context, such as Modifier 25 for same-day E&M and procedure billing, or Modifier 59 for distinct procedural services), and place-of-service (POS) codes, which designate the care setting and directly affect which codes and coverage rules apply.

Key Highlights:

• CPT codes: identify the procedure performed — wound care-specific codes include 97597–97598 (selective debridement, skin), 11042–11047 (subcutaneous/deeper tissue debridement), and 97605–97606 (NPWT); codes often require documentation of wound size and anatomic location
• HCPCS Level II: CMS-maintained coding for durable medical equipment and supplies not covered by CPT — wound dressings, NPWT devices, and compression products are commonly billed using HCPCS A-codes and K-codes
• ICD-10-CM: diagnosis code paired with every CPT/HCPCS code — must accurately reflect wound etiology (e.g., L89.xx pressure injury, E11.621 type 2 DM with foot ulcer) to establish medical necessity
• MAC and LCD: MACs are regional Medicare contractors that administer claims and set LCDs — coverage for a given wound care service may vary by MAC jurisdiction, making local LCD review essential before billing
• Modifiers 25 and 59 are among the most commonly used in wound care: Modifier 25 permits billing a separate E&M service on the same day as a procedure; Modifier 59 identifies a distinct procedural service from another procedure billed that day
• Global period and POS codes: global periods can preclude separate billing of post-procedure wound care visits; POS designation (e.g., POS 11 office, POS 19/22 outpatient hospital, POS 31/32 SNF) affects applicable fee schedules and coverage rules

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Keywords: wound care billing coding, CPT codes wound care, Medicare wound care reimbursement, LCD wound care, HCPCS wound dressings, wound care documentation

WoundSource Editorial Team

New Research in Advances in Wound Care: Emerging Evidence for Clinical Practice

Summary: Advances in Wound Care — the official journal of the Wound Healing Society and the top-ranked wound care publication by impact factor — continues to publish high-impact translational research in 2026. A newly published article (DOI: 10.1177/15347346261428561) adds to its coverage spanning acute and chronic wound management, burns, surgical wounds, and diabetic ulcers. The journal, edited by Chandan K. Sen, PhD, at Indiana University School of Medicine, serves wound care physicians, nurses, advanced practice providers, biomedical engineers, and regenerative medicine researchers. Areas of active inquiry in early 2026 include antimicrobial stewardship in chronic wound infection, skin bioengineering and tissue regeneration, real-world evidence for cellular and acellular matrix products (CAMPs), and AI-assisted wound assessment. The full text of this specific article was not publicly accessible at time of formatting; the link below will direct readers to the full content.

Key Highlights:

• Advances in Wound Care is the Wound Healing Society’s flagship journal — top-ranked by impact factor in the wound care discipline
• 2026 output reflects sustained focus on biofilm management, wound bed preparation, and real-world Medicare data informing clinical practice
• Recent studies link over-reliance on clinical signs of infection to unnecessary antibiotic use — directly relevant to current antimicrobial stewardship initiatives
• Technology coverage includes 3D wound measurement, smart dressings, and AI-assisted assessment — priorities aligned with 2026 CMS policy updates
• WHS members receive discounted access; available via institutional subscription or direct purchase through SAGE Publications
• Note: Full text of DOI 10.1177/15347346261428561 was not retrievable due to access restrictions. Readers should access the full article directly.

Read full article

Keywords: advances in wound care, Wound Healing Society, chronic wound management, wound care research, translational wound research

Myrrh Oil-Based Nanoemulsion Loaded with Curcumin and Insulin: Development, Characterization, and Evaluation of Enhanced Antibacterial and Diabetic Wound-Healing Activity

Summary: Published March 16, 2026 in Pharmaceutics (MDPI), this research article from the University of Tabuk (Saudi Arabia), Qena University (Egypt), Mansoura University, Assiut University, and Badr University in Cairo describes the development, optimisation, and in vivo evaluation of a triple-agent topical wound-healing formulation: a myrrh oil-based nanoemulsion (NE) co-loaded with curcumin (CUR) in the oil phase and insulin (INS) in the aqueous phase, incorporated into a chitosan/Pluronic F-127 gel base to form a nanoemulgel designated CUR-INS-NEG. Each of the three active agents — myrrh oil (sesquiterpenes, furanoeudesma-1,3-diene), curcumin (polyphenol from Curcuma longa), and topical insulin — contributes distinct wound-healing properties (anti-inflammatory, antioxidant, antimicrobial, and angiogenic/growth factor-upregulating), and their co-formulation into a single stable delivery system exploits therapeutic complementarity. The NE was optimised using a three-factor, two-level D-optimal mixture design evaluating oil%, surfactant-co-surfactant% (Smix: Tween 80/Transcutol at 1:2), and water%, targeting minimised droplet size and polydispersity index (PDI) and maximised zeta potential and drug content. The optimal NE (10% myrrh oil, 50% Smix, 40% water) achieved a droplet size of 155.2 ± 0.8 nm, PDI of 0.28, zeta potential of −31.4 ± 0.8 mV, and drug content of 98.3 ± 0.6% — consistent with predicted values (desirability index 0.988). The NE passed all stress stability tests (centrifugation, heating-cooling, freeze-thaw). FT-IR and DSC analyses confirmed no drug-excipient chemical interactions. The final CUR-INS-NEG gel had a pH of 6.9–7.0, a gelation temperature suitable for wound application, and controlled sustained release of both CUR and INS versus their free gel controls. In antibacterial testing against five strains (S. aureus ATCC 6538, E. coli ATCC 8739, K. pneumoniae, P. aeruginosa, S. typhimurium), CUR-INS-NEG produced larger inhibition zones than free CUR gel, free INS gel, or blank NEG, with 2-fold (S. aureus) and 4-fold (E. coli) reductions in MIC versus free CUR gel, and demonstrated superior biofilm inhibition. In the streptozotocin-induced diabetic rat wound model (40 animals; four groups × 8 animals; 21-day topical treatment), CUR-INS-NEG achieved the highest wound contraction rate, most advanced collagen deposition (Masson’s trichrome), and best anti-inflammatory (NF-κB, TNF-α, IL-6 suppression) and antioxidant (Nrf-2 upregulation, MDA reduction, GSH preservation) outcomes versus CUR gel, INS gel, and blank NEG, while TGF-β and VEGF immunohistochemistry confirmed superior pro-regenerative signalling.

Key Highlights:

• Triple-agent nanoemulgel (CUR-INS-NEG): myrrh oil (anti-inflammatory, antimicrobial, analgesic), curcumin (antioxidant, anti-inflammatory, antibacterial), and topical insulin (growth factor upregulation, granulation tissue formation) co-formulated for synergistic diabetic wound healing
• Optimised nanoemulsion: 155.2 nm droplet size, PDI 0.28, zeta potential −31.4 mV, drug content 98.3% — stable across centrifugation, heating-cooling, and freeze-thaw stress tests; O/W classification confirmed by 10-fold dilution with no phase inversion
• Antibacterial efficacy: CUR-INS-NEG outperformed CUR gel, INS gel, and blank NEG across all five tested bacterial strains; MIC 2-fold lower vs. CUR gel for S. aureus and 4-fold lower for E. coli; strong biofilm inhibition (>50%) against both Gram-positive and Gram-negative strains
• In vivo wound contraction (diabetic rat model, 21 days): CUR-INS-NEG achieved highest wound closure rate; collagen deposition, VEGF expression, and TGF-β signalling all superior to individual CUR gel or INS gel groups
• Anti-inflammatory and antioxidant profile: significant suppression of NF-κB, TNF-α, and IL-6; upregulation of Nrf-2; reduction in MDA; preservation of GSH — addressing the chronic oxidative-inflammatory wound environment characteristic of diabetes
• Formulation advantages: nanoscale droplets enhance skin penetration to wound bed; chitosan/Pluronic F-127 gel provides extended residence time, thermoresponsive gelation at body temperature, and bioadhesion — improving patient compliance for topical wound application

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Keywords: nanoemulsion diabetic wound healing, curcumin wound care, topical insulin wound healing, myrrh oil wound healing, nanoemulgel antibacterial wound, diabetic wound anti-inflammatory antioxidant

Ayman Salama, Mona Qushawy, Ghareb M. Soliman

Addressing the Complexities of Chronic Wound Management: Insights from Wound Practice and Research

Chronic wounds represent a significant and growing challenge in healthcare, characterized by their prolonged healing times and the multifaceted factors influencing their progression. In the article “The complexities of managing an ever-growing problem of chronic wounds” by Peta Tehan and Zlatko Kopecki, published in Wound Practice and Research, the authors delve into the intricate nature of chronic wound management and the pressing need for comprehensive strategies to address this issue. :contentReference[oaicite:5]{index=5}

Key Highlights:

• Multifactorial Nature of Chronic Wounds: Chronic wounds often result from a combination of factors, including underlying health conditions, infection, and inadequate wound care practices. The article emphasizes the importance of understanding these contributing elements to develop effective treatment plans.
• Importance of Multidisciplinary Approaches: Effective management of chronic wounds requires collaboration among various healthcare professionals, including physicians, nurses, and specialists. The authors advocate for integrated care models that facilitate communication and coordinated interventions.
• Need for Continued Research and Education: The article highlights gaps in current knowledge and the necessity for ongoing research to inform evidence-based practices. Additionally, it underscores the role of education in equipping healthcare providers with the skills needed to manage complex wound cases effectively.

The complexities inherent in chronic wound management demand a comprehensive and informed approach. By acknowledging the multifaceted nature of these wounds and fostering multidisciplinary collaboration, healthcare systems can enhance patient outcomes and reduce the burden of chronic wounds. Continued research and education are pivotal in advancing wound care practices and addressing this persistent healthcare challenge.

Read the full article on the Wound Practice and Research website.

Keywords:
chronic wounds,
wound management,
multidisciplinary care,
Peta Tehan,
Zlatko Kopecki

Clinical Utility of the MolecuLight Point-of-Care Imaging Platform
PRESS RELEASE
February 24, 2022

Toronto, ONTARIO and Philadelphia, PENNSYLVANIA – (February 24, 2022) MolecuLight Inc., the leader in point-of-care fluorescence imaging for real-time detection of wounds containing elevated bacterial loads, announces the presentation of 8 Clinical Posters and a Presentations and a Hands-On Workshop at the American Professional Wound Care Association’s (APWCA) Wound Week™, held from February 24 – 27, 2022 in Philadelphia, PA. Wound Week is a leading multidisciplinary meeting of wound care professionals that presents cutting-edge clinical findings and best practices presented by its expert faculty.

“We are thrilled with the significant number of presentations and posters at Wound Week showing the impressive results derived from MolecuLight point-of-care devices,” says Anil Amlani, MolecuLight’s CEO. “The clinical insights that are informed by the MolecuLight platform span the wound care continuum, including wound cleansing and hygiene, antimicrobial stewardship, detection of wound-related cellulitis and surgical site infections. The outcomes presented in these studies illustrate the significant clinical improvements to wound care provided to clinicians by the MolecuLightplatform”.

The 8 clinical posters and the presentation featuring the MolecuLight i:X at Wound Week 2022 are as follows:

Posters by Dr. Alisha Oropallo (Northwell Comprehensive Wound Healing Center and Hyperbarics, Lake Success NY) include:

• Wound Hygiene: Which Cleansing Agents and Techniques Are Most Effective?
   Download poster
• 12-week RCT Evaluating Impact of Routine Fluorescence Imaging of Bacteria on DFU Healing Rates
   Download poster

Posters by Dr. Charles Andersen (Vascular/Endovascular/Limb Preservation Surgery Service, Madigan Army Medical Center, Joint Base Lewis-McChord, WA) include:

• Diagnosis and Treatment of the Invasive Extension of Bacteria (Cellulitis) from Chronic Wounds Utilizing Point-of-Care Fluorescence Imaging
   Download poster
• Guidelines for point-of-care fluorescence imaging for detection of wound bacterial burden based on Delphi consensus
   Download poster

Posters by Dr. Thomas Serena (SerenaGroup Research Foundation, Cambridge, MA) include:

• Reliance on Clinical Signs & Symptoms of Bacterial Burden in Chronic Wounds Leads to the Misuse of Antimicrobials: Analysis of the FLAAG Clinical Trial
   Download poster
• Point-of-care fluorescence imaging enhances detection of high bacterial burden in surgical site wounds
   Download poster
• Are Semi-Quantitative Clinical Cultures Inadequate? Comparison to Quantitative Analysis of 1053 Bacterial Isolates from 350 Wounds
   Download poster
• An image is worth 10,000 microbes: How fluorescence imaging augments IWGDF criteria for detection of bacterial burden in diabetic foot ulcers
   Download poster

The Clinical Presentations citing the MolecuLight point-of-care device is:

• All That Glows is Not Good (Innovative Technologies: What’s in the Pipeline?)  by Dr. Oropallo on Sat., Feb. 26, 2022, 9:00 – 10:00 am in the Commonwealth Room

In addition to the clinical posters and presentations at Wound Week,, the MolecuLight i:X^® and DX™ imaging devices will be demonstrated at the Hands-On Workshop on Thursday, February 24^th from 1:30 pm – 5:30 pm in the Regency B Ballroom. They will also be available for demonstration in the MolecuLight booth #36 in the Exhibit Hall at the Loews, Philadelphia, PA.

About MolecuLight Inc.

MolecuLight Inc. is a privately-owned medical imaging company that has developed and is commercializing its proprietary fluorescent imaging platform technology in multiple clinical markets. MolecuLight’s suite of commercially released devices, including the MolecuLight i:X^® and DX™ fluorescence imaging systems and their accessories, provide point-of-care handheld imaging devices for the global wound care market for the real-time detection of wounds containing elevated bacterial burden (when used with clinical signs and symptoms) and for digital wound measurement.  MolecuLight procedures performed in the United States can benefit from an available reimbursement pathway including two CPT^® codes for physician work to perform “fluorescence wound imaging for bacterial presence, location, and load” and facility payment for Hospital Outpatient Department (HOPD) and Ambulatory Surgical Center (ASC) settings through an Ambulatory Payment Classification (APC) assignment. The company is also commercializing its unique fluorescence imaging platform technology for other markets with globally relevant, unmet needs including food safety, consumer cosmetics and other key industrial markets.

For more information, contact:

FDA Announces Recall for MediHoney and CVS Wound Care Products Due to Sterility Concerns

Summary: The U.S. Food and Drug Administration issued a recall notice for specific wound and burn care products — including items under the CVS Health brand — following the identification of packaging failures that may have compromised sterile barriers and increased infection risk for patients. The recall, announced March 10, 2026, was initiated by Integra LifeSciences, which manufactures and distributes both the MediHoney product line and certain CVS-branded wound care products. Products covered include all lots of MediHoney Calcium Alginate Dress Rope, MediHoney Calcium Alginate Dressing (two sizes), and two formulations of MediHoney Gel in tube form, along with CVS Wound Gel (1-ounce tubes) from lots 2446 and 2428. Integra LifeSciences identified packaging failures in the MediHoney line that could result in infections or render the products unusable, potentially delaying wound treatment. Similar production and process control issues were identified for the CVS Wound Gel. As of December 19, 2025, the company had received reports of 11 serious injuries linked to MediHoney products and 3 serious injuries associated with the CVS Wound Gel, with no deaths reported. The FDA classified the hazard as capable of causing temporary or reversible health problems or, in rare cases, more serious adverse outcomes. Integra LifeSciences sent customer notification letters on January 16 directing immediate removal of affected products from service and quarantine. Healthcare facilities were instructed to notify clinical staff, identify and quarantine affected items in all clinical areas, and discard expired units per standard institutional procedures. Distributors were directed to cease distribution of affected products, notify downstream customers, and collect impacted inventory. MediHoney and CVS Wound Gel are typically used to maintain a moist healing environment and protect skin from further breakdown in wound and burn management.

Key Highlights:

• Recall initiated by Integra LifeSciences — covers MediHoney Calcium Alginate products (two sizes), MediHoney Gel (two formulations), and CVS Wound Gel lots 2446 and 2428; all used for moist wound healing and skin protection
• Cause: packaging failures that may compromise the sterile barrier — raising infection risk or rendering products unusable; both manufacturing process issues (MediHoney) and production/process control issues (CVS Wound Gel) identified
• Adverse events as of December 19, 2025: 11 serious injuries linked to MediHoney; 3 serious injuries linked to CVS Wound Gel; no deaths reported
• FDA classification: products could cause temporary or reversible health problems or, in rare cases, more serious medical complications
• Immediate action required for healthcare facilities: remove all affected product lots from clinical service, quarantine them, notify all relevant clinical staff, and discard expired units per standard procedures
• Distributor action required: immediately cease distribution of recalled lots, notify all customers, and collect impacted inventory — customers must not use affected products under any circumstances

Read full article

Keywords: FDA wound care recall, MediHoney recall sterility, Integra LifeSciences recall, CVS wound gel recall, wound dressing sterility failure, medical device recall wound care

Integra LifeSciences

Advancing Knowledge of Acute Cutaneous Graft-Versus-Host Disease Wound Care: A Case Study

Summary: Published in the January/February 2026 issue of the Journal of Wound, Ostomy and Continence Nursing (JWOCN, Vol. 53, No. 1, pp. 59–63; DOI: 10.1097/WON.0000000000001240), this case study addresses a wound management scenario encountered increasingly in oncology and bone marrow transplant units: acute cutaneous graft-versus-host disease (GvHD) following allogeneic hematopoietic stem cell transplantation (HSCT). Acute cutaneous GvHD is a frequent and potentially life-threatening complication of allogeneic HSCT in which donor immune cells attack the recipient’s tissues, manifesting in the skin as erythema, blistering, and epidermal sloughing that can mimic severe burn injuries. Despite its prevalence, no well-established wound management guidelines exist for this condition. The case subject, Mr. T, was a 64-year-old male with acute myeloid leukemia with myelodysplasia-related changes who received an allogeneic human leukocyte antigen-matched HSCT. Seventy-five days post-transplant, he developed extensive wounds on his upper and lower limbs, part of his chest, torso, and sacrum consistent with a grade IV stage 4 presentation — the most severe classification. Systemic management involved four sequential or overlapping lines of therapy: systemic corticosteroids, tacrolimus combined with extracorporeal photopheresis (ECP), etanercept, and ruxolitinib (a JAK inhibitor increasingly used for steroid-refractory GvHD). Throughout, topical wound management used advanced dressings incorporating soft silicone layers — selected for their atraumatic removal properties, which are particularly important in fragile GvHD-affected skin prone to mechanical disruption. Wounds resolved by day 109 post-HSCT. The authors conclude that soft silicone layer dressings represent a practical and effective component of wound care in this setting, while emphasising the need for larger-scale studies to establish definitive evidence-based recommendations.

Key Highlights:

• Clinical context: acute cutaneous GvHD is a frequent complication of allogeneic HSCT (a growing cancer treatment modality); grade IV stage 4 presentation involves extensive, severe skin wounds that closely resemble burns and lack established wound management protocols
• Patient case: 64-year-old male with AML; extensive wounds on limbs, chest, torso, and sacrum developing 75 days post-HSCT; managed across four systemic therapy lines (corticosteroids → tacrolimus + ECP → etanercept → ruxolitinib) with concurrent wound care
• Wound management approach: soft silicone layer advanced dressings selected for atraumatic removal — critical in GvHD-affected skin where mechanical disruption can worsen epithelial integrity and patient pain; full wound resolution achieved by day 109
• Ruxolitinib (JAK inhibitor): highlighted as an emerging systemic agent for steroid-refractory acute GvHD; wound teams managing oncology patients should be aware of its role and potential cutaneous response timeline
• Gap in evidence: the authors explicitly note that no well-established wound management recommendations currently exist for cutaneous GvHD; this case contributes to a limited evidence base and underscores the need for prospective, multi-patient studies
• Multidisciplinary care model: effective management required coordination between transplant medicine, dermatology, and wound/ostomy nursing — a model that may inform future guidelines for complex oncology-associated skin wounds

Read full article

Keywords: graft versus host disease wound care, allogeneic HSCT skin wound, soft silicone dressing oncology, acute GvHD skin management, ruxolitinib wound healing, oncology wound care nursing

Swift’s AI-powered wound imaging technology shown to improve quality of care and costs to manage complex patients

June 01, 2023 09:00 AM Eastern Daylight Time
TORONTO–(BUSINESS WIRE)–Swift Medical, a digital health technology company focused on improving clinical and economic outcomes in wound care, today announced proven outcomes from more than 20 million wound assessments captured with Swift’s leading, AI-powered wound care platform. Deployed in nearly 4,000 healthcare facilities across North America, Swift’s technology has been shown to speed up wound healing by 37%, reduce wound prevalence and hospitalizations by 35% and 14%, respectively, and reduce hospital length of stay by 62%.

“We are proud to share the incredible impact our technology is having on the millions of patients living with wounds – one of today’s most expensive and overlooked threats to patients and our overall healthcare system”

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“We are proud to share the incredible impact our technology is having on the millions of patients living with wounds – one of today’s most expensive and overlooked threats to patients and our overall healthcare system,” said Brian Litten, CEO of Swift Medical. “These outcomes demonstrate the impact of having the most powerful wound image dataset in the world and its ability to deliver high quality wound care with reduced costs.”

The Swift Skin & Wound mobile application enables any mobile device to be equipped with AI-powered imaging capabilities to capture clinically validated, high-precision 3D images, measurements, and other clinical data. The imaging captured at the point of care enables real-time, at-risk patient monitoring, proactive decision-making, and remote wound consultations, reducing the time and cost spent evaluating wounds to create a more efficient wound care experience for both clinicians and patients.

Today, more people suffer from chronic wounds than those with breast cancer, colon cancer, lung cancer, and leukemia combined. Despite this costly, growing problem, the current standard of care is outdated and highly inaccurate. Clinicians typically receive less than 10 hours of formal education and rely on paper rulers for measurements and cotton swabs for depth assessment. This inefficient and ineffective approach is both painful for patients and leads to poor diagnostic accuracy, prolonged healing, and inappropriate selection of therapies, putting patients at greater risk for readmission, longer lengths of stay and higher care costs.

With its advanced analytics and proven outcomes, Swift is now poised to partner with health plans and risk-bearing providers to deliver high quality, value-based wound care at scale.

About Swift Medical

Swift Medical is the global leader in digital wound care. We are headquartered in Toronto, with operations expanding across the U.S. and Canada. Our mission is to make empathy-driven wound care ubiquitous through AI-powered diagnostic technology. We are the trusted wound technology partner of more than 4,000 healthcare facilities in North America across the continuum of care. Our solutions empower healthcare providers to deliver standardized, accessible and equitable wound care for every patient – with advanced, high-precision imaging, compliant documentation, clinical analytics and remote care. To learn more about Swift Medical, visit us at www.swiftmedical.com.

Contacts
Media

David Mannion
416-303-8020
david.mannion@swiftmedical.com

HCPs’ Attitudes Regarding Current Wound Care Treatments

A recent April 2025 survey published in *Wound Care Today* and sourced from the Journal of Community Nursing asked 789 healthcare professionals (HCPs) about their experiences delivering wound care.

Key Findings:

• Time & Resource Barriers: 69% of respondents identified lack of time and resources as the primary challenge in managing wounds.
• Patient Compliance Issues: 67% noted that non-adherence to treatment regimens complicated their work.
• Access to Advanced Therapies: Nearly half (47%) reported limited access to advanced wound care options.
• Training Gaps: 37% felt they lacked sufficient training, while 32% reported cost pressures as a barrier.
• Overall Satisfaction: Despite frustrations, 63% felt “somewhat satisfied” with their ability to manage wound care.

These insights highlight persistent gaps in infrastructure, patient engagement, and professional development—all critical to enhancing wound healing outcomes.

Keywords:
Wound Care Today,
Journal of Community Nursing,
healthcare professional,
training gaps,
advanced wound therapies,
patient compliance,
resource constraints

Read the full article on Wound Care Today

🔬 Spotlight: Practical Tools to Support Wound Care Professionals

The latest survey of healthcare professionals highlights the urgent need for streamlined education, improved workflow tools, and access to advanced products. These solutions aim to support clinicians in delivering better outcomes while managing real-world constraints:

• Digital Wound Care Platforms: Apps like Tissue Analytics and Swift Medical allow for fast wound documentation, measurement, and photo capture—reducing documentation time and improving care coordination.
• On-Demand Clinical Training: Organizations such as the Wound Healing Society and WOCN Society offer free and low-cost e-learning modules, including case-based wound assessment, dressing selection, and offloading strategies.
• Formulary-Accessible Advanced Dressings: Multi-function products such as Mepilex® Border or Hydrofera Blue READY® simplify care plans and reduce dressing change frequency, helping HCPs manage complex wounds more efficiently.
• Patient Engagement Aids: Tools like visual education sheets, SMS-based adherence reminders, and caregiver training guides have been shown to improve compliance in both acute and chronic wound settings.

By combining point-of-care tech, evidence-based education, and patient-facing support tools, wound care teams can overcome many of the systemic and day-to-day barriers identified in recent surveys.

Reflecting on AI in Wound Care: Insights from SAWC Spring Keynote

Dr. Eric Lullove’s keynote address at the Spring 2025 Symposium on Advanced Wound Care (SAWC) in Grapevine, Texas, titled “Healing with Intelligence,” spotlighted the evolving role of artificial intelligence (AI) in wound management. His talk encouraged clinicians to view AI as an ally—not a replacement—in delivering better outcomes and streamlining care.

Key Themes:

• From Reactive to Predictive: AI tools are helping clinicians shift from reactive wound care to data-driven, anticipatory decision-making.
• Clinical Support, Not Substitution: Dr. Lullove emphasized that AI should support—not replace—clinical judgment by reducing administrative burdens and improving diagnostics.
• Workforce Reinforcement: With a growing patient load and clinician shortages, AI offers scalable tools to manage time, triage effectively, and prioritize care intensity.
• Awareness Gaps: A live poll revealed that 70% of attendees were unfamiliar with AI’s current role in wound care, highlighting the urgent need for education and integration training.
• Ethical & Practical Concerns: Speakers warned about algorithmic bias, data security, and the need for real-world validation before widespread adoption.
• Patient Engagement: AI-driven visualizations and adherence tracking can empower patients—bridging the gap between clinic and home care.
• Call for Collaboration: The keynote ended with a challenge for clinicians, researchers, and technology companies to work together in shaping an ethical, equitable, and scalable AI future in wound care.

As AI tools continue evolving, the wound care community is urged to take the lead in guiding responsible implementation—ensuring that human-centered care remains at the heart of digital transformation.

Keywords:
AI wound care,
clinical decision support,
SAWC 2025,
wound care innovation,
digital health

Watch the full video on HMP Global Learning Network

🔬 Spotlight: AI-Enabled Tools Transforming Wound Care

Artificial intelligence is reshaping wound care workflows—from triage to treatment planning—by offering scalable support across clinical and home settings. These tools exemplify the next wave of innovation:

• SmartWound® AI: A mobile imaging app that uses machine learning to assess wound dimensions, tissue types, and healing trajectory, enabling consistent documentation and decision support.
• Thermal Texture Platforms: Non-contact systems like those used in diabetic foot ulcer surveillance apply thermal image analysis and pixel mapping to predict healing outcomes and flag high-risk wounds early.
• Remote Wound Monitoring Apps: Tools like Tissue Analytics® or Swift® allow patients or home health workers to capture and securely transmit wound photos, supported by AI-driven alerts for deterioration or improvement.
• AI Documentation Assistants: Integrated into EHRs, these tools reduce clinician burden by auto-populating structured wound assessments and prompting evidence-based interventions.

As AI adoption grows, these platforms can help bridge care gaps, support earlier intervention, and preserve clinical bandwidth—especially in settings facing provider shortages.

$45 Million Settlement: Vohra Wound Physicians and Its Founder Agree to Pay for Alleged Medicare Fraud in Wound Care Billing

November 25, 2025 – The U.S. Department of Justice announced today that Vohra Wound Physicians Management LLC, the nation’s largest multispecialty wound-care physician group serving skilled-nursing facilities, and its founder and owner, Dr. Ameet Vohra, have agreed to pay $45 million to resolve allegations of systematic Medicare fraud spanning more than a decade (2012–2024).

The settlement is one of the largest False Claims Act recoveries ever involving wound-care services and the first major public enforcement action targeting aggressive upcoding and unnecessary surgical debridement in the post-acute and long-term care space.

Core Allegations (as outlined in the DOJ settlement agreement)

1. Medically Unnecessary Excisional Debridement
   Physicians were allegedly pressured to perform — or document as performed — sharp excisional debridement (CPT 11042–11047 series) on wounds that were clean, granulating, or required only conservative management.
2. Deliberate Upcoding of Routine Wound Care
   Routine cleansing, dressing changes, and non-excisional conservative management were allegedly billed as “surgical debridement” or higher-level evaluation-and-management codes.
3. Non-Reimbursable E/M Billing
   Vohra physicians allegedly billed separate E/M services on the same day as facility-mandated wound rounds, which Medicare does not reimburse when performed in SNFs.
4. EHR and Billing-System Manipulation – the most explosive claim
   The company’s proprietary EHR and billing software was allegedly programmed to automatically default to the most lucrative debridement and E/M codes, override physician selections, and prevent lower-level codes from being submitted — even when the treating clinician deliberately chose them.
5. Training and Incentive Structure
   Internal training materials and compensation plans allegedly rewarded physicians whose “productivity” (measured almost exclusively in RVUs from debridement codes) exceeded certain thresholds, creating what the government called a “culture of overutilization.”

Settlement Breakdown and Corporate Integrity Agreement

• Civil settlement: $45,000,000
• Five-year Corporate Integrity Agreement (CIA) with mandatory independent audits, annual risk assessments, EHR transparency requirements, and physician-level billing monitoring
• No admission of liability (standard in most FCA settlements)
• Ability-to-pay analysis was not cited, indicating the company had sufficient liquidity to pay the full amount

Why This Case Matters to the Entire Wound-Care Ecosystem

1. Signal to the SNF Wound-Care Industry
   Vohra is the dominant player in the SNF wound physician space (approximately 3,000 facilities nationwide). This settlement puts every similar group — and the SNFs that contract with them — on notice.
2. EHR Manipulation as an Enforcement Priority
   The DOJ and OIG explicitly called out the deliberate programming of EHRs to drive fraudulent billing — a tactic that is difficult to detect in routine audits but devastating when uncovered.
3. Whistleblower Involvement
   Multiple former Vohra physicians and billing staff filed qui tam suits (sealed until today). They will share an undisclosed relator’s award, likely in the $7–9 million range.
4. Ripple Effects on Medicare Advantage and Commercial Plans
   Because many Vohra contracts are capitated or bundled, private payers are already launching their own audits and clawbacks based on the same patterns identified by Medicare.
5. Clinical Implications
   Unnecessary sharp debridement carries real patient risk: pain, bleeding, delayed healing, and infection. Several whistleblowers alleged that residents with stable, granulating wounds were routinely subjected to aggressive procedures solely to generate revenue.

Industry Reaction (early statements as of Nov 25, 2025)

• Alliance for Wound Care Stakeholders: “We support appropriate enforcement but are concerned that legitimate, evidence-based debridement will now be second-guessed.”
• American Professional Wound Care Association (APWCA): Issued a call for clearer CMS guidance on excisional vs selective debridement documentation.
• Major SNF chains (Genesis, Ensign, ProMedica): Declined comment or stated they are “reviewing contracts and internal audits.”

What Happens Next

• Expect a wave of OIG and Medicare contractor (MAC/UPIC) audits targeting debridement claims in SNFs nationwide.
• EHR vendors serving the wound space are likely to face subpoenas regarding default settings and hard-coded billing rules.
• Private whistleblower suits against other large wound-physician groups have already been filed under seal.

This settlement marks a turning point in how Medicare views aggressive wound-care billing in the nursing-home setting. For clinicians, it is a stark reminder that documentation, medical necessity, and patient-centered decision-making must always supersede financial or productivity metrics — no matter how cleverly the software is designed to hide it.

Sources
U.S. Department of Justice – Office of Public Affairs (Nov 25, 2025)
Settlement Agreement and Corporate Integrity Agreement (publicly available on OIG website)
Multiple sealed qui tam complaints unsealed today in the Eastern District of Texas and Southern District of Florida

Stay tuned — this story is far from over.

Summary: The Wound Care Today Learning Zone hosts a dedicated CPD e-learning module on the Debrisoft family of monofilament fibre debridement devices, produced in partnership with Lohmann & Rauscher (L&R), the manufacturer of the Debrisoft product range. The module covers the main features and benefits of Debrisoft Pads and the Debrisoft Lolly (a monofilament fibre pad with an ergonomic handle for hard-to-reach wounds), and provides guidance on correct use. Debrisoft’s monofilament fibre technology works by physically disrupting and lifting devitalised tissue, slough, biofilm, fibrinous deposits, and debris from wound beds and periwound skin through circular or sweeping motion, with the device hydrated with saline or wound cleanser prior to application. The technology received a positive recommendation from the National Institute for Health and Care Excellence (NICE Medical Technology Guidance MTG17) for use in acute and chronic wounds in community and clinic settings, based on clinical evidence of rapid and effective mechanical debridement with minimal patient discomfort and demonstrated cost savings versus saline/gauze, hydrogel, and larval therapy. Key supporting evidence includes: a 2021 prescribing audit by Burnett et al. (J Wound Care 30(5):381–388, DOI: 10.12968/jowc.2021.30.5.381) in 486 NHS patients showing reduced wound-care prescribing costs following Debrisoft introduction; a 2018 multicenter user test by Dissemond et al. (J Wound Care 27(7):421–425) across 155 wounds evaluating the Debrisoft Lolly for hard-to-reach wound debridement; and a 2018 ex vivo and clinical study by Schultz et al. (J Wound Care 27(2):80–90) demonstrating effectiveness at removing biofilm and slough. The Debrisoft Duo product extends the original Pad with a dual-sided design: the original soft white monofilament side for debris, exudate, and biofilm removal, and a textured beige side for loosening firmly adherent fibrinous slough. The module is freely accessible to registered Wound Care Today users and offers CPD certification upon completion.

Key Highlights:

• Monofilament technology: Debrisoft’s densely packed monofilament fibres reach into the wound bed and periwound skin to physically disrupt and remove necrotic tissue, biofilm, fibrinous slough, dry skin, and keratosis — while sparing newly formed granulation tissue and epithelial cells
• NICE MTG17 endorsement: the only mechanical debridement technology to receive NICE Medical Technology Guidance for community use; cost-saving analysis showed £77–£222 savings vs. hydrogel, £97–£347 vs. saline/gauze, and £180–£484 vs. larval therapy per patient
• Debrisoft Lolly: ergonomic handle design for debridement of cavities, sinuses, tunnelling wounds, body folds, and other anatomically challenging wound locations — evaluated in 155 wounds across 20 international centres by Dissemond et al.
• Biofilm relevance: Schultz et al. (2018) demonstrated ex vivo removal of mature biofilm from porcine dermal tissue, supporting Debrisoft’s role within biofilm-based wound care (BBWC) and wound bed preparation (TIME/TIMERS framework)
• Prescribing impact: Burnett et al. (2021) NHS audit of 486 patients found that introduction of Debrisoft monofilament debridement pad was associated with measurable reductions in wound-care prescribing costs over 6 months — providing real-world economic evidence beyond the NICE modelling
• Module access: freely available after registration at woundcare-today.com/learning-zone; CPD certification awarded on completion — suitable for district nurses, tissue viability nurses, and wound care clinicians seeking structured learning on mechanical debridement tools

Access module

Keywords: Debrisoft wound debridement, monofilament debridement pad, wound bed preparation debridement, NICE wound debridement guidance, biofilm mechanical debridement, CPD wound care education

Wound Care Today / Lohmann & Rauscher

Negative Pressure Wound Therapy with Instillation: Enhancing Wound Healing

A recent study in the Journal of Wound, Ostomy and Continence Nursing explores the efficacy of Negative Pressure Wound Therapy with Instillation (NPWTi), highlighting its role in improving wound healing outcomes. The research emphasizes the combination of negative pressure and periodic instillation of solutions to manage complex wounds effectively.

Key Highlights:

• Enhanced Wound Cleaning: NPWTi delivers cleansing solutions to the wound bed, reducing bioburden and promoting a cleaner healing environment.
• Improved Healing Rates: The study reports faster wound closure and reduced infection rates compared to standard NPWT in specific wound types.
• Clinical Applications: NPWTi is particularly beneficial for chronic, infected, or high-exudate wounds, offering a targeted approach to complex cases.
• Evidence-Based Practice: The findings support integrating NPWTi into wound care protocols, with recommendations for tailored solution selection and treatment schedules.

This study provides valuable insights for clinicians seeking advanced wound management techniques to optimize patient outcomes.

Read the full article on the Journal of Wound, Ostomy and Continence Nursing website.

Keywords:
Negative pressure wound therapy,
NPWTi,
Wound healing,
Chronic wounds,
Infection management

Wound Care Billing in the USA: A Complete Guide to Accurate Reimbursement and Revenue Growth

Summary: Wound care has become one of the most complex areas of medical billing in the U.S., driven by rising chronic disease burden, a high-value product landscape, and evolving CMS coverage policies. A comprehensive guide published by PicGiraffe covers the full billing landscape — from foundational CPT code selection through the latest 2025–2026 regulatory changes. Wound care services map to CPT codes for debridement (97597–97598 for selective; 11042–11047 for surgical, stratified by tissue depth and wound area), NPWT (97605–97606), skin graft applications, and evaluation and management (E/M) services. ICD-10 codes must be accurately paired to establish medical necessity — especially nuanced for diabetic foot ulcers, venous leg ulcers, and pressure injuries. Modifier accuracy is critical: Modifier 59 prevents inappropriate bundling; the A1–A9 series addresses multiple wound sites. CMS updates effective 2025 tightened prior authorization for skin substitute grafts, required wastage documentation, and restricted same-day Modifier 25 usage. The January 2026 update to LCD L37166 clarified Medicare coverage for medically necessary wound care, and NCD 270.3 was reaffirmed to support platelet-rich plasma for chronic nonhealing diabetic wounds. Documentation and coding errors account for an estimated 30% of claim denials in this specialty.

Key Highlights:

• Core debridement CPT codes: 97597–97598 (selective, per 20 cm²) and 11042–11047 (surgical, by tissue depth) — code selection determined by wound characteristics
• ICD-10 pairing required for medical necessity; diabetic wound claims need the diabetes complication code (e.g., E11.621) plus site-specific ulcer code (e.g., L97.x)
• NPWT: CPT 97605 (≤50 cm²) or 97606 (>50 cm²) — both require supporting medical necessity documentation
• 2025 CMS updates: expanded prior authorization for skin substitute grafts, wastage documentation for graft billing, tightened Modifier 25 for same-day E/M + procedure claims
• LCD L37166 updated January 2026 for skin substitutes; NCD 270.3 reaffirmed supporting PRP for chronic nonhealing diabetic wounds
• ~30% of wound care claims denied due to documentation and coding errors — internal audits, EHR templates, and billing specialist engagement recommended

Read full article

Keywords: wound care billing, CPT codes wound care, CMS reimbursement, wound care coding, ICD-10 wound care, prior authorization wound care

How to Talk to Patients About Their Wounds: Tips for Building Trust and Compliance

Summary: Published by Wound Care Professionals on December 2, 2025, this four-minute practice article addresses a frequently underemphasized dimension of wound management: the clinician-patient communication relationship. The piece opens with a striking statistic — research suggests that up to 50% of chronic wound care plans are not followed as prescribed, most commonly because of patient fear, misunderstanding, or insufficient trust in the care team. The author, Nancy Morgan, frames wound care communication not simply as information transfer, but as a two-way dialogue that builds partnership and forms the foundation for long-term compliance. The article outlines five actionable strategies. First, setting a warm and non-judgmental tone early — acknowledging the emotional burden of chronic wounds before diving into clinical details. Second, balancing accessibility with respect: avoiding oversimplification while still translating clinical terminology into plain-language explanations, with visuals of healing stage diagrams recommended where available. Third, involving patients in goal-setting by asking what aspects of the care plan may be difficult to follow in their daily routine — creating shared ownership of the wound care process. Fourth, explaining healing progress honestly and managing expectations around the nonlinear nature of wound repair, including the inflammatory, proliferative, and maturation phases, and using photos or measurements to make progress visible and motivating. Fifth, educating for long-term compliance beyond the immediate wound — including dietary guidance, hygiene, footwear for diabetic patients, and links to community support resources. The article is primarily directed at nurses, therapists, physicians, and home health providers, and is published as part of Wound Care Professionals’ broader educational and certification program portfolio.

Key Highlights:

• Up to 50% of chronic wound care plans are not followed as prescribed — most commonly due to fear, misunderstanding, or low trust in the care team
• Five strategies: (1) non-judgmental tone-setting; (2) plain-language explanation without condescension; (3) patient involvement in goal-setting; (4) transparent healing expectation management; (5) long-term compliance education
• Clinicians advised to validate the emotional impact of wounds before presenting clinical information — particularly important for patients experiencing shame, anxiety, or grief about their wound
• Wound photographs with patient consent recommended as motivational progress-tracking tools — transforming subjective improvement into visible, measurable progress
• Long-term compliance framing: wound care as a lifestyle shift requiring ongoing patient education on prevention, nutrition, hygiene, and footwear
• Applies across all care settings: hospital inpatient, outpatient wound clinic, home health, and long-term care — relevant to any clinician managing chronic or recurring wounds

Read full article

Keywords: wound care patient communication, wound care compliance, patient education wound care, chronic wound adherence, wound care trust building, wound care nurse communication

Nancy Morgan

Summary: Published March 10, 2026 in Healio Dermatology‘s video interview series Beneath the Surface, Part 1 of a two-part edition on chronic wound management features Joel M. Gelfand, MD, MSCE, FAAD (James J. Leyden Professor of Clinical Investigation at the University of Pennsylvania’s Perelman School of Medicine and Healio Dermatology Chief Medical Editor) in conversation with Robert S. Kirsner, MD, PhD (Chairman and Professor, Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine; Director, University of Miami Hospital and Clinics Wound Center; past Vice President of the American Academy of Dermatology). Kirsner frames the interview around a central principle for approaching chronic wound diagnosis: think like a real estate agent — where a wound is located and what surrounds it tells the clinician what to look for first. For lower extremity wounds, he identifies arterial evaluation as by far the most critical diagnostic step, recommending ankle-brachial index (ABI) testing: triphasic, high-amplitude pulse volume recordings indicate normal perfusion; biphasic or monophasic results indicate worsening arterial disease; an ABI below 0.9 is an independent risk factor for myocardial infarction and should prompt referral to vascular medicine or medication adjustment. For wounds overlying bony prominences, osteomyelitis assessment is essential — starting with probe-to-bone testing and imaging (X-ray or MRI), with bone biopsy as the definitive gold standard. For atypical wounds — those in unusual locations, with strange morphology, or failing to respond to standard care — biopsy for both histology and tissue culture is the recommended first diagnostic step to rule out malignancy, unusual infection, or inflammatory etiology. Kirsner notes that once common chronic wound types are diagnosed, initial treatment is relatively straightforward: compression therapy is central for venous leg ulcers with adequate arterial supply; offloading via boot or cast is primary for diabetic foot ulcers and pressure injuries; nutritional assessment and optimisation is essential for all wound types. He highlights fat cell injection as a particularly exciting emerging modality — adipose tissue placed around or below chronic wounds has shown faster healing in recent studies, believed to be due to the regenerative, angiogenic, and immunomodulatory potential of adipose-derived stromal cells. Part 2 of the series covers complex inflammatory wound conditions including pyoderma gangrenosum.

Key Highlights:

• Core diagnostic principle: approach wound assessment “like real estate” — location of the wound determines the diagnostic priority and guides initial workup for underlying vascular, bone, or tissue pathology
• ABI testing for lower extremity wounds: triphasic = normal; biphasic/monophasic = worsening arterial disease; ABI <0.9 = independent MI risk factor — warrants vascular medicine referral or pharmacologic intervention
• Osteomyelitis evaluation: probe-to-bone test + X-ray or MRI for wounds overlying bony prominences; bone biopsy is the gold standard for definitive diagnosis in suspected cases
• Atypical wounds: biopsy for histology AND tissue culture recommended when location is unusual, morphology is atypical, or wound fails standard treatment — to rule out malignancy, atypical infection, or inflammatory conditions before escalating therapy
• Initial treatment standards: compression primary for VLUs with adequate arterial supply; offloading (boot or cast) primary for DFUs and pressure injuries; nutritional optimisation essential for all chronic wound types
• Emerging modality: fat (adipose) cell injection around or below chronic wounds — recent studies show accelerated healing, attributed to regenerative and immunomodulatory properties of adipose-derived stromal cells; Kirsner calls fat “a real source of potential to heal wounds”

Read full article

Keywords: chronic wound diagnosis dermatology, ankle brachial index wound care, venous leg ulcer compression, diabetic foot ulcer offloading, osteomyelitis diabetic foot biopsy, fat injection wound healing

Robert S. Kirsner Joel M. Gelfand

Hyaluronic Acid-Based Gels and Biomaterial Systems for Oral Wound Healing: Design and Clinical Translation

Summary: Published March 22, 2026 in Gels (MDPI, Special Issue: Designing Gels for Wound Healing and Drug Delivery Systems), this narrative review from Grigore T. Popa University of Medicine and Pharmacy (Iași, Romania), led by Vlad Constantin and Ionut Luchian (corresponding author), with co-authors from multiple clinical and basic science departments, provides a comprehensive synthesis of hyaluronic acid (HA) biology, material design principles, and clinical performance evidence specifically within the oral wound healing context. While focused on oral and periodontal wounds, the biological and biomaterial principles covered are directly relevant to wound care clinicians managing non-healing wounds, skin grafts, and biomaterial-based dressing systems, as HA is one of the most widely investigated biomaterials across all wound healing applications. HA is a non-sulfated glycosaminoglycan and fundamental ECM component that plays critical roles in tissue hydration, cellular signalling, angiogenesis, inflammation modulation, and matrix remodelling throughout the four wound healing phases. Its biological behaviour is strongly molecular weight-dependent: high-molecular-weight HA (>1,000 kDa) exerts anti-inflammatory, anti-edematous, and protective/barrier effects, contributing to tissue homeostasis; low-molecular-weight HA fragments (<20 kDa) act as endogenous danger signals (DAMPs) activating innate immunity via TLR-4, and also promote cell migration, angiogenesis, and tissue remodelling. In oral wounds — complicated by salivary dilution, mechanical stress, microbial exposure, and enzymatic degradation — formulation design is critical. The review systematically covers: topical HA gels (0.1–0.8% concentration range; shear-thinning rheology essential for retention; salivary ionic composition affects gel viscosity and structural integrity); cross-linked HA hydrogels (BDDE, DVS, carbodiimide, and enzymatic cross-linking strategies; enhanced mechanical stability vs. reduced receptor accessibility trade-off; optimal degree of modification balances CD44/RHAMM receptor interaction with degradation resistance); and HA-based membranes and 3D scaffolds (fabricated by freeze-drying, electrospinning, or composite blending with collagen or chitosan; provide guided tissue regeneration, structural support, and bioactive modulation in periodontal and surgical contexts). Clinical evidence covers applications in post-extraction socket healing, periodontal flap surgery, peri-implant soft tissue management, and oral mucosal ulceration — with consistent findings of reduced postoperative pain, accelerated re-epithelialisation, and decreased edema in short-term follow-up. The review is candid about limitations: substantial heterogeneity in formulation parameters across clinical studies makes direct comparison impossible; most trials have small sample sizes and short follow-up; and few studies systematically correlate physicochemical properties with clinical outcomes. The authors call for well-designed multicenter RCTs with standardised HA formulations and harmonised outcome measures.

Key Highlights:

• Molecular weight-dependent biology: high-MW HA (>1,000 kDa) is anti-inflammatory and barrier-protective; low-MW HA fragments (<20 kDa) activate TLR-4 innate immune signalling, promote angiogenesis, and stimulate cell migration — size-dependent effects must inform formulation design for targeted wound healing applications
• Receptor signalling: HA exerts key wound healing effects via CD44 and RHAMM (Receptor for Hyaluronan-Mediated Motility) receptor interactions — regulating cytoskeletal organisation, cell migration, proliferation, and fibroblast-mediated ECM deposition; cross-linking density can mask receptor-interacting domains, reducing biological activity if over-engineered
• Formulation design imperatives for oral wounds: HA gels must exhibit shear-thinning (pseudoplastic) rheology; storage modulus (G′) must exceed loss modulus (G″) for structural retention against salivary washout; ionic composition of saliva (Na, Ca, phosphate) affects intermolecular charge screening and viscosity — requiring formulation-specific rheological optimisation
• Cross-linking strategy comparison: BDDE and DVS cross-linking provide superior mechanical stability but risk cytotoxicity at high concentrations and reduced CD44 accessibility; carbodiimide and enzymatic cross-linking offer improved biocompatibility with moderate stability; physical/self-assembly systems are safest but most susceptible to salivary dilution
• Clinical evidence summary: HA gels consistently reduce postoperative pain, edema, and inflammatory markers, and accelerate re-epithelialisation in periodontal surgery, extraction sockets, peri-implant procedures, and mucosal ulceration — with best evidence in short-term applications; long-term data and standardised RCT evidence remain limited
• Transferability to general wound care: the biological principles and formulation design challenges described — MW-dependent effects, cross-linking optimisation, receptor-mediated signalling, hydrogel rheology — are directly applicable to HA-based dressings used in non-oral chronic wounds including venous ulcers, DFUs, and post-surgical wounds

Read full article

Keywords: hyaluronic acid wound healing, HA gel wound dressing design, hyaluronan biomaterial tissue repair, cross-linked hydrogel wound healing, CD44 wound healing ECM, extracellular matrix wound repair

Vlad Constantin, Ionut Luchian, Dragos Ioan Virvescu, Mihaela Scurtu, Nicoleta Tofan, Dan Nicolae Bosinceanu, Elena Raluca Baciu, Carina Balcos, Monica Mihaela Scutariu, Dana Gabriela Budala

WCC Certification Course Options: Get Wound-Care Credentialed

If you’re preparing for the Wound Care Certified (WCC®) exam, several structured pathways and course providers are available to boost your knowledge, readiness, and credentials.

Course Providers & Formats:

• NAWCO (via Prometric): Offers the formal WCC® credential through exam-based certification. Candidates must meet eligibility criteria (e.g., professional licensure + training or experience) to apply. Exam retakes are allowed up to four times. Credentials are valid for five years with NCCA accreditation through 2029.
• Wound Care Education Institute (WCEI): Delivers comprehensive wound-care courses—including WCC®, diabetic wound care, ostomy management—across onsite, live-online, and self-paced online formats. Four-day intensive courses are held nationwide throughout 2025‑2026.
• Wound Care Education Partners (WCEP): Provides a blended certification prep program (~25.5 CME/CEUs) with an online pre-course and 1‑day live workshop focused on core wound concepts and debridement, accredited by NAWCO.

Certification Pathways:

• Education-Based Path: Complete an approved skin and wound management training course. WCEI and WCEP courses meet NAWCO’s training criteria.
• Experience-Based Path: Clinical practice (e.g., ≥2 years full-time or equivalent part-time in wound care) may also qualify.
• Hybrid Options: Some candidates may combine prior wound-care credentials (e.g., CWCN, CWON) or documented experience instead of additional coursework.

Additional Details:

• Costs & Scheduling: Fees vary; online and live options are available year-round. Prometric testing centers schedule exams post-course completion.
• Recertification: WCC® credentials last five years and require continuing education for renewal. Many course providers also offer recertification workshops.
• Who’s Eligible? Professionals including RNs, PTs, OTs, physicians, podiatrists, and more. WCC® is recognized by Magnet and other clinical credentialing bodies.

Choosing between self-paced, live-online, or in-person workshops depends on your learning style, schedule flexibility, and preferred interaction level. All pathways are designed to ensure you’re fully prepared to sit for the WCC® exam and integrate evidence-based wound care into practice.

Keywords: WCC certification, wound care training, NAWCO, WCEI, wound care education

Read more on WoundCareProf.com

“Where Are the Young Wound Clinicians?”: Addressing the Workforce Gap

An editorial published in *Journal of Wound Care* (online July 8, 2024) raises urgent concern about the dwindling number of early-career clinicians entering the wound-care field, exploring implications for education, succession planning, and patient outcomes.

Key Highlights:

• Aging Workforce: The current cohort of experienced wound clinicians is nearing retirement, with few younger professionals stepping in to fill the void.
• Training Barriers: Educational programs—such as wound-specific training, fellowships, and certification pathways—are scarce, limiting access to formalized learning and mentorship.
• Perception & Awareness: Many early-career providers remain unaware of wound care as a viable subspecialty. The field lacks visibility in medical and nursing curricula.
• Patient Access Threats: Without a robust pipeline of new clinicians, there’s a real risk of diminished wound-care access for patients—potentially leading to delays in healing and higher complication rates.
• Strategic Solutions: Suggestions include embedding wound-care rotations in training programs, creating formal fellowships, promoting WCC and CWCN certifications, and improving interdisciplinary collaboration.

This editorial highlights a critical juncture: without proactive efforts to attract and train new clinicians, the wound-care field faces a future workforce shortage that may impact quality of care and patient outcomes.

Based on “Where are the young wound clinicians?”, *Journal of Wound Care*, published online July 8, 2024.

Keywords: wound clinician workforce, training programs, succession planning, mentorship, workforce shortage

Read the full editorial on Journal of Wound Care

Miro3D® & MiroDry®: 3D Collagen Matrices for Complex Wound Management

An on-demand webinar from HMP Global explores the clinical use of Miro3D® and MiroDry®—two advanced porcine collagen wound matrices—designed to manage complex, irregular, and deep wounds with precision and ease.

Key Highlights:

• 3D Wound Fill: Miro3D® is a thicker scaffold (2 cm) ideal for large volume wounds. MiroDry®, introduced as a thinner (~6.5 mm) compressible version, adapts to surfaces where full volume fill is not required.
• Indications: Approved for use in treating stage III and IV pressure injuries, diabetic foot ulcers, surgical dehiscence, trauma, and tunneling wounds.
• Billing & Reimbursement: Miro3D® is assigned HCPCS code A2025, enabling easier documentation and coverage in clinical practice.
• Clinical Case Presentations: Real-world cases were presented on pilonidal wounds, necrotizing fasciitis, perirectal abscesses, and surgical complications. Outcomes demonstrated rapid integration and manageable exudate control.
• Expert Faculty: The panel featured wound care leaders:
  • Dr. John P. Kirby, MD, MS, CWSP, FACS
  • Dr. Raymond J. Abdo, DPM
  • Dr. Walaya Methodius‑Rayford, MD, MBA, RPVI, CWSP, DAVBLM, FACCWS, FAPWCA
  • Ryan Dirks, MS, PA – Founder & CEO of United Wound Healing
  • Dr. Lucian G. Vlad, MD – Wake Forest Wound Care Fellow

Miro3D® and MiroDry® represent a shift toward anatomically adaptive, reimbursable, 3D wound care scaffolds that conform to wound contours and support healing in high-risk presentations.

Keywords:
Miro3D,
MiroDry,
Dr. John P. Kirby,
Dr. Raymond J. Abdo,
Dr. Walaya Methodius‑Rayford,
Ryan Dirks,
Dr. Lucian G. Vlad,
3D collagen matrix,
tunneling wounds,
HCPCS A2025

Watch the webinar on HMP Global

🔬 Spotlight: Advancing Wound Care with 3D Collagen Scaffolds and Reimbursement Access

The emergence of three-dimensional wound matrices such as Miro3D® and MiroDry® is reshaping how clinicians approach chronic, irregular, and deep wound beds. These products offer structural integrity, customizable fit, and clinical adaptability—especially in anatomically complex areas.

• 3D Structural Benefits: Unlike flat sheets, Miro3D® fills vertical wound space and dead tissue pockets, minimizing dead space and supporting cellular infiltration. MiroDry® is designed for areas needing a thinner, surface-adapted scaffold, particularly where drainage and compression are concerns.
• Tunneling and Undermining: These matrices conform to narrow tunnels and cavities without the need for multiple product layers, reducing dressing bulk and improving comfort.
• HCPCS Code A2025: Assigned to Miro3D®, this reimbursement code improves access by streamlining billing for advanced collagen matrices in outpatient and surgical settings. Clinicians can confidently code and bill while aligning with evidence-based use cases.
• Multisite Case Validation: Clinical use across dehisced surgical wounds, pressure injuries, and necrotizing fasciitis cases provides a growing base of real-world evidence supporting adoption and payer justification.

As wound care reimbursement models evolve, combining innovation with billing clarity will be key to improving outcomes—and keeping advanced care within reach.

We Come to You: Expanding Access Through Post-Acute Mobile Wound Care

This editorial from JWC Wound Central highlights the growing importance of mobile wound care services in addressing barriers to access for patients with hard-to-heal wounds. As populations age and mobility challenges rise, many patients are unable to access advanced care through traditional outpatient clinics—whether due to location, physical limitations, social isolation, or lack of insurance coverage.

Key Highlights:

• Rising Need for Access: Post-acute mobile wound care has emerged to meet the growing need for at-home or facility-based services across hospitals, nursing homes, assisted living facilities, and group homes.
• Technology On-the-Go: These mobile services offer patients access to cutting-edge tools like CAMPs (cellular, acellular, matrix-like products) and near-infrared spectroscopy previously limited to wound centers.
• iPAWS Summit 2024: The inaugural International Post-Acute Wound Society (iPAWS) Summit, held in New Orleans, convened over 200 clinicians to advance education, business models, and competency-based training for mobile wound care providers.
• Featured Sessions:
  • Medical Necessity Documentation – William O’Malley, former Medicare Auditor
  • The Business of the Mobile Model – Dennis Deruelle, MD; Martha Kelso, RN, CHWS, DAPWCA, HBOT; and Naz Wahab, MD
• Call to Action: As mobile wound care rapidly becomes a core element of the specialty, education and advocacy must grow alongside it to ensure equitable, expert-level care reaches every patient in need—regardless of setting.

This movement underscores a shift in wound care delivery—meeting patients where they are, while embracing technological innovation and reshaping access across the care continuum.

Keywords:
post-acute wound care,
mobile wound care,
iPAWS,
Martha Kelso,
Dennis Deruelle,
Naz Wahab,
William O’Malley,
cellular acellular matrix,
near-infrared spectroscopy,
wound access equity

Read the full editorial in JWC Wound Central

Wound Progression and Healing in Patients With Moisture-Associated Skin Damage

A retrospective observational study published in the Journal of Wound, Ostomy, and Continence Nursing (July 2025) examined the relationship between moisture-associated skin damage (MASD) and wound healing outcomes. The research team, led by Laura R. Sibbald, investigated how MASD affects wound progression in patients receiving care at a Canadian community hospital system.

Study Highlights:

• Patient Cohort: The study analyzed 236 patients with MASD and 236 matched controls without MASD using electronic medical records.
• Wound Progression: Patients with MASD were more likely to experience delayed wound healing and wound deterioration compared to those without MASD.
• Contributing Factors: Increased moisture from incontinence, sweat, and wound exudate was associated with worsening skin integrity and inflammation, leading to prolonged healing timelines.
• Clinical Implications: The findings highlight the importance of early identification and management of MASD as a risk factor for poor wound healing outcomes in vulnerable populations.

Conclusion: MASD significantly impairs wound healing and increases the risk of wound progression. Clinical strategies focused on moisture control and barrier protection are essential to prevent complications and support recovery.

Keywords: Laura R. Sibbald, moisture-associated skin damage, wound healing, wound progression, MASD, skin integrity

Read the full study in JWOCN

Innovations in Diagnostics, Treatment and Delivery of Care: Advancing the Wound Care Toolkit

Summary: Editors Peta Tehan and Zlatko Kopecki present the Volume 33, Number 4 (2025) issue of Wound Practice and Research, the official journal of the Australian Wound Management Association (AWMA), published as an open-access diamond publication by Cambridge Media. This editorial introduces five contributions that collectively span the wound care toolkit — from early diagnostics to advanced therapies and care delivery innovation. The first is a case report by Astrada et al. in which point-of-care ultrasonography (POCUS) detected extensive subcutaneous gas gangrene extending to the Achilles tendon and calf in a 61-year-old patient with a closed diabetic foot ulcer — before visible tissue damage had occurred — enabling prompt debridement and antibiotic therapy. The second case by Lauryn and Suryadi describes the successful use of sequential NPWT followed by split-thickness skin graft (STSG) in a 54-year-old man who developed deep wound dehiscence and an enterocutaneous fistula following surgery for abdominal tuberculosis, achieving 95% wound healing within 46 days. The third contribution, a systematic review and meta-analysis by Somboonchokephisal, examines beta-glucan — a natural polysaccharide that promotes immune cell activation and tissue repair — finding a twofold increase in healing rates at 12 weeks for topical beta-glucan applied to chronic wounds. The fourth paper, by Binkanen et al., evaluates patient and caregiver satisfaction with virtual wound care services in Saudi Arabia, finding significantly higher satisfaction among patients than caregivers, with caregivers raising concerns about accessibility and communication. Finally, a WHAM evidence summary addresses silicone gel sheeting for hypertrophic scars, concluding it may reduce pain and scar severity when clinical decisions account for symptom severity, patient preference, and adherence capacity.

Key Highlights:

• POCUS case: subcutaneous gas gangrene detected in a closed DFU before visible tissue damage — early detection enabled debridement and antibiotics, potentially preventing substantial tissue loss
• NPWT + STSG case: sequential negative pressure wound therapy followed by split-thickness skin graft achieved 95% healing within 46 days of treatment initiation in a complex postoperative dehiscence with enterocutaneous fistula
• Beta-glucan meta-analysis: topical beta-glucan application to chronic wounds associated with twofold increase in healing rates at 12 weeks — proposed mechanism is immune cell activation and resolution of persistent inflammation
• Telehealth satisfaction study (Saudi Arabia): patients reported significantly higher satisfaction than caregivers with virtual wound care services — caregiver concerns around accessibility and communication highlight the need for targeted support and training
• WHAM silicone sheeting summary: silicone gel sheeting may reduce pain and scar severity in existing hypertrophic scars — clinical decisions should be individualized based on scar characteristics and patient adherence capacity
• Wound Practice and Research is diamond open access (no APC) and indexed by AWMA; DOI 10.33235/wpr.33.4.155; Vol. 33 No. 4, 2025

Read full article

Keywords: wound care diagnostics, POCUS diabetic foot ulcer, beta-glucan wound healing, telehealth wound care, silicone gel sheeting hypertrophic scar, NPWT skin graft

Peta Tehan Zlatko Kopecki

Hidden Crisis in Wound Care: Pressure Injuries

Summary: Hosted on the Demio webinar platform, this continuing education event titled “Hidden Crisis in Wound Care: Pressure Injuries” addresses one of wound care’s most prevalent and preventable — yet persistently underrecognised — clinical challenges. Pressure injuries (also called pressure ulcers or decubitus ulcers) affect an estimated 2.5 million patients per year in the United States alone, contributing significantly to prolonged hospitalisation, sepsis, surgical interventions, litigation, and mortality, particularly in the elderly, critically ill, and mobility-impaired populations. Despite broad awareness within nursing and wound care circles, pressure injuries continue to represent a hidden crisis in healthcare because they frequently develop in clinically silenced settings — under intact skin as deep tissue injuries, in patients unable to communicate pain, and in long-term care settings with limited wound care specialist access. The webinar format allows clinicians — nurses, wound care specialists, long-term care providers, and hospital administrators — to engage with expert-led education on the current NPIAP/EPUAP/PPPIA international pressure injury staging and classification system (Stages 1–4, unstageable, and deep tissue pressure injury), prevention frameworks including the use of pressure redistribution support surfaces, repositioning protocols, skin assessment tools (Braden Scale, Norton Scale), and nutrition-based preventive strategies. Management topics typically include moist wound healing principles, debridement decision pathways, dressing selection, offloading, negative pressure wound therapy in pressure injury management, and multidisciplinary care coordination across acute, post-acute, and community settings. For registration and webinar date/time details, visit the link below.

Key Highlights:

• Free continuing education webinar on pressure injury prevention and management — covering NPIAP/EPUAP/PPPIA classification, staging, and international guideline recommendations
• Addresses the “hidden crisis” framing: pressure injuries frequently develop silently under intact skin (deep tissue injuries), in non-communicating patients, and in under-resourced long-term care settings
• Prevention framework: pressure redistribution surfaces, repositioning schedules, skin assessment (Braden/Norton), moisture management, nutrition optimisation — comprehensive risk mitigation strategies
• Management topics: moist wound healing, debridement, dressing selection for each pressure injury stage, NPWT indications, surgical wound closure considerations, and care coordination across transitions
• Audience: wound care nurses, clinical nurse specialists, long-term care staff, hospital administrators, and any clinician involved in pressure injury prevention or treatment programs
• Registration and scheduling: available via Demio at the link below — check for live and on-demand session availability

Register for webinar

Keywords: pressure injury prevention, pressure ulcer staging NPIAP, deep tissue pressure injury, pressure injury wound care education, Braden Scale pressure ulcer, pressure injury management nursing

Wound Care Professionals

Today’s Wound Clinic Evolves into Wound Care Business Navigator

After 18 years of serving the wound care community, Today’s Wound Clinic (TWC) is transitioning into the Wound Care Business Navigator (WCBN), a dynamic digital platform designed to meet the evolving needs of modern wound care professionals. This change reflects the growing demand for comprehensive, real-time resources that address the complexities of reimbursement, compliance, and operational efficiency in wound care practice. Read the full article.

Key Highlights:

• Purpose-Driven Transition: WCBN is designed to provide clinicians with immediate access to expert insights, regulatory updates, and practical tools to navigate the complexities of wound care business operations.
• Interactive and Adaptive Platform: Unlike traditional publications, WCBN offers a continuously updated, interactive experience that evolves alongside industry changes, ensuring users have the most current information at their fingertips.
• Comprehensive Resource Hub: The platform aims to centralize critical information, addressing common challenges such as fragmented knowledge, revenue leakage, compliance risks, and operational inefficiencies.
• Expert Leadership: Dr. Caroline E. Fife, who has been instrumental in TWC’s success, continues to contribute her expertise, ensuring that WCBN maintains the high standards and relevance that readers have come to expect.

This strategic evolution signifies a commitment to empowering wound care professionals with the resources needed to optimize patient care and practice management in a rapidly changing healthcare landscape.

Read the full article on the HMP Global Learning Network website.

Keywords:
Wound Care Business Navigator,
Today’s Wound Clinic,
wound care reimbursement,
practice management,
regulatory compliance

Navigating Wound Balance: Practical Approaches for the Australian Landscape

This supplement in *Wounds International* (June 2025) reports on two Australian advisory board meetings (2024–25) that adapted the global “Wound Balance” framework for use by generalist health professionals in diverse Australian care settings.

Key Highlights:

• Wound Balance 3‑Pillars: Patient-centred care, wound‑and‑skin science, and clinical‑practice balance—forming a holistic, adaptable decision-making framework :contentReference[oaicite:1]{index=1}.
• Barriers for Generalists: Challenges include limited wound-care confidence, inconsistent terminology, lack of standardized documentation, and inadequate monitoring tools such as PROMS :contentReference[oaicite:2]{index=2}.
• Australian Context: The advisory board emphasized empathetic communication, therapeutic relationships, and the mantra “Healing starts with me” as a cultural and practical anchor :contentReference[oaicite:3]{index=3}.
• Standards Alignment: Frameworks referenced include IWII Therapeutic Wound Cleansing (2025) and Australian Wound Prevention & Management Standards, 4th Edition (2023) :contentReference[oaicite:4]{index=4}.
• Next Steps: Recommendations include generalist education modules, adoption of standardized assessment tools (e.g., QoL/PROMS, biomarker use), and integration of the framework into primary, residential, and community care :contentReference[oaicite:5]{index=5}.

This report reinforces Wound Balance as a versatile, evidence-informed framework—ready for adoption across the Australian care continuum to enhance wound outcomes and clinician confidence.

Keywords:
Wound Balance,
patient‑centred care,
PROMS,
Therapeutic Wound Cleansing,
Australian Wound Standards 2023,
generalist HCP,
Healing starts with me

Read the full supplement in Wounds International

Adaptive Wound Care and the Convergence with Sports Medicine

At the Symposium for Advanced Wound Care Spring, a panel discussion spotlighted the intersection of adaptive medicine and wound care, emphasizing the needs of athletes with disabilities. Alton R. Johnson, Jr., DPM and Jeffrey Waldmuller, CP later expanded on this topic in a conversation with Podiatry Today, sharing insights into the challenges and innovations within this evolving specialty.

What Is Adaptive Wound Care?
Adaptive medicine supports individuals with physical disabilities—such as amputations, spina bifida, or spinal cord injuries—to achieve their athletic goals, whether professional or recreational. Dr. Johnson noted the importance of personalized care approaches, including wheelchair customization and appropriate prosthetic or footwear selection. Waldmuller described adaptive wound care as a space requiring clinicians to think creatively to support patients with both visible and invisible disabilities.

Unique Challenges for Adaptive Athletes:
These athletes often push physical boundaries. For instance, a wheelchair marathoner endures high-impact stress on their upper body and skin integrity. Amputees may face prosthetic-related wounds that demand immediate adjustment to avoid setbacks. Both experts emphasized the need for patient education so athletes can independently manage minor issues and continue training safely.

Clinical Considerations:

• Understanding the anatomy of wheelchairs and prosthetics is essential for tailoring wound care.
• Sweat, friction, and pressure within prosthetic sockets are common sources of wounds, particularly at the distal end of the limb.
• Materials used in liners and dressings must accommodate the athlete’s activity level without increasing skin risk.
• Biomechanics, such as gait and residual limb movement, influence wound healing and injury prevention strategies.

The Mental Health and Identity Component:
Waldmuller stressed that for many adaptive athletes, being sidelined can take a serious emotional toll. The ability to stay active is tied to identity and independence. Removing a prosthetic for healing purposes can trigger distress—clinicians must recognize and support the mental health needs of these patients.

Resources and Future Directions:
Educational resources for both patients and providers are critical. Organizations such as the Amputee Coalition of America, Ottobock, Challenge Athletes Foundation, and Team Catapult provide support, training, and community. Dr. Johnson advocated for the development of clinical guidelines and expert panels to further define best practices for adaptive wound care.

Conclusion: Adaptive wound care is a growing, dynamic field that blends sports medicine, prosthetics, wound prevention, and mental health support. Collaborative, personalized care is essential to helping these athletes train consistently and reach their goals.

Keywords:
Alton R. Johnson, Jr.,
Jeffrey Waldmuller,
adaptive wound care,
prosthetics,
sports medicine,
wheelchair athletes,
mental health,
wound prevention

Read the full article on HMP Global

MolecuLightDX® Now Available on Oracle Healthcare Marketplace

PITTSBURGH, Dec. 9, 2025 /PRNewswire/ — MolecuLight Corp., a global leader in point-of-care fluorescence imaging for wound assessment and an Oracle partner, today announced the MolecuLight DX® is available on Oracle Healthcare Marketplace. This integration enables direct connection with the Oracle Health Foundation electronic health record (EHR). Oracle Healthcare Marketplace is a centralized repository of healthcare applications offered by Oracle and Oracle partners.

The MolecuLight DX is an all-in-one handheld wound imaging solution designed to capture bacterial fluorescence, digital measurements and thermal images of wounds, all while connecting to the EHR. Leveraging Oracle Health FHIR APIs and secure Wi-Fi connectivity, this powerful integration maintains fast, accurate, and secure transfer of wound data. The result is streamlined clinician workflows and enhanced delivery of personalized, data-driven wound care.

Key Advantages of the MolecuLight DX and Oracle Health Foundation EHR integration:

• Synchronization of patient data and records from the EHR to the MolecuLight DX via a patient MRN lookup.
• Automatic Wi-Fi enabled upload of wound documentation to EHR to update the patient record, including:
  • Standard and bacterial autofluorescence images that detect and pinpoint areas of elevated bacterial burden.
  • Wound measurements, including length, width, and depth, for accurate and full documentation.
  • Thermal images to visualize and quantify clinically relevant temperature variations.
• Full compatibility with Oracle’s patient encounter scheduling workflow.

Oracle Healthcare Marketplace is a one-stop shop for Oracle customers seeking trusted healthcare applications that offer unique solutions.

“Integrating the MolecuLight DX with Oracle Health represents a major step forward in improving clinical efficiency for customers,” said Anil Amlani, CEO, MolecuLight. “By automating the upload of wound images and measurements directly into the EHR, clinicians can reduce manual entry and streamline their workflows, spending less time on paperwork and more time focused on patient care. This integration offers advanced wound imaging as part of care delivery, enabling quicker, more informed decisions and improved patient outcomes.”

About MolecuLight and its Wound Imaging Devices

MolecuLight is a privately held medical imaging company with a global footprint, dedicated to manufacturing and commercializing the MolecuLight i:X® and DX® wound imaging devices. Both FDA-cleared Class II point-of-care systems provide real-time detection of elevated bacterial burden and accurate digital wound measurement. The MolecuLight DX® additionally offers thermal imaging for comprehensive wound assessment. The technologies’ effectiveness and clinical utility are supported by more than 100 peer-reviewed publications.

About Oracle’s Partner Program

Oracle’s partner program helps Oracle and its partners drive joint customer success and business momentum. The newly enhanced program provides partners with choice and flexibility, offering several program pathways and a robust range of foundational benefits spanning training and enablement, go-to-market collaboration, technical accelerators, and success support. To learn more, visit oracle.com/partner.

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Case Report: Optimizing Wound Care — Tailored Nutritional Strategies with Immune-Modulating Enteral Nutrients

Summary: Published March 13, 2026 in Frontiers in Nutrition (Clinical Nutrition section, impact factor 5.1), this descriptive case series from NMC Speciality Hospital and Al Tadawi Specialty Hospital (Dubai, UAE) reports on four adult patients with advanced pressure ulcers (all grade 4) receiving long-term enteral nutrition in acute or long-term care settings, managed with individualized, dietitian-led nutritional therapy within a comprehensive multidisciplinary care bundle. The cases reflect the practical application of ESPEN and ASPEN guidelines’ emphasis on individualized nutritional therapy, early enteral feeding, optimised energy and protein delivery, glycaemic control, and selective use of conditionally essential nutrients (arginine, glutamine, and β-hydroxy-β-methylbutyrate/Ca-HMB). Case 1: a 73-year-old with CVA, diabetes, HTN, and CAD — protein 1.2 g/kg, 20–25 kcal/kg from a diabetic-specific formula plus HMB/arginine/glutamine supplementation; grade 4 ulcer healed at 11 months. Case 2: a 30-year-old with bipolar disorder, severe malnutrition (BMI 15.82), and multiple pressure ulcers — nutritional intervention initiated cautiously to prevent refeeding syndrome, with protein targets up to 2.8 g/kg and energy 50 kcal/kg at peak; BMI increased to 18.11 and ulcers fully healed at 12 months. Case 3: a 38-year-old with hypoxic-ischemic brain damage, grade 4 sacral and leg pressure ulcers — targets 38 kcal/kg and 1.6 g/kg protein; notable improvement and weight gain over 12 months. Case 4: an 85-year-old with CVA, Alzheimer’s disease, and grade 4 left gluteal ulcer — formula switched to hydrolysed formulation after intolerance developed at 8 months; healed at 10 months. All four cases demonstrated progressive pressure ulcer improvement within a multidisciplinary framework including pressure-relieving mattresses, scheduled repositioning, glycaemic control (target 140–180 mg/dL), standardised wound care, and head-of-bed elevation. The authors note that causal inference cannot be established from this observational series, and call for prospective studies with standardised wound measurement tools.

Key Highlights:

• Four cases of grade 4 pressure ulcers in critically ill, long-term hospitalised adults; all achieved healing within 10–12 months with dietitian-led individualised enteral nutrition plus multidisciplinary wound care
• Immunonutrition protocol: each 24 g sachet providing glutamine 7 g + arginine 7 g + Ca-HMB 1.5 g; used selectively in patients with severe malnutrition or impaired wound healing and reviewed regularly
• Protein targets individualised: ranging from 1.2 g/kg (diabetic, stable) to 2.8 g/kg (severe malnutrition with refeeding risk); early initiation and gradual advancement to minimise intolerance
• Refeeding syndrome prevention highlighted in Case 2 (BMI 15.82): electrolyte monitoring (phosphate, magnesium, potassium) with caloric increase over 4–8 weeks — important safety consideration for malnourished wound patients
• Formula adaptation: Case 4 required switch to hydrolysed formula after intolerance at 8 months — highlights the need for ongoing reassessment and flexibility in enteral formula selection over prolonged follow-up
• Limitation: observational design with concurrent interventions; causal contribution of nutrition to wound healing cannot be isolated — prospective RCTs with standardised wound assessment tools needed

Read full article

Keywords: nutrition wound healing pressure ulcer, enteral nutrition pressure injury, arginine glutamine wound care, HMB wound healing nutrition, immunonutrition critical care wounds, protein energy wound healing

Fiji Antony, Wafaa Ayesh

Wound Remodelling Strategies for Challenging Wound Topographies

Even with optimal debridement, certain wounds resist healing due to unfavorable base elevations or edge configurations. In this insightful article, Igor Melnychuk explores advanced wound remodelling techniques designed to overcome these barriers and promote effective closure.

Key strategies discussed include:

• Base Contouring: Lowering elevated wound beds to align with the periwound skin, facilitating keratinocyte migration.woundsinternational.com

• Edge Resection: Trimming vertical or undermined edges at a 45° angle to eliminate impediments to epithelialization.woundsinternational.com+1woundsinternational.com+1

• Innovative Techniques: Introducing methods like edge trenching, soap scrap, and parallel pocket incisions, inspired by grafting principles, to address complex wound geometries without extensive tissue removal.woundsinternational.com

These approaches are particularly beneficial for wounds exhibiting features such as epiboly, undermining, or raised bases, where traditional healing processes are compromised.

Read the full article here: Wound Remodelling: Approaches and Techniques Aimed at Closure of Wounds with Unfavourable Base or Edges

About the Author: Igor Melnychuk

Igor Melnychuk is a dedicated wound care specialist with extensive experience in managing complex and hard-to-heal wounds. His work focuses on developing and implementing innovative techniques to enhance wound healing outcomes. Through his research and clinical practice, Igor contributes significantly to the advancement of wound care methodologies.

Note: This synopsis is intended for educational purposes and to inform wound care professionals about recent advancements in wound management strategies.

US Wound Registry Releases White Paper on Evaluating Real-World Data in Wound Care

The U.S. Wound Registry (USWR) has published a comprehensive white paper titled “Analysis of Bias Criteria Checklist for Wound Care Registries & EHRs,” aimed at improving the quality and reliability of wound care research derived from real-world data. This document offers a practical tool for identifying bias in observational studies using electronic health records (EHRs), a crucial step in refining clinical decision-making and treatment evaluation.

Key Highlights:

• Wound Care Burden: Chronic wounds affect 8.2 million Medicare patients and cost the healthcare system an estimated $96.8 billion annually.
• Real-World Evidence Gap: Many patients with multiple comorbidities are excluded from randomized controlled trials, making real-world data vital to understanding actual treatment outcomes.
• The ABC Checklist: The Analysis of Bias Criteria (ABC) checklist—modeled after the STROBE Statement—offers a structured approach for assessing observational wound care studies derived from EHRs.
• USWR’s Role: Founded in 2005, USWR is a CMS-approved Qualified Clinical Data Registry (QCDR), focused on measuring, reporting, and improving quality of care in wound and podiatric medicine.

The white paper is especially timely as CMS increasingly emphasizes quality measures and value-based care in wound management. It provides clinicians, researchers, and policymakers with a framework to critically appraise registry-based data in ways that align with both scientific rigor and practical application.

Read the full white paper on the US Wound Registry website.

Keywords:
US Wound Registry,
EHR data,
Bias criteria checklist,
Real-world evidence,
Chronic wounds,
QCDR,
STROBE Statement

Therapeutic Wound and Skin Cleansing: Clinical Evidence and Recommendations

The International Wound Infection Institute (IWII) has released a comprehensive consensus document titled Therapeutic Wound and Skin Cleansing: Clinical Evidence and Recommendations. This publication aims to redefine wound cleansing as a critical, evidence-based component of wound care, moving beyond traditional, ritualistic practices. It emphasizes the importance of targeted cleansing strategies to prevent infection and promote optimal healing outcomes.

Key Highlights:

• Holistic Cleansing Approach: The document underscores the necessity of cleansing not just the wound bed, but also the wound edge, periwound, and surrounding skin. This comprehensive approach ensures the removal of contaminants and supports the overall healing process.
• Evidence-Based Practices: Utilizing a systematic literature review and expert consensus, the guidelines provide clear recommendations on cleansing techniques, solutions, and equipment. This ensures that practices are grounded in the latest clinical evidence.
• Decision-Support Tools: The publication offers practical tools and step-by-step guidance to assist healthcare professionals, caregivers, and patients in performing effective wound cleansing tailored to individual needs.

This consensus document serves as a vital resource for clinicians and caregivers, advocating for the allocation of appropriate time and resources to wound cleansing practices. By adopting these evidence-based recommendations, healthcare providers can enhance patient outcomes, reduce infection rates, and contribute to more efficient wound management strategies.

Read the full consensus document on the Wounds International website.

Keywords:
wound cleansing,
skin cleansing,
IWII,
Terry Swanson,
Emily Haesler,
Karen Ousey

Periwound Skin: Understanding and Managing the Skin Surrounding Wounds

Proper care of the periwound skin—the area extending approximately 1.5 inches from the wound edge—is essential for effective wound healing. This delicate skin is susceptible to damage from moisture, adhesives, and infection, which can impede the healing process. Read the full article.

Key Highlights:

• Moisture-Associated Skin Damage (MASD): Excessive wound exudate can lead to maceration, causing redness, irritation, and pain in the periwound area. Managing moisture levels is crucial to prevent skin breakdown.
• Medical Adhesive-Related Skin Injury (MARSI): Improper application or removal of wound dressings can strip the skin, leading to MARSI. Over 25% of post-surgical patients experience MARSI in the periwound region.
• Signs of Periwound Complications: Indicators include induration (hardening), erythema (redness), swelling, bruising, red streaks emanating from the wound, fever, or general malaise.
• Prevention Strategies:
  • Gently clean the periwound area during each dressing change.
  • Use barrier creams like petroleum jelly to protect against moisture.
  • Minimize dressing changes to those recommended by healthcare providers.
  • Carefully remove adhesives by pressing down on the skin beneath to reduce trauma.
  • Regularly assess the periwound area for any changes or signs of damage.
• Treatment Approaches: Addressing periwound skin damage involves preventing further injury and promoting healing. This may include repositioning bandages, using barrier creams, and consulting healthcare providers for tailored care plans.

Maintaining the integrity of the periwound skin is vital for optimal wound healing. Incorporating periwound care into the overall wound management plan can enhance patient outcomes and reduce complications.

Read the full article on the Verywell Health website.

Keywords:
periwound skin,
moisture-associated skin damage,
medical adhesive-related skin injury,
wound healing,
barrier creams

EWMA Releases Palliative Wound Care Guidelines: Focused on Symptom Management

The European Wound Management Association (EWMA), in collaboration with EPUAP, WHS, and Wounds Australia, has published evidence-based guidelines in the *Journal of Wound Management* (Vol 26, Suppl 1, 2025). These recommendations address the care of non-healing and palliative wounds by focusing on symptom relief rather than healing alone.

Key Highlights:

• Holistic Symptom Management: Emphasis on alleviating pain, odor, exudate, bleeding, and itch to enhance comfort and quality of life in patients with palliative wounds :contentReference[oaicite:1]{index=1}.
• Patient- and Family-Centered Care: Care plans are designed collaboratively, respecting patient preferences and involving caregivers in decision-making :contentReference[oaicite:2]{index=2}.
• Education & Multidisciplinary Approach: Guidelines recommend integrating palliative wound care principles throughout medical education and encouraging teamwork between clinicians, dietitians, psychologists, social workers, and palliative care specialists :contentReference[oaicite:3]{index=3}.
• Research & Innovation Encouraged: Highlights the need for further clinical trials and industry collaboration to develop targeted products and techniques—especially for malignancy-related wounds :contentReference[oaicite:4]{index=4}.
• Policy and Access Implications: Urges the development of institutional and national policies to ensure equitable resource access, use of telehealth, and standardized symptom-targeted protocols :contentReference[oaicite:5]{index=5}.

These guidelines reflect EWMA’s commitment to improving outcomes for patients with palliative wounds through a compassionate, evidence-based, and multidisciplinary approach, tailored to the needs of those at all stages of wound progression.

Read the full guidelines supplement in the EWMA News section and download it for free.

Keywords:
palliative wound care,
symptom management,
quality of life,
multidisciplinary care,
telehealth

Expediting Acute Wound Healing via Multimodal Therapy: A Case Series

A prospective case series published in *Wound Management & Prevention* (Dec 2024) by Gallagher et al. reports outcomes from 124 patients with complex acute surgical or traumatic wounds treated using a combination-therapy approach at Christiana Care’s Acute Surgical Wound Service.

Key Highlights:

• Patient & Wound Spectrum: 124 adult patients with diverse acute wounds (up to 1120 cm³) treated from admission through healing.
• Timely Specialist Involvement: Median time to wound specialist consult was just 2 days post-injury. :contentReference[oaicite:1]{index=1}
• Integrated Treatment Protocol: All patients received hypochlorous acid–based cleanser paired with negative pressure wound therapy, collagen, silver, manuka honey, and/or advanced foam dressings. :contentReference[oaicite:2]{index=2}
• Strong Healing Response: The median healing time was 19 days across 366 wounds, indicating rapid recovery. :contentReference[oaicite:3]{index=3}
• Barriers Identified: Smoking, immunocompromise, and limited access to supplies were linked to delayed healing. :contentReference[oaicite:4]{index=4}

This mixed-modality strategy—with prompt wound specialist intervention and targeted therapeutics—substantially decreased healing time, reduced healthcare visits, and improved resource use, suggesting a scalable model for acute wound services.

Read the full case series in the archived issue of Wound Management & Prevention.

Keywords:
multimodal wound therapy,
hypochlorous acid cleanser,
negative pressure wound therapy,
complex acute wounds,
Christiana Care

An Audit to Assess the Impact of Prescribing a Monofilament Fibre Debridement Pad for Patients with Unhealed Wounds After Six Months

Summary: Published May 2, 2021 in the Journal of Wound Care (Vol. 30, No. 5, pp. 381–388; DOI: 10.12968/jowc.2021.30.5.381; PMID: 33979215) by Joanna Burnett, Andrew Kerr, Margaret Morrison, and Abbe Ruston, this NHS prescribing audit provides real-world economic evidence for the impact of introducing the Debrisoft monofilament fibre debridement pad into wound-care practice in England. Debrisoft — a sterile pad of densely packed monofilament fibres (Lohmann & Rauscher) — has robust evidence as a rapid and effective mechanical method for removing dry skin, biofilm, and devitalised tissue from acute and chronic wounds with minimal patient discomfort. It received NICE Medical Technology Guidance (MTG17) recommending adoption based on modelled cost savings versus comparators including saline/gauze, hydrogels, and larval therapy. However, the NICE guidance itself acknowledged that post-implementation, real-world evidence of prescribing impact was limited at the time of evaluation. This audit addresses that gap. Using a dataset obtained from the NHS Business Services Authority for 486 uniquely identified patients who had been newly prescribed the monofilament fibre debridement pad, the audit analysed prescribing records over 6 months following first prescription. The analysis focused on changes in wound-care prescribing costs, prescription frequency, and dressing product use before and after Debrisoft introduction. Results demonstrated a significant reduction in overall wound-care prescribing costs associated with Debrisoft introduction, supporting the NICE cost-saving model in a real-world NHS community setting. The authors note several methodological considerations: the dataset reflects prescribing patterns rather than direct clinical outcomes (wound healing or wound area reduction); confounding factors such as concurrent clinical interventions cannot be fully isolated; and the population reflects patients with unhealed wounds of mixed aetiology and severity. Nevertheless, the audit provides the kind of health system-level prescribing data that complements clinical effectiveness studies and reinforces the economic argument for Debrisoft adoption in community wound care pathways.

Key Highlights:

• NHS prescribing database: 486 patients newly prescribed Debrisoft monofilament fibre debridement pad across England; data sourced from NHS Business Services Authority — provides real-world prescribing impact evidence absent from earlier NICE MTG17 modelling
• Cost reduction finding: introduction of Debrisoft associated with significant reductions in overall wound-care prescribing costs over 6-month follow-up period — consistent with and supporting the NICE cost-saving projections (£77–£484 per patient versus comparators in earlier modelling)
• Debrisoft mechanism context: monofilament fibres physically disrupt and lift devitalised tissue, slough, biofilm, and debris; NICE-recommended as the best-evidenced mechanical debridement method for community use; effective across wound aetiologies including venous ulcers, DFUs, pressure injuries, and post-surgical wounds
• Evidence context: the 2021 Burnett audit is one of only a few post-NICE real-world prescribing studies; complements the earlier Roes et al. 2019 clinical outcome and practitioner satisfaction studies and the Schultz et al. 2018 biofilm removal evidence
• Methodological note: outcomes are prescribing-based rather than wound healing endpoints; confounders present; population is heterogeneous — authors recommend complementary prospective trials with standardised wound assessment tools to confirm cost-effectiveness and clinical healing outcomes
• Access: article published in the Journal of Wound Care (MAG Online Library/Magonlinelibrary); full text requires journal subscription or institutional access; abstract and PMID 33979215 available via PubMed

Read full article

Keywords: monofilament debridement pad NHS, wound care prescribing costs, Debrisoft clinical evidence, NICE MTG17 wound debridement, wound bed preparation community nursing, chronic wound debridement audit

Joanna Burnett, Andrew Kerr, Margaret Morrison, Abbe Ruston

A recent economic evaluation using a Markov model assessed the cost-effectiveness of dehydrated human amnion/chorion membrane (DHACM) for Medicare beneficiaries with venous leg ulcers (VLUs). The study compared DHACM—applied following recommended timing and frequency—to no advanced treatment (NAT) over three years, using real-world claims from over 530,000 patients. Results showed that DHACM not only saved $170 per patient but also improved quality-adjusted life years (QALYs), producing a net monetary benefit of $1,178. The treatment was cost-effective in over 63% of simulations and linked to lower recurrence rates. With chronic wounds placing a heavy and growing burden on Medicare—VLUs alone cost $14.9 billion annually—these findings support DHACM as a superior, cost-saving strategy. Providers and payers are encouraged to prioritize DHACM in wound care formularies to improve outcomes and reduce system-wide costs … read more

The authors:

1. William H. Tettelbach, MD, FACP, FIDSA, FUHM, CWSP

Dr. Tettelbach is board-certified in Undersea & Hyperbaric Medicine, Infectious Diseases, and Internal Medicine. He has held leadership roles at MiMedx, OnSite Advanced Care, and RestorixHealth, and serves as an adjunct professor at Duke University School of Medicine. ​WICE Radiology+8Press Release Hub+8ORCID+8

• ORCID Profile

2. Vickie R. Driver, DPM, MS, FACFAS

Dr. Driver is a Professor at Washington State University School of Medicine and the Founding Chair of the Board of Directors for the Wound Care Collaborative Community. She has served as System-Wide Medical Director of Wound Care and Hyperbaric Centers at INOVA Healthcare and is a Fellow of the Royal College of Physicians and Surgeons-Glasgow. ​hmpglobalevents.com+5woundcarecc.org+5woundcarecc.org+5reddressmedical.com+4sawcf.eventscribe.net+4Maggie Online Library+4

• Wound Care Collaborative Community Profile

3. Alisha Oropallo, MD, FACS, FSVS, FAPWCA

Dr. Oropallo is a Professor at the Zucker School of Medicine at Hofstra/Northwell and Director of the Comprehensive Wound Healing Center at Northwell Health. She is board-certified in General and Vascular Surgery and is a Fellow of the American College of Surgeons. ​LinkedIn+4ResearchGate+4CITI Program+4woundcarecc.org

• Northwell Health Profile

4. Martha R. Kelso, RN, CHWS, HBOT

Ms. Kelso is the CEO of Wound Care Plus, LLC, one of the nation’s largest mobile wound care providers. She is recognized as a visionary in mobile medicine and is a published author and clinical editor for multiple peer-reviewed journals. ​hmpglobalevents.com+3Log in or sign up to view+3LinkedIn+3hmpglobalevents.com+3pawsic.org+3LinkedIn+3

• PAWSIC Bio

5. Jeffrey A. Niezgoda, MD, FACHM, MAPWCA, CHWS

Dr. Niezgoda is the President and Chief Medical Officer of WebCME and serves as the CMO for Kent Imaging. He is the Past President of the American Professional Wound Care Association and the American College of Hyperbaric Medicine. ​LinkedIn+8ipawssummit.org+8kentimaging.com+8

• Kent Imaging Leadership Profile

6. Naz Wahab, MD, FAAFP, FAPWCA

Dr. Wahab is a board-certified family physician and wound care specialist. She serves as the Medical Director for the Mountain View Outpatient Wound Care and Hyperbaric Center and is an active member of several wound care organizations. ​reddressmedical.com+4Medical News Today+4aawconline.memberclicks.net+4aawconline.memberclicks.net+3reddressmedical.com+3campswoundcaresummit.com+3

• RedDress Medical Profile

7. Julie L. De Jong

Information on Julie L. De Jong’s professional background in wound care is limited in the provided sources. Further details may be available through institutional affiliations or publications.​

8. Brandon Hubbs

Mr. Hubbs is an experienced Cardiovascular Administrator and Nurse, affiliated with FirstHealth of the Carolinas. ​LinkedIn

• LinkedIn Profile

9. R. Allyn Forsyth

Dr. Forsyth has contributed to research on wound care, including studies on the cost of chronic wound care for Medicare beneficiaries. ​ResearchGate

10. Gregory A. Magee, MD

Dr. Magee is an Associate Professor of Clinical Surgery at the Keck School of Medicine of USC. He completed fellowships in surgical critical care and trauma surgery at USC and in vascular surgery at the University of Colorado Denver. ​Healthgrades+4Keck School of Medicine of USC+4SC CTSI Profiles+4Keck Medicine of USC

• Keck Medicine Profile

11. Paul Steel

Specific information about Paul Steel’s professional background in wound care is not readily available in the provided sources. Further details may be found through academic publications or institutional affiliations.​

12. Benjamin G. Cohen, DPM

Dr. Cohen is a Podiatric Medicine specialist and Podiatric Surgeon based in Aiken, South Carolina. He is recognized as an advanced expert in his field. ​Medifind+1Maggie Online Library+1

• MediFind Profile

13. William V. Padula, PhD

Dr. Padula is an Assistant Professor of Pharmaceutical & Health Economics at the USC Mann School of Pharmacy and a Fellow at the USC Leonard D. Schaeffer Center for Health Policy & Economics. His research focuses on cost-effectiveness analysis and healthcare delivery, particularly regarding pressure injury prevention. ​USC Schaeffer+2USC Mann School of Pharmacy+2SC CTSI Profiles+2NCBI+3USC Schaeffer+3ResearchGate+3

• USC Schaeffer Center Profile

Reevaluating the ‘Golden Period’ in Traumatic Laceration Repair

Traditionally, the “golden period” for primary closure of traumatic lacerations has been considered to be within 6 to 8 hours post-injury, based on early 20th-century animal studies. However, recent insights suggest that this timeframe may be more flexible than previously thought.

Key Insights:

• Extended Closure Window: Emerging evidence indicates that clean lacerations, especially on the face, may be safely closed up to 24 hours after injury in healthy individuals.
• Factors Influencing Closure Decisions: The decision to close a wound beyond the traditional window should consider the wound’s cleanliness, location, and the patient’s overall health status.
• Individualized Assessment: Rather than adhering strictly to a fixed timeframe, clinicians are encouraged to assess each wound individually, balancing the risks of infection against the benefits of primary closure.

This evolving perspective underscores the importance of personalized clinical judgment in wound management, moving beyond rigid time constraints to optimize patient outcomes.

Read the full article on the Clinical Advisor website.

Keywords:
Traumatic lacerations,
Golden period,
Wound closure timing,
Infection risk,
Clinical judgment

Comparative Assessment of Negative Pressure Wound Therapy Systems

A recent study in the Journal of Wound, Ostomy and Continence Nursing compares various Negative Pressure Wound Therapy (NPWT) systems, evaluating their efficacy, usability, and patient outcomes. The research provides insights to guide clinicians in selecting optimal NPWT devices for wound management.

Key Highlights:

• Efficacy Comparison: The study assesses NPWT systems based on healing rates, infection control, and exudate management across different wound types.
• Usability Factors: Device portability, ease of application, and patient comfort are critical in determining clinical suitability.
• Patient Outcomes: Systems with advanced features, like adjustable pressure settings, showed improved patient satisfaction and faster healing.
• Clinical Recommendations: The findings advocate for tailored NPWT selection based on wound characteristics and patient needs.

This research is a valuable resource for wound care professionals seeking to optimize NPWT use in clinical practice.

Read the full article on the Journal of Wound, Ostomy and Continence Nursing website.

Keywords:
Negative pressure wound therapy,
NPWT systems,
Wound healing,
Patient outcomes,
Sarah Johnston

Global Guideline for Post-Operative Incision Care: A New Standard for Surgical Wound Management

In January 2025, the International Surgical Wound Complications Advisory Panel (ISWCAP) released a groundbreaking global guideline focused exclusively on post-operative incision care. Published as a supplement in the Journal of Wound Care, this consensus document addresses the critical need for standardized practices in managing closed surgical incisions, distinguishing them from chronic wounds and those healing by secondary intention. The guideline serves as a living document, intended to evolve with emerging evidence and clinical insights.

Key Highlights:

• Individualized Treatment Plans: The guideline emphasizes the necessity of tailoring surgical wound treatment plans to individual patient needs, considering factors such as comorbidities, surgical procedure type, and risk of complications.
• Comprehensive Risk Assessment: It provides a framework for assessing risk factors associated with surgical wound complications, including patient-related factors (e.g., diabetes, obesity), surgical factors (e.g., duration of surgery, type of incision), and postoperative care considerations.
• Evidence-Based Dressing Selection: The guideline offers recommendations on selecting appropriate dressings based on wound characteristics, aiming to promote optimal healing environments and reduce the risk of infection.

The ISWCAP’s global guideline represents a significant advancement in postoperative care, providing clinicians with a structured approach to incision management. By focusing on individualized care plans, thorough risk assessment, and evidence-based interventions, the guideline aims to improve patient outcomes, reduce the incidence of surgical wound complications, and standardize care practices across various healthcare settings. As a living document, it will continue to incorporate new research findings and clinical experiences, ensuring its relevance and applicability in the ever-evolving field of surgical wound care.

Read the full guideline on the Journal of Wound Care website.

Keywords:
postoperative incision care,
surgical wound management,
ISWCAP,
Kylie Sandy-Hodgetts,
Sara Carvalhal,
Melissa Rochon,
Gulnaz Tariq

Upcoming Event: Paediatric Skin Health and Wound Healing Study Day

The Society of Tissue Viability is hosting a comprehensive virtual study day on paediatric skin health and wound healing, scheduled for June 17, 2025, from 9:30 AM to 4:00 PM. This free event is designed for healthcare professionals involved in paediatric care, including children’s nurses, paediatric specialist nurses, tissue viability nurses, allied health professionals, GPs, and nursing students. :contentReference[oaicite:3]{index=3}:contentReference[oaicite:4]{index=4}

Key Highlights:

• Patient and Family Perspectives: Aarron and Jacqueline Higgins will share their experiences of managing a child’s chronic wound, providing valuable insights into the challenges faced by families. :contentReference[oaicite:7]{index=7}
• Holistic Wound Assessment: Rachel Allaway, Tissue Viability Clinical Nurse Specialist at Great Ormond Street Hospital, will discuss comprehensive approaches to wound assessment in children. :contentReference[oaicite:10]{index=10}
• Managing Hypergranulation: Jansy Williams, Lead Paediatric Tissue Viability Specialist at Alder Hey Children’s NHS Foundation Trust, will present problem-solving strategies for hypergranulation in paediatric wounds. :contentReference[oaicite:13]{index=13}
• Nutrition’s Role in Healing: Natalie Yerlett, Interim Head of Dietetics at Great Ormond Street Hospital, will explore the impact of nutrition on wound healing processes. :contentReference[oaicite:16]{index=16}
• Antimicrobial Stewardship: Claire Gardiner, Paediatric Tissue Viability CNS at the Royal Hospital for Children in Glasgow, will address responsible antimicrobial use in paediatric wound care. :contentReference[oaicite:19]{index=19}
• Pressure Ulcer Prevention: Judith Kay and Sophie Whitecroft from Great Ormond Street Hospital will discuss the importance of seating, posture, and equipment selection in preventing and managing pressure ulcers in children. :contentReference[oaicite:22]{index=22}

This study day offers up to five hours of participatory learning, contributing to NMC revalidation requirements. Attendees will also benefit from industry presentations by organizations such as Flen Health, Pressure Care Management, Mediq, and Medstrom, providing insights into the latest products and innovations in paediatric wound care. :contentReference[oaicite:25]{index=25}:contentReference[oaicite:26]{index=26}

For more information and to register, visit the Society of Tissue Viability website.

Keywords:
paediatric wound care,
skin health,
hypergranulation,
nutrition and wound healing,
antimicrobial stewardship,
pressure ulcer prevention

ISTAP Best Practice Recommendations for Prevention and Management of Periwound Skin Complications

The International Skin Tear Advisory Panel (ISTAP) has published comprehensive guidelines to enhance the prevention and management of periwound skin complications. These recommendations emphasize the significance of periwound skin health in promoting effective wound healing and reducing associated complications. Read the full document.

Key Highlights:

• Definition of Periwound: The periwound is identified as the area surrounding a wound that may be affected by wound-related factors and/or underlying pathology.
• Risks of Periwound Damage: Complications such as maceration, skin stripping, and medical adhesive-related skin injury (MARSI) can delay healing, increase infection risk, and elevate treatment costs.
• Assessment Protocols: Regular evaluation of the periwound area should be integrated into wound assessments, focusing on skin integrity, moisture levels, and signs of infection or inflammation.
• Management Strategies: Effective approaches include managing exudate to prevent moisture-associated skin damage (MASD), using appropriate dressings, and employing gentle cleansing techniques with pH-balanced solutions.
• Infection Control: Implementing antimicrobial stewardship principles is crucial to prevent and manage infections without contributing to antimicrobial resistance.
• Education and Training: Ongoing education for healthcare professionals and caregivers is essential to ensure best practices in periwound care are understood and applied consistently.

These guidelines serve as a valuable resource for clinicians aiming to improve patient outcomes through diligent periwound care.

Read the full document on the Wounds International website.

Keywords:
periwound skin care,
moisture-associated skin damage,
medical adhesive-related skin injury,
wound assessment,
antimicrobial stewardship

Using Patient-Reported Experiences to Inform the Use of Foam Dressings for Hard-to-Heal Wounds: Perspectives from a Wound Care Expert Panel

Summary: An international expert panel convened to address a persistent gap between clinical efficacy outcomes and the lived experience of patients managing hard-to-heal (chronic) wounds — published in the Journal of Wound Care (November 2024). The panel identified five core patient-reported experience (PRE) domains that are underserved by current dressing selection practice: wound-related pain, wound odour, wound-related itch, excessive exudate management, and self-care capacity. While foam dressings are widely selected based on exudate management benchmarks and laboratory performance data, the panel argues this fails to capture what matters most to patients, particularly those managing wounds over extended periods in community and home settings. The review maps specific foam dressing properties — including odour control features, atraumatic removal characteristics, high absorption and retention capacity, and extended wear time — to each PRE domain, providing a practical framework for dressing selection that centres patient experience. The paper also addresses self-management capacity, recognizing that many wound patients change their own dressings and require dressings that are straightforward to apply and remove independently. The panel calls on wound care providers, research scientists, and the healthcare industry to work collaboratively to address these unmet needs, and frames the paper as a call for accountability across all stakeholders involved in wound dressing development and deployment.

Key Highlights:

• Five PRE domains identified as priority targets for foam dressing design and selection: pain, odour, itch, exudate management, and self-care capacity
• Current foam dressing selection largely driven by lab performance data; panel argues clinical and patient-experience gaps remain underaddressed
• Dressing properties mapped to specific PRE outcomes — providing a practical selection framework for clinicians and product developers
• Self-management dimension elevated: dressings must support patients who independently manage their own wound care at home
• International panel spans nursing, podiatry, biomedical engineering, dermatology, and wound care research (11 institutions across 8 countries)
• Relevance: Patient-centred wound care is gaining policy traction; this framework supports both practice and regulatory discussions around real-world dressing performance

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Keywords: foam dressings, patient-reported outcomes wound care, hard-to-heal wounds, wound pain, wound odour, wound self-management

Kevin Woo Nick Santamaria Dimitri Beeckman Paulo Alves Breda Cullen Amit Gefen José Luis Lázaro-Martínez Hadar Lev-Tov Bijan Najafi Andrew Sharpe Terry Swanson

Multimodality Therapy Shows Promise of “Therapeutic Advance” in Lower Extremity Wound Treatment

Summary: Vascular News reported on March 1, 2026 on a special communication published in the January 2026 issue of the Journal of Vascular Surgery: Venous and Lymphatic Disorders (JVS-VL) in which lead author Joann M. Lohr (William Jennings Bryan Dorn VA Medical Center, Columbia, USA) and colleagues present a comprehensive review of the mechanistic, translational, and clinical evidence supporting the combined use of pressurised intermittent topical oxygen (TWO2) therapy and non-contact cyclical compression as an integrative multimodality approach to lower extremity wound management. The central argument is that chronic wounds — including diabetic foot ulcers (DFUs) and venous leg ulcers (VLUs) — persist through a self-reinforcing cycle of tissue hypoxia, oedema, persistent inflammation, lymphatic dysfunction, ischaemia/reperfusion injury, bioburden, and tissue fibrosis. Most current interventions address only one or two of these drivers simultaneously, limiting efficacy. The proposed combination targets three key pathophysiological drivers concurrently: topical oxygen increases tissue oxygen tension, enhances microbial defence, promotes inflammation resolution through redox signalling and specialised pro-resolving mediator (SPM) synthesis, supports angiogenesis, and optimises collagen synthesis and ECM remodelling during tissue repair; while non-contact cyclical compression improves lymphatic clearance of inflammatory mediators, reduces oedema, restores perfusion, mitigates ischaemia/reperfusion injury, and activates mechanotransductive pathways supporting angiogenesis and tissue repair. Together, the authors argue, these modalities exert synergistic effects across multiple wound repair mechanisms, making the combination a potentially significant therapeutic advance. The review draws on a 2020 double-blinded RCT (Frykberg et al., Diabetes Care) showing 41.7% DFU closure at 12 weeks versus 13.5% in controls (p=0.004), with only 6.7% recurrence at 12 months versus 40% in controls; and a 132-patient prospective controlled study (Twafick et al., 2012) showing 76% versus 46% VLU healing (p<0.0001) with median time-to-closure of 57 versus 107 days. The TWO2 technology is marketed by AOTI Inc.; co-author Melodie M. Blakely is a clinical investigator for AOTI.

Key Highlights:

• Combination targets a “trifecta” of chronic wound drivers: tissue hypoxia, persistent inflammation, and lymphatic dysfunction — simultaneously, through two synergistic modalities
• Topical oxygen mechanism: raises wound tissue oxygen tension, enhances antimicrobial defence, drives SPM synthesis for inflammation resolution, supports angiogenesis and durable collagen crosslinking
• Cyclical compression mechanism: clears inflammatory mediators via lymphatic drainage, reduces oedema, restores microvascular perfusion, activates mechanotransductive repair pathways
• DFU RCT (Frykberg, Diabetes Care 2020): 41.7% closure at 12 weeks vs. 13.5% control (p=0.004); 56% vs. 27% at 12 months (p=0.013); 6.7% vs. 40% recurrence (p=0.070)
• VLU study (Twafick, 2012, n=132): 76% vs. 46% healing (p<0.0001); median time-to-closure 57 vs. 107 days; 6% vs. 47% recurrence at 36 months (p<0.0001)
• Authors conclude the integrative approach may “accelerate healing, enhance clinical outcomes, reduce complications, and achieve durable closure in difficult wounds of varied aetiologies” — framing it as adjunctive to current best practice standard wound care

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Keywords: topical oxygen therapy wound, cyclical compression wound healing, multimodality wound treatment, venous leg ulcer treatment, diabetic foot ulcer oxygen, wound hypoxia lymphatic

Joann M. Lohr Melodie M. Blakely

Chitosan-Entrapped TiO2 Nanoparticles Synthesized Using Calendula officinalis Flower Extract — Photophysical Characterization, Biocompatibility, and Textile Dye Remediation

Summary: Published March 19, 2026 in Polymers (MDPI), this study from the Medical Bionanotechnology Laboratory, Saveetha Medical College and Hospital, SIMATS (Chennai, India), led by Koyeli Girigoswami, reports the green synthesis and characterisation of chitosan-entrapped TiO2 nanoparticles produced using dried Calendula officinalis (pot marigold) flower extract as a reducing and stabilising agent — resulting in a biocompatible nanocomposite (CTS-TiO2-CO) evaluated for photocatalytic textile dye remediation. Though primarily an environmental materials science study, this work carries relevance to wound care through three converging elements: chitosan is one of the most widely used polymers in wound dressings due to its biodegradability, biocompatibility, and film-forming capacity; Calendula officinalis has established wound-healing, anti-inflammatory, and antimicrobial properties (containing saponins, tannins, flavonoids, and furanoeudesma-1,3-diene); and TiO2-based antimicrobial nanoparticles have been investigated in the context of wound infection management and antimicrobial photocatalytic therapies. The nanocomposite was synthesised via a sol-gel method, producing crystalline anatase TiO2 nanoparticles (105–114 nm SEM diameter, spherical) that were then entrapped in chitosan, yielding a flower-shaped nanocomposite (326 nm SEM diameter, 490 nm hydrodynamic diameter, zeta potential +36 mV). The chitosan coating increased stability and reduced aggregation versus uncoated CO-TiO2. In vitro biocompatibility: >82% Chinese hamster lung fibroblast (V79) viability at 100 μg/mL. In vivo biocompatibility: 85% zebrafish embryo hatchability at 50 μg/mL, with no developmental abnormalities observed. Photocatalytic activity against crystal violet textile dye reached 26.76% degradation at 1 h, 52.02% at 2 h, and 69.19% at 4 h of sunlight exposure. GC-MS analysis identified 2-Formylhistamine as the dominant phytochemical in the CO extract (34.79%), proposed to facilitate metal ion bioreduction and nanoparticle capping during synthesis. The authors note that visible-light absorption range and dye degradation efficiency could be further improved by metal or non-metal doping, and that reusability cycling studies are needed before real-world remediation deployment.

Key Highlights:

• Green synthesis rationale: Calendula officinalis dried flower extract (containing flavonoids, saponins, tannins, coumarins, and 2-Formylhistamine as dominant bioactive) replaces toxic chemical reducing agents — producing biocompatible crystalline anatase TiO2 nanoparticles (105–114 nm) via a sustainable sol-gel approach
• Chitosan entrapment: chitosan coating (0.025%, pH 7.2) significantly reduced aggregation, increased hydrodynamic stability (zeta potential +36 mV), and enhanced biocompatibility versus uncoated TiO2 — key advantages for any potential biological or wound-adjacent application
• Biocompatibility profile: >82% fibroblast (V79) viability at 100 μg/mL in MTT assay; 85% zebrafish embryo hatchability at 50 μg/mL with no observed morphological abnormalities — supporting a low-toxicity safety profile up to tested doses
• Photocatalytic dye degradation: 69.19% crystal violet degradation after 4 hours of sunlight exposure; mechanism involves UV/visible-light generation of electron-hole pairs, producing •OH and O2•− radicals that degrade the dye chromophore via N-demethylation and oxidative ring-opening
• Wound care material context: chitosan-based nanocomposites incorporating antimicrobial metal oxide nanoparticles (TiO2, ZnO, CeO2) are an active area of wound dressing research; Calendula officinalis extract has documented anti-inflammatory, wound-healing, and antimicrobial properties — making this synthesis strategy potentially transferable to antimicrobial wound dressing platforms
• Limitations: visible-light photocatalytic efficiency could be improved with doping; reusability cycles not yet evaluated; dye degradation tested with crystal violet only; toxicity profiled at limited doses; wound-specific antimicrobial testing not conducted in this study

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Keywords: chitosan nanoparticle wound dressing, TiO2 antimicrobial wound, Calendula officinalis wound healing, green synthesis nanocomposite biocompatible, photocatalytic antimicrobial wound care, chitosan polymer wound healing

Sushmitha Sundarraj, Sridhanya Mysore Shreethar, Nivitha Shri Chandrasekaran, Koyeli Girigoswami

of Detecting Bacterial Burden in Surgical Site Wounds by 11-Fold

Authors Suggest that Fluorescence Imaging of Bacterial Burden is Positioned to Change
Contemporary Paradigms of Post-Surgical Wound Management

Nutrition and Wound Healing: Practical Takeaways for Wound Care Practitioners

At WoundCon Spring 2025, experts Dr. Nancy Munoz and Dr. Mary Litchford emphasized the pivotal role of nutrition in wound healing. They highlighted that optimal healing is not solely reliant on topical treatments but also heavily depends on the patient’s nutritional status.

Macronutrients:

• Carbohydrates: Serve as the primary energy source, supporting cellular activities and the inflammatory response. Emphasis should be on high-fiber, complex carbohydrates like whole grains, legumes, fruits, and vegetables.
• Fats: Unsaturated fats, found in olive oil, nuts, and seeds, maintain cellular integrity and reduce inflammation. Saturated and trans fats should be minimized due to their pro-inflammatory effects.
• Proteins: Essential for tissue regeneration and immune defense. Patients may require 1.25 to 1.5 grams of protein per kilogram of body weight, increasing to 2.0 grams/kg in severe cases. Both animal-based and well-planned plant-based proteins are beneficial.

Read the full article on the WoundSource website.

Keywords:
Nutrition,
Wound Healing,
Macronutrients,
Micronutrients,
Hydration,
Nancy Munoz,
Mary Litchford

WRAHPS: New Guidelines Aim to Standardize Preclinical Wound Research

In an effort to enhance the quality and reproducibility of preclinical wound healing studies, a consortium of experts has introduced the Wound Reporting in Animal and Human Preclinical Studies (WRAHPS) guidelines. Published in the January-February 2025 issue of Wound Repair and Regeneration, these guidelines provide comprehensive checklists and reporting templates for commonly used animal and human ex vivo wound models.

Key Highlights:

• Standardization of Reporting: WRAHPS offers detailed checklists to ensure consistent documentation of experimental conditions, facilitating transparency and comparability across studies.
• Enhancing Translational Research: By addressing the variability in preclinical models and methodologies, the guidelines aim to bridge the gap between laboratory findings and clinical applications.
• Comprehensive Coverage: The guidelines encompass various aspects of preclinical studies, including animal species selection, wound induction methods, assessment techniques, and data analysis protocols.

The development of WRAHPS involved collaboration among researchers from institutions such as the University of Miami, University of Pennsylvania, The Ohio State University, and the University of Illinois Chicago. The initiative underscores the importance of meticulous reporting in advancing wound care research and ultimately improving patient outcomes.

Read the full article on the PubMed Central website.

Keywords:
Preclinical wound models,
WRAHPS guidelines,
Standardized reporting,
Translational research,
Animal models in wound healing,
Human ex vivo models

Palliative Wound Care: Managing Symptoms to Enhance Quality of Life

The European Wound Management Association (EWMA) has published comprehensive guidelines focusing on the management of wound-related symptoms in palliative care settings. Recognizing that not all wounds are healable, the document emphasizes a patient-centered approach aimed at alleviating distressing symptoms and improving the quality of life for individuals with life-limiting conditions.

Key Highlights:

• Symptom Management Focus: The guidelines prioritize the control of pain, odor, exudate, bleeding, and itching over wound healing, acknowledging the unique challenges in palliative wound care.
• Holistic Care Approach: Emphasis is placed on interdisciplinary collaboration, involving dietitians, psychologists, social workers, and palliative care specialists to address the complex needs of patients.
• Patient and Family Involvement: Care plans are encouraged to be developed in partnership with patients and their families, ensuring that treatment aligns with their preferences and goals.
• Education and Research: The document advocates for the inclusion of palliative wound care principles in medical curricula and calls for further research to develop and validate new symptom management interventions.

These recommendations serve as a valuable resource for healthcare professionals, educators, policymakers, and industry stakeholders committed to enhancing palliative wound care practices.

Read the full article on the Journal of Wound Management website.

Keywords:
Palliative wound care,
Symptom management,
Quality of life,
EWMA,
Interdisciplinary care

St. Louis Wound & Vascular Symposium 2025

The St. Louis Wound & Vascular Symposium, set for June 21, 2025, at the Hilton St. Louis Frontenac, offers wound care professionals 7 CME hours. This one-day event features expert-led sessions on vascular surgery, complex wound management, and innovative treatments.

Key Highlights:

• CME Credits: Earn 7 CME hours through advanced wound and vascular care sessions.
• Expert Topics: Explore vascular surgery, complex cases, and new treatments with leading specialists.
• Audience: Designed for clinicians, nurses, and specialists in vascular surgery, dermatology, podiatry, and plastic surgery.
• Networking: Connect with peers to enhance clinical practice and share insights.

This symposium is an essential opportunity for wound care professionals to advance their expertise.

Register for the event on the St. Louis Wound & Vascular Symposium website.

Keywords:
Wound care symposium,
CME event,
Vascular surgery,
Complex wound management,
St. Louis symposium

Dr. Lisa Gould: Blending Classical Guitar with Wound Care Expertise

A recent Wound Healing Society feature highlights Dr. Lisa Gould, a plastic surgeon who combines her wound care expertise with classical guitar performance. Practicing at South Shore Hospital, she brings discipline from music to clinical precision.

Key Highlights:

• Wound Care Leadership: Dr. Gould, a Wound Healing Society leader, advances research and treatment for complex wounds.
• Classical Guitar: She performs at events like the Rhode Island Philharmonic’s Amica Rush Hour Series.
• Clinical Role: As a plastic surgeon at South Shore Hospital, she specializes in difficult wound problems.
• Multidisciplinary Approach: Her musical discipline enhances focus and empathy in patient care.

Dr. Gould’s unique blend of music and medicine inspires wound care professionals to embrace diverse passions.

Read the full article on the Caroline Fife, MD website.

Keywords:
Wound care expert,
Classical guitar,
Plastic surgery,
Wound Healing Society,
Lisa Gould

Introducing the American College of Clinical Wound Specialists (ACCWS)

The American College of Clinical Wound Specialists (ACCWS) is a multidisciplinary organization dedicated to advancing wound care through education, certification, and professional collaboration. By uniting certified wound care professionals, ACCWS fosters a community committed to delivering evidence-based care and advocating for the recognition of wound care specialists.

Key Highlights:

• Educational Initiatives: ACCWS offers both on-site and conference-based educational programs, with plans to introduce online courses, ensuring accessible, high-quality wound care education for all members.
• Advocacy and Certification: The organization supports professionals holding certifications such as CWS®, CWSP®, and WCC®, promoting their recognition and validity in clinical practice and reimbursement policies.
• Leadership and Governance: The ACCWS Board of Directors comprises esteemed professionals, including Chairwoman Tracy Winkley, MPT, CWS, CLT, FACCWS, DAPWCA; Immediate Past Chair Jean Archer, DPM, FACPM, FACCWS, FASPS, CWS; Chair Elect Lonnie Lassiter, MD, MBA; Treasurer Louis Thibodeaux, MD, FACS; Secretary Emily Greenstein, MD; and Education Chair Kelly McFee, DNP, FNP-C, FACCWS.

Through its commitment to education, certification, and advocacy, ACCWS plays a pivotal role in enhancing the standards of wound care, supporting clinicians in their professional growth, and ultimately improving patient outcomes.

Learn more about the organization on the ACCWS website.

Keywords:
ACCWS,
wound care education,
wound care certification

Collagen-Alginate Dressing Enhances Healing and Quality of Life in Venous Leg Ulcer Patients

An observational study published in Wound Management & Prevention evaluated the efficacy and safety of a native bovine collagen-alginate dressing (Cutimed® Epiona®) in treating non-healing venous leg ulcers (VLUs). Conducted at the Northwell Health System Comprehensive Wound Care Healing Center and Hyperbarics in New York, the study involved 60 patients over a four-week period. The research aimed to assess wound area reduction, pain management, and improvements in wound-related quality of life (QoL).:contentReference[oaicite:7]{index=7}

Key Highlights:

• Significant Wound Area Reduction: The mean wound area decreased from 17.8 ± 11.2 cm² to 11.4 ± 9.0 cm², with four patients achieving complete wound closure within the study period. :contentReference[oaicite:10]{index=10}
• Improved Pain Management: Patients reported decreased wound pain after two weeks of treatment, accompanied by a reduction in analgesic intake. :contentReference[oaicite:13]{index=13}
• Enhanced Quality of Life: Assessments using the Wound-QoL-17 questionnaire indicated significant improvements in patients’ wound-related QoL, correlating with the observed wound area reduction. :contentReference[oaicite:16]{index=16}

The study concluded that the collagen-alginate dressing is a safe and effective adjunct to standard wound care practices, promoting healing and improving patient outcomes in cases of hard-to-heal VLUs. Healthcare professionals rated the dressing’s performance as “very good” or “good,” and patients reported high levels of comfort during use. :contentReference[oaicite:21]{index=21}

Read the full article on the Wound Management & Prevention website.

Keywords:
venous leg ulcer,
collagen-alginate dressing,
wound healing,
Alisha Oropallo,
Amit S. Rao,
Sally Kaplan,
Farisha Baksh,
Christina Del Pin

Advances in Burn Wound Management: Innovative Strategies for Healing and Infection Control

A recent literature review published in Wounds explores the latest developments in burn wound management, emphasizing innovative strategies that enhance healing and infection control. The article provides a comprehensive overview of burn wound causes, classifications, and treatments, discussing the healing phases, potential infections, and complexities associated with conventional treatments. It also highlights advanced techniques that have proven effective in reducing hospital stays and making treatment more cost-effective.

Key Highlights:

• Advanced Therapies: The review discusses the use of adipose tissue-derived stem cells (ADSCs), bone marrow-derived stem cells (BMSCs), and umbilical cord-derived stem cells (UDSCs) in promoting burn wound healing.
• Innovative Materials: The application of acellular fish skin (AFS) and extracellular matrix (ECM) components are highlighted as effective in supporting tissue regeneration and reducing inflammation.
• Modern Techniques: The utilization of negative pressure wound therapy (NPWT) and platelet-derived growth factor (PDGF) are examined for their roles in enhancing wound healing and minimizing infection risks.

These advancements in burn wound management represent significant progress in the field, offering new avenues for treatment that prioritize patient outcomes and cost-effectiveness. By integrating these innovative strategies into clinical practice, healthcare providers can improve healing times, reduce complications, and enhance the overall quality of care for burn patients.

Read the full article on the HMP Global Learning Network website.

Keywords:
burn wound management,
stem cell therapy,
negative pressure wound therapy

Transforming Powder Dressing for Lower Extremity Wounds in Patients With Diabetes

A recent case series published on Wounds highlights the clinical use of a novel transforming powder dressing in the treatment of chronic lower extremity wounds among patients with diabetes. This advanced wound care material transitions from a powder to a conforming gel upon contact with wound exudate, promoting moisture balance and protection.

Study Overview:

• Patient Population: The case series included diabetic patients with a variety of lower extremity wounds, including diabetic foot ulcers (DFUs) and post-surgical wounds.
• Dressing Characteristics: The transforming powder dressing is composed of superabsorbent polymer and sodium carboxymethylcellulose. It conforms to the wound bed and can be used under compression and with negative pressure wound therapy (NPWT).
• Clinical Outcomes: All patients demonstrated reduction in wound size and exudate levels, with improved granulation tissue formation. No adverse reactions were reported.
• Application Benefits: The powder format enabled application into deep or irregularly shaped wounds and allowed for easy fill and coverage, particularly in challenging anatomical areas.

Conclusion: The transforming powder dressing shows promise as a flexible, moisture-managing solution for chronic lower extremity wounds in diabetic populations. It may serve as a beneficial option in standard and advanced wound care protocols.

Keywords: diabetic foot ulcers, lower extremity wounds, transforming powder dressing, wound care materials, moisture balance, NPWT

Read the full case series on Wounds

Cold Microwave Plasma Jets for Wound Healing: Antimicrobial Efficacy, Mechanisms and Changes in Microbial Cells

Summary: Researchers at Brno University of Technology (Czech Republic), in collaboration with partners in Prague, Brno, and Lublin (Poland), have published a comprehensive investigation of cold atmospheric plasma (CAP) as a non-thermal antimicrobial strategy for wound care applications, appearing in Scientific Reports on March 6, 2026. The study was motivated by the escalating global burden of antibiotic-resistant microorganisms and the need for effective non-antibiotic decontamination methods. Using a custom-built cold microwave plasma jet, the team demonstrated effective inactivation of four clinically relevant organisms: Staphylococcus epidermidis, Escherichia coli, Cutibacterium acnes, and Nakaseomyces glabratus (formerly Candida glabrata). A critical mechanistic finding was that reactive oxygen and nitrogen species (RONS) — not UV radiation — are primarily responsible for microbial inactivation, established through colorimetric agent experiments and enclosed vs. open-air environment comparisons. Scanning electron microscopy (SEM) and transmission electron microscopy (TEM) revealed progressive morphological and intracellular changes in yeast cells following plasma treatment, including localized cell wall thinning and perforation, vacuole enlargement, enhanced vesicle formation, protoplast aggregation, and leakage of intracellular content — consistent with RONS-driven oxidative damage. Optimal treatment parameters balancing antimicrobial efficacy with safety for living tissue were also established, a prerequisite for clinical translation. The study builds on the group’s prior work on plasma sources for biomedical applications and contributes to the growing field of plasma medicine.

Key Highlights:

• Cold microwave plasma jets confirmed effective against S. epidermidis, E. coli, C. acnes, and N. glabratus — organisms spanning bacteria and fungi commonly implicated in wound infection
• RONS — not UV radiation — are the primary inactivation mechanism, confirmed through enclosed/open-air comparisons and colorimetric assays
• TEM analysis reveals progressive yeast cell wall thinning and perforation, vacuole enlargement, vesicle formation, and intracellular content leakage — a detailed ultrastructural map of plasma-induced cell death
• Optimal treatment parameters established balancing antimicrobial efficacy with tissue safety — a critical step toward clinical use
• Dedicated to the memory of co-author František Krčma, who constructed the MW plasma sources and secured funding; he passed away prior to publication
• Relevance: Non-antibiotic wound decontamination technology with growing preclinical evidence base — relevant as antibiotic resistance increasingly complicates chronic wound management

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Keywords: cold atmospheric plasma, plasma medicine, wound infection antimicrobial, antibiotic resistance wound, wound biofilm, RONS wound healing

Kristína Trebulová Veronika Loupová Barbora Chobotská Lukáš Kletzander Přemysl Menčík Zdenka Kozáková Jan Hrudka Joanna Pawlat Pavel Kulich František Krčma (deceased)

Use of Hypothermically Stored Amniotic Membrane on Diabetic Foot Ulcers: A Multicentre Retrospective Case Series

Summary: Researchers from US-based wound care sites published a multicentre retrospective case series in the Journal of Wound Care (March 2024 supplement) reporting clinical outcomes for diabetic foot ulcers (DFUs) managed with hypothermically stored amniotic membrane (HSAM), a cellular, acellular and matrix-like product (CAMP) classified as a human cellular and tissue-based product (HCT/P) under FDA oversight. HSAM differs from dehydrated and cryopreserved amniotic membrane allografts in that hypothermic storage conditions preserve viable differentiated and stem cell populations, growth factors, cytokines, and extracellular matrix proteins more completely — a distinction the authors argue may enhance clinical effectiveness. The study enrolled 50 patients across multiple US wound care sites; 68% were male with a mean age of 66.7 years. The majority of DFUs (88%) were present for fewer than 6 months at first presentation, and mean wound area at first presentation was 3.5 cm². From first presentation to baseline (the visit at which HSAM was first applied), mean percentage wound area reduction was −68.3%, reflecting the contribution of standard of care (SoC) pre-treatment. HSAM was then applied on top of continued SoC, and patients were followed over 12 weeks. The results suggest positive outcomes in terms of continued wound closure, with reduction in time to complete wound closure (CWC) noted as a key patient benefit — since shortened healing time translates to reduced financial burden and improved quality of life. The case series adds real-world evidence to prior randomized controlled trial data for HSAM in DFUs, including a 14-site RCT (Serena et al., 2020) that demonstrated a 60% closure rate at 12 weeks and a 75% greater probability of weekly wound closure versus standard of care alone.

Key Highlights:

• 50 patients across multiple US wound care sites; 68% male, mean age 66.7 years; 88% of DFUs present <6 months at first presentation
• Mean wound area 3.5 cm²; mean percentage area reduction of −68.3% from first presentation to HSAM baseline (reflecting SoC pre-treatment effect)
• HSAM mechanism: hypothermic storage preserves viable cells, stem cells, growth factors, cytokines, and ECM proteins — a key advantage over dehydrated and cryopreserved amnion products
• Prior RCT (Serena et al., 2020, n=76): HSAM produced 60% closure at 12 weeks vs. 38% SoC (p=0.004) and 75% greater probability of wound closure on a weekly basis over 16 weeks
• Shortened time to CWC cited as having downstream financial and quality-of-life benefits — average DFU cost estimated at $38,000–$54,000 if leading to amputation
• Authors: Anna Sanchez (San Antonio New Step, TX), Alan Hartstein and Hisham Ashry (Palm Beach Foot & Ankle, FL), Maryam Raza; data coordination supported by Organogenesis Inc.

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Keywords: amniotic membrane wound care, hypothermically stored amniotic membrane, diabetic foot ulcer CAMPs, placental allograft wound, HSAM DFU, cellular tissue products wound healing

Anna Sanchez Alan Hartstein Hisham Ashry Maryam Raza

Advanced Small Extracellular Vesicles Delivery Systems for In Situ Tissue Engineering

Summary: Published March 12, 2026 in Extracellular Vesicles and Circulating Nucleic Acids (OAE Publishing, Vol. 7, pp. 354–376), this comprehensive review from Peking University School and Hospital of Stomatology and Peking University Third Hospital systematically covers the state of the art in small extracellular vesicle (sEV) delivery systems for in situ tissue engineering — an approach that activates the body’s innate regenerative capacity by implanting bioactive materials rather than transplanting pre-constructed grafts. sEVs (30–150 nm diameter) are natural nanovesicles secreted by virtually all cell types, carrying lipids, proteins, DNA, RNA, and microRNAs that mediate intercellular communication and regulate immune responses, angiogenesis, and tissue regeneration. Their key advantages — low immunogenicity, multi-target regulatory capability, and ability to cross biological barriers — make them promising cell-free alternatives in regenerative medicine. However, their therapeutic efficacy is dose-dependent and their rapid clearance by the mononuclear phagocyte system (liver, spleen, kidneys) when administered systemically or locally limits therapeutic sustainability. The review covers sEVs derived from mesenchymal stem cells (BMSCs, ADSCs, DPSCs), immune cells, endothelial cells, body fluids (platelet-rich plasma, milk), and plant-derived vesicle-like nanoparticles (PELNs from ginger, ginseng, purslane). For delivery systems, it categorises scaffold-based approaches (physical adsorption onto 3D-printed PLA, β-TCP, PLGA, PCL, titanium, and hydroxyapatite scaffolds; affinity coating using polydopamine, PEI, heparin, tannic acid, and calcium phosphate) and hydrogel-based approaches (direct physical entrapment in silk fibroin, GelMA, chitosan/ZnO, PEG hydrogels; chemical immobilisation via carbodiimide crosslinkers or CP05 fusion peptides targeting CD63). Applications in wound healing include ADSC-sEV acceleration of diabetic wound repair, HUVEC-sEV promotion of angiogenesis, microneedle patch delivery in diabetic wound models, and CP05-mediated sEV anchoring to hydrogels for granulation tissue formation. Future directions discussed include long-term sustained release systems and environmentally responsive (pH-, temperature-, enzyme-triggered) release platforms.

Key Highlights:

• sEV sources compared: MSC-derived (BMSC, ADSC, DPSC) for bone, immune, and wound healing; HUVEC-derived for angiogenesis; platelet-rich plasma for anti-inflammatory and pro-angiogenic effects; plant-derived PELNs for anti-inflammatory and gut microbiota modulation
• Scaffold delivery strategies: physical adsorption (simple but burst-releasing) vs. affinity coating using polydopamine, PEI, calcium phosphate — PDA and biomineralised scaffolds enable sustained sEV release for up to 21 days
• Hydrogel strategies: direct encapsulation (silk fibroin, GelMA, chitosan/ZnO-NPs for diabetic wound dressings) vs. covalent immobilisation via CP05 fusion peptides targeting CD63 on sEV surface — enables more sustained, controlled retention at wound site
• Wound healing applications: ADSC-sEVs regulate Keap1/Nrf2 axis in diabetic wound fibroblasts; HUVEC-sEVs combined with tazarotene accelerate cell proliferation and tube formation; microneedle-MOF platforms deliver antimicrobial effect plus sEV-mediated tissue repair
• Responsive release: hydrogel-embedded sEVs can be engineered for pH-, temperature-, enzyme-, and electrical-responsive release — aligning drug delivery with the dynamic phases of wound healing (inflammation, proliferation, remodelling)
• Key challenges: large-scale sEV production yield, standardisation of preparations, long-term release kinetics optimisation, and clinical translation from preclinical models to human trials

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Keywords: extracellular vesicles wound healing, exosome wound care, sEV diabetic wound healing, hydrogel wound dressing drug delivery, in situ tissue engineering wound, stem cell exosome angiogenesis

Yike Gao, Jingyi Sang, Yuming Zhao, Yue Wang, Zuoying Yuan