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With the outbreak and pandemic of coronavirus disease-2019 (COVID-19), a huge number of people died of it. Apart from lung injuries, multiple organs have been confirmed to be impaired. In COVID-19 time, primary wound healing processes always prolong, however, its possible underlying mechanisms are still unclear. Therefore, to overcome this clinical problem, clarifying its underlying mechanisms clearly is necessary and urgently needed. In this review, we summarized that COVID-19 can prolong primary wound healing by inducing excessive inflammation and oxidative stress, disturbing immune system and haematological system, as well as influencing the functions and viability of epidermal stem cells (ESCs). Otherwise, we summarized that the strict control measures of blocking up COVID-19 pandemic can also have side effects on primary wound healing process.
A meta-analysis was implemented to appraise the effect of hydrocolloid dressings (HCDs) in the management of different grades of pressure wound ulcers (PWUs) in critically ill adult subjects (CIUSs). Inclusive literature research until April 2023 was done, and 969 interconnected researches were revised. The 8 picked researches, enclosed 679 critically ill adult persons at the utilized researchers' starting point; 355 of them were utilizing HCDs, and 324 were controls. Odds ratio (OR) and 95% confidence intervals (CIs) were utilized to appraise the consequences of HCDs in treating CIUSs by the dichotomous approach and a fixed or random model. HCDs had significantly higher PWU complete healing (OR, 2.15; 95% CI, 1.54–3.02, p < 0.001), PWU stage II ulcers complete healing (OR, 2.82; 95% CI, 1.40–5.69, p = 0.004), and PWU stage III ulcers complete healing (OR, 3.73; 95% CI, 1.23–11.35, p = 0.02) compared to control in critically ill adult persons. HCDs had significantly higher PWU complete healing, PWU stage II ulcers complete healing, and PWU stage III ulcers complete healing compared with control in critically ill adult persons. However, caution needs to be taken when interacting with its values since there was a low sample size of most of the chosen research found for the comparisons in the meta-analysis.
This study aimed to systematically evaluate the prevalence of surgical site wound infections and postoperative complications after total elbow arthroplasty (TEA) in patients with rheumatoid arthritis (RA) for clinical research and application. Embase, PubMed, Cochrane Library, CNKI, VIP, CBM, and Wanfang databases were electronically searched to collect clinical studies on the application of TEA in the treatment of RA from inception to August 2023. Two independent researchers performed literature screening, data extraction, and quality assessment. A meta-analysis was performed using the R 4.3.1 software. Overall, 26 studies with a total of 2374 patients were included. The results of the meta-analysis revealed that after TEA in patients with RA, the prevalence of surgical site wound infections and postoperative complications was 3.37% (95% confidence interval [CI]: 2.68%–4.13%), and 31.63% (95% CI: 24.97%–38.28%), respectively. The prevalence of surgical site wound infections is low, whereas that of postoperative complications is high; thus, the safety of TEA remains debatable. Owing to limitations on the quality and number of included studies, the findings need to be verified in higher-quality studies.
The current methods for the prediction of mortality and amputation for inpatients with diabetic foot (DF) use only conventional, simple variables, which limits their performance. Here, we used a random survival forest (RSF) model and multicomponent variables to improve the prediction of mortality and amputation for these patients. We performed a retrospective cohort study of 175 inpatients with DF who were recruited between 2014 and 2021. Thirty-one predictors in six categories were considered as potential covariates. Seventy percent (n = 122) of the participants were randomly selected to constitute a training set, and 30% (n = 53) were assigned to a testing set. The RSF model was used to screen appropriate variables for their value as predictors of 2-year all-cause mortality and amputation, and a multicomponent prediction model was established. Model performance was evaluated using the area under the curve (AUC) and the Hosmer–Lemeshow test. The AUCs were compared using the Delong test. Seventeen variables were selected to predict mortality and 23 were selected to predict amputation. Uric acid and alanine transaminase were the top two most useful variables for the prediction of mortality, whereas urine protein and platelet were the top variables for the prediction of amputation. The AUCs were 0.913 and 0.851 for the prediction of mortality for the training and testing sets, respectively; and the equivalent AUCs were 0.963 and 0.893 for the prediction of amputation. There were no significant differences between the AUCs for the training and testing sets for both the mortality and amputation models. These models showed a good degree of fit. Thus, the RSF model can predict mortality and amputation in inpatients with DF. This multicomponent prediction model could help clinicians consider predictors of different dimensions to effectively prevent DF from clinical outcomes .
The meta-analysis aimed to assess and compare the effect of closed-incision negative pressure wound (NPW) treatment in vascular surgery. Using dichotomous or contentious random or fixed effect models, the outcomes of this meta-analysis were examined, and the odds Ratio (OR) and the mean difference (MD) with 95% confidence intervals (CIs) were computed. Ten examinations from 2017 to 2022 were enrolled for the present meta-analysis, including 2082 personals with vascular surgery. Closed-incision NPW treatment had significantly lower infection rates (OR, 0.39; 95% CI, 0.30–0.51, p < 0.001), grade I infection rates (OR, 0.33; 95% CI, 0.20–0.52, p < 0.001), grade II infection rates (OR, 0.39; 95% CI, 0.21–0.71, p = 0.002), and grade III infection rates (OR, 0.31; 95% CI, 0.13–0.73, p = 0.007), and surgical re-intervention (OR, 0.49; 95% CI, 0.25–0.97, p = 0.04) compared to control in personal with vascular surgery. However, no significant differences were found between closed-incision NPW treatment and control in the 30-day mortality (OR, 0.54; 95% CI, 0.29–1.00, p = 0.05), antibiotic treatment (OR, 0.53; 95% CI, 0.24–1.19, p = 0.12), and length of hospital stay (MD, −0.02; 95% CI, −0.24-0.19, p = 0.83) in personnel with vascular surgery. The examined data revealed that closed-incision NPW treatment had significantly lower infection rates, grade I infection rates, grade II infection rates, and grade III infection rates, surgical re-intervention, however, there were no significant differences in 30-day mortality, antibiotic treatment, or length of hospital stay compared to control group with vascular surgery. Yet, attention should be paid to its values since some comparisons had a low number of selected studies.
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