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Diabetic foot ulceration (DFU) contributes significantly to diabetes-related morbidity and amputation. In Barbados, where amputation rates are among the highest globally, the influence of socioeconomic factors on ulceration outcomes remains underexplored. Educational attainment, a social determinant of health, may influence health behaviours, engagement with healthcare services, and ultimately clinical outcomes. This study examines whether educational attainment is associated with diabetic foot ulcer severity, as measured by the SINBAD scoring system, and six-week healing outcomes among inpatients with DFU. A prospective observational study was conducted over 6 months at Barbados' sole public hospital. A total of 176 participants admitted with a diagnosis of DFU were recruited. Baseline demographics, comorbidities, and ulcer characteristics were collected, and SINBAD scores were determined. Random forest modelling was employed to evaluate predictors of complete healing at 6 weeks and to assess ulcer severity stratified by educational attainment. Of the cohort, 17.5% reported primary education as their highest attainment level, compared with 2.9% of the general adult population. The mean SINBAD score was 2.45 among those with primary education and 2.51 among those with secondary education (p > 0.05). No statistically significant association was found between educational attainment and healing outcomes at 6 weeks. Educational attainment in this inpatient DFU cohort was lower than that of the general Barbadian population; however, it was not significantly associated with ulcer severity or six-week healing outcomes. In a universal healthcare setting, equitable access to care may attenuate the effect of educational attainment on clinical outcomes. These null findings highlight the need for future adequately powered studies incorporating health literacy assessment and key clinical confounders. Nonetheless, the observed disparity in educational attainment among DFU inpatients suggests that foot health education initiatives should be designed to be accessible to individuals across all educational levels.
To investigate whether micronized acellular dermal matrix (mADM) can be used to treat diabetes-related and traumatic foot wounds with bone defects after bone or joint resection. We retrospectively reviewed 52 patients who underwent bone or joint resection, followed by mADM-assisted reconstruction of diabetes-related or traumatic foot wounds between 2021 and 2024. mADM was applied using sheet-type, paste-type or combined formulations in one- or multi-stage procedures. Wound healing, contour preservation and radiological alignment were assessed. Among the 52 patients (43 with diabetes and 9 with trauma), complete epithelialization was achieved in 48 (mean follow-up: 14.8 months; mean time to wound closure: 5.6 weeks). Four cases showed recurrence or delayed healing and five developed mild early local infection; all were controlled with additional wound care or antibiotics, with no progressive osteomyelitis or graft loss. In 40 radiologically evaluable cases, the toe length and alignment were generally preserved (mean toe length ratio: 91.6% and no angular deformity > 10°). mADM-assisted reconstruction may be useful for treating diabetes-related and traumatic foot wounds with bone defects after bone or joint resection. Its role appears to lie in dead-space management, contour preservation and durable wound coverage, rather than bone replacement.
Early detection of sacral pressure injuries (PIs) in immobilised polytrauma patients remains challenging. This study evaluated ultrahigh-frequency (UHF) ultrasound combining structural and haemodynamic parameters for early PI diagnosis. In a prospective cohort of 73 polytrauma patients (Injury Severity Score 16–25), daily sacrococcygeal assessments were performed over 15 days using UHF ultrasound (Mindray Resona 11; L20-5 s probe). Parameters included 2D morphology, perfusion (colour power angiography [CPA]), flow metrics (peak systolic velocity [PSV]), Braden Scale and inflammatory markers. PI incidence was 27.4% (n = 20; all stage I/II). Haemodynamic markers outperformed 2D ultrasound: CPA grade ≥ 1 (AUC = 0.858, 80.0% sensitivity) and PSV > 5.55 cm/s (AUC = 0.841, 95.0% sensitivity). Combined CPA + PSV achieved superior accuracy (AUC = 0.922). Systemic inflammation showed no intergroup differences. UHF ultrasound detects early PIs by capturing ischaemia-reperfusion changes. The CPA + PSV protocol provides nurses with a rapid (< 5 min), sensitive bedside tool to guide proactive interventions.
This study aimed to explore how persons living with a hard-to-heal wound and their family members experience care. The inclusion criteria for patients were wounds that had persisted for more than 6 weeks or hard-to-heal wounds that had recently healed. The study included 16 participants (13 patients and 3 family members) from primary healthcare services in Örebro County, Sweden. The interview data were transcribed and analysed using reflexive thematic analysis. One overarching theme was generated: Navigating an uncertain path towards healing, along with three subthemes: (1) Striving to be an active agent, (2) Being part of collaboration efforts and (3) Being a bystander in the search for the right treatment. Together, these themes illustrate how patients and family members engaged in an uncertain care process as they sought to understand the condition and manage care in everyday life. These everyday efforts reflected forms of invisible agency, as participants did not always recognise them as meaningful contributions to wound care. The findings highlight the importance of person-centred approaches that recognise and value patients' and family members' everyday contributions to wound care and support self-management through partnerships among patients, family members and HCPs.
Chronic diabetic foot ulcers and venous leg ulcers remain difficult to treat due to delayed healing and high complication rates. Biologic skin allografts derived from living or amniotic tissue provide extracellular matrix components, cytokines, growth factors and viable cells that facilitate tissue repair. This investigation systematically reviewed randomised controlled trials comparing Apligraf, Theraskin, Amnioband, Amnioexcel, EpiCord and Epifix for chronic lower extremity wounds. Searches were conducted in PubMed, Embase and Cochrane databases. Primary outcomes included complete wound closure at 12 weeks, time to healing and percent area reduction. Secondary outcomes included infection, amputation and recurrence rates. Nineteen trials with a total of 1303 participants met inclusion criteria. Analysis demonstrated statistical significance in 12-week wound closure (p = 0.0394), with Theraskin achieving the highest mean closure (84.7%) and Amnioexcel the lowest (37.5%). Epifix and Amnioband showed faster healing trends and greater closure advantages compared with standard care. Reported complications were uncommon and inconsistently defined. While no single graft demonstrated statistically superior outcomes, descriptive trends suggest Theraskin, Epifix and Amnioband may offer greater clinical benefit. These findings provide comparative insight to guide clinical selection of skin substitutes and highlight the need for large-scale head-to-head trials to establish relative efficacy.
Post-burn itching is an important symptom that negatively affects patients during both the treatment and rehabilitation processes. Understanding patients' lived experiences regarding post-burn itching is essential to improving patient care. This qualitative study was conducted using a phenomenological approach. In-depth, face-to-face interviews were held with 10 patients who experienced itching after burn injuries. Data collection occurred between January and May 2024. Thematic analysis was employed to evaluate the data. Analysis of the data revealed four main themes and 13 sub-themes. The main themes identified were: (1) the psychological burden of itching, (2) the bodily experience of itching, (3) difficulties in daily life, and (4) coping strategies. The study findings provide detailed insights into the experiences of patients suffering from post-burn itching. These results enhance current knowledge in this area and may inform the development of holistic, patient-centred, and community-based care strategies tailored to patient needs.
Chronic diabetic wounds persist because of impaired angiogenesis, dysregulated transforming growth factor beta activity and delayed matrix remodelling. Non-thermal atmospheric pressure plasma therapy represents a potential non-pharmacologic approach to overcome these barriers. This study compared reactive nitrogen–dominant and reactive oxygen–dominant plasma exposures under identical apparatus conditions in a diabetic wound model. A universal plasma jet operated with nitrogen or argon gas was applied to streptozotocin-induced diabetic rats. Wound area reduction and time to 90% closure were quantified. Histological evaluation assessed re-epithelialisation and collagen deposition and immunohistochemistry measured angiogenesis using cluster of differentiation 31 staining and transforming growth factor beta expression. Nitrogen plasma treatment demonstrated sustained improvement in wound reduction relative to diabetic controls and reached 90% closure on day 19, whereas argon plasma reached this threshold on day 24 and diabetic controls exceeded 30 days. Nitrogen plasma was also associated with an earlier, self-limited angiogenic response characterised by an early cluster of differentiation 31 peak on day 6, together with patterns consistent with enhanced collagen maturation and earlier normalisation of transforming growth factor beta expression. Overall, these findings suggest mechanistic differences between reactive nitrogen–dominant and reactive oxygen–dominant plasma exposures in regulating angiogenesis and matrix remodelling during diabetic wound repair. These results indicate that plasma gas chemistry may influence wound-healing trajectories, supporting the potential of plasma therapy as a translational adjunct approach for difficult-to-heal wounds.
The aim was to validate the Spanish/Spain version of the Wound-QoL-14. Clinical data were prospectively collected from participants who completed the questionnaire at baseline and at a follow-up visit. COSMIN guidelines were followed to evaluate feasibility, reliability, construct validity and responsiveness. Overall, 323 participants (71.1 ± 14.6 years; 52% males) were included. Feasibility was excellent (missing items: 0.95%). Reliability was good (very good internal consistency [McDonald's omega: 0.934] and test–retest reliability [concordance correlation coefficient: 0.915; 95% CI: 0.837–0.956. Standard error of measurement: 0.141]). Regarding construct validity, the survey showed good structural validity since the three factors extracted after the exploratory factor analysis were confirmed (Comparative fit index: 0.942. Tucker–Lewis index: 0.927. Standardized root mean square residual: 0.042. Root mean square error of approximation: 0.089; 90% CI: 0.077–0.102) and good known-groups and convergent validities (4/4 and 7/9 predefined hypotheses supported, respectively). Criterium validity was excellent (Spearman's rho with Wound-QoL-17 global score: 0.934). Finally, the instrument was suitable to detect improvement (Floor effect: 0.3%. Ceiling effect: 1.5%. Area under the receiving operator characteristic curve: 0.795; 95% CI: 0.732–0.858; p < 0.001. Standardized effect size: 0.928. Standardized response mean: 0.852). The Spanish/Spain version of the Wound-QoL-14 is a reliable and valid instrument to assess the health-related quality of life in Spanish patients with chronic wounds.
The wound-scratch assay is a widely used in vitro model for studying collective cell migration, a fundamental process contributing to wound closure and re-epithelialisation. Owing to its simplicity, low cost, and adaptability, it has become a foundational tool for early-stage wound-healing research and therapeutic screening. The assay involves generating a defined gap in a confluent cell monolayer and monitoring gap closure over time as a surrogate readout of repair. This narrative review examined 199 published studies, identifying 73 relevant to wound healing. A technical hierarchy of wound creation methods was identified across three main categories: mechanical approaches (e.g., pipette tips and cell scrapers), accessible but prone to operator-dependent variability; semi-automated systems (e.g., inserts and wound maker devices), which improve reproducibility; and fully-automated robotic platforms offering high precision and high-throughput capability. While these advances enhance technical consistency, they do not overcome the assay's fundamental biological constraints. Importantly, gap closure in the wound-scratch assay primarily reflects planar collective cell migration and does not recapitulate the integrated inflammatory, vascular, metabolic, and extracellular matrix-dependent processes that govern wound repair in vivo. Consequently, bioactive compounds acting through antioxidant, anti-inflammatory, angiogenic, or matrix-modulating pathways may have their therapeutic potential underestimated or misclassified when assessed using migration-only readouts. Preliminary in-house (unpublished) data are presented to illustrate this limitation, demonstrating modest migration effects for compounds with established wound-healing activity in vivo. Despite these limitations, the wound-scratch assay remains a valuable first-line, hypothesis-generating tool when interpreted appropriately, with future utility dependent on integration with adapted models and complementary assays for translation.
Beta Glucans (β-glucans) are naturally occurring polysaccharides that have positive effects on healing in acute and chronic wounds. This study aimed to identify how β-glucans modulate macrophage polarisation and inflammation to aid the healing response. Flow cytometry was used to assess the effect of β-glucan on human monocytes during differentiation into M0, M1 and M2 macrophages. Subsequently, a murine full-thickness excisional wound healing model was conducted where wounds were treated with either β-glucan hydrogel or vehicle, at the time of wounding. The wounds were analysed to determine the rate of wound closure, the effect on inflammation, and matrix deposition. β-glucan promoted differentiation of monocytes to M0 macrophages but inhibited differentiation of M0 macrophages to pro-inflammatory M1 macrophages with no effect on M2 macrophage formation. In vivo, treatment of excisional wounds with β-glucan hydrogel accelerated healing with an earlier, more resolved inflammatory phase containing greater numbers of M2 macrophages and fewer neutrophils within the wound. No statistically significant effect on matrix deposition was observed. β-glucans modulate macrophage differentiation and accelerate healing in excisional wounds with no adverse effect on matrix formation. β-glucans are a potential therapeutic approach for treatment of hard-to-heal wounds in humans.
Although Negative Pressure Wound Therapy (NPWT) has been increasingly used in wound care to improve impaired healing, there is little scientific evidence supporting its role and underlying biomolecular mechanisms. Aims of the present study are to provide a quantitative analysis of recent literature investigating NPWT in diabetic wound healing focusing on healing duration, wound closure, hospitalisation period and complications, and qualitative insight into studies analysing biomolecular mechanisms. The systematic review and meta-analysis were conducted following PRISMA guidelines (PROSPERO: CRD42024524813). 21 studies published in PubMed, Cochrane Library, EMBASE between 2019 and 2024 were included. Clinical studies indicated NPWT was superior to standard care dressings (SCD), promoting faster wound healing with significantly reduced hospitalisation times by 7.8 days (95% CI: −14.2 to −1.4, p = 0.017), and significantly reduced complications rates, particularly major and minor amputations (95% CI: −10.2 to −1.3, p = 0.01). Mechanistic in vitro and animal studies highlighted NPWT can reduce local inflammation, oxidative stress, support angiogenesis and improve scarring, essential components of normal healing. Although studies suggest NPWT is more effective than SCD for diabetic wound healing, the paucity of studies, small cohorts and scarce outcomes consistency make defining clear conclusions challenging. There is still more evidence required to fully understand NPWT's role in the complex diabetic wound healing.
Pilonidal sinus disease (PSD) is associated with substantial morbidity because of wound complications and recurrence after surgery. Adjunct laser hair removal (LHR) has been incorporated into postoperative management in some settings, but real-world outcomes in cohorts treated uniformly with LHR remain incompletely described. This study aimed to characterize postoperative outcomes after PSD surgery in a large integrated healthcare system in which adjunctive LHR was standard practice and to compare outcomes by surgical approach. We performed a retrospective descriptive cohort study of patients aged 14–89 years who underwent operative treatment of PSD with adjunctive LHR at Kaiser Permanente Northern California between 2012 and 2024. Outcomes included repeat procedures, 30-day surgical site infection (SSI), and unplanned clinic visits. Outcomes were summarized as proportions overall and by surgical approach. Exploratory bivariable logistic regression examined associations between sex or body mass index (BMI) and outcomes. Multivariable modeling was not performed because of low event counts and sparse covariate distributions, which resulted in unstable models. Among 168 patients, the overall repeat procedure rate was 16.7%, the 30-day SSI rate was 14.4%, and 39.3% had at least one unplanned clinic visit. Patients treated with Bascom flap closure had fewer repeat procedures (10.4% vs. 20.8%) and fewer unplanned visits (33.8% vs. 43.6%) than those undergoing pilocystectomy, with similar SSI rates (14.9% vs. 14.0%). In exploratory analyses, sex and BMI were not significantly associated with outcomes in either surgical group. In this real-world cohort managed uniformly with adjunctive LHR, postoperative outcomes appeared to vary more by surgical approach than by sex or BMI. These findings are descriptive and do not estimate the independent effect of LHR. Controlled comparative studies are needed to determine the contribution of LHR to PSD outcomes.
Chronic non-healing wounds represent a major global public health challenge. Their persistence is frequently attributed to localized biological deficits that cause them unresponsive to conventional therapeutic modalities. While Platelet-Rich Plasma (PRP) has demonstrated promising results as an adjunctive treatment by delivering highly concentrated growth factors, its clinical application is currently impeded by a lack of clinical standardization, particularly optimal injection frequency, interval, and dosage. The aim of this study is to rigorously evaluate the efficacy and safety of a specific, non-intensive two-dose PRP injection protocol for accelerating the reduction of wound area in patients with various types of refractory chronic wounds. We conducted a prospective, single-arm, pretest-posttest study enrolling 18 patients with refractory non-healing wounds, defined as lesions persisting for a minimum period of 4 weeks which had failed to achieve definitive closure under optimized standard care. Autologous high-concentration PRP was injected intradermally around the wound margin at baseline (Day 0) and again 3 weeks later (Day 21). Wound area was digitally measured at baseline and subsequently at 7, 11 and 15 weeks. The primary outcome was the mean reduction in wound area (cm2) at the 15-week follow-up, assessed using a Paired Samples t-test. The mean patient age was 57.89 ± 15.64 years, and wounds had a mean chronicity of 15.83 ± 19.05 months. The PRP preparation achieved a mean platelet concentration 8.5 times greater than the peripheral blood threshold (first injection) and 7.0 times greater than the threshold (second injection), confirming high therapeutic quality. Analysis of the total cohort demonstrated a statistically significant reduction in mean wound area from baseline 27.41 ± 70.38 cm2 to 15 weeks 21.5 ± 68.96 cm2. Three patients (16.67%) achieved complete epithelialization. Subgroup trends suggested diabetic and venous ulcers responded more favourably than radiation-induced ulcers. The protocol was safe, with no systemic or severe localized adverse events observed among participants. The defined two-dose PRP injection protocol provides a clinically effective and safe adjunctive therapy that significantly promotes wound area reduction in challenging chronic non-healing wounds. This reproducible, low-frequency protocol offers a rationale for standardization in advanced wound care, warranting validation through future large-scale Randomized Controlled Trials (RCTs).
Debridement is widely used across various wound types, but its biological significance differs fundamentally between acute and chronic hard-to-heal wounds. In acute wounds, debridement directly triggers the initiation of regeneration; however, in chronic wounds, persistent biofilm, insufficient angiogenesis and dysregulated inflammation lead to a prolonged cycle of inflammation and proliferation, making traditional one-off debridement insufficient to change the healing trajectory. Therefore, the concept of debridement needs to evolve from an acute wound model to a sequential, biologically driven continuous management strategy. Maintenance debridement, by dynamically regulating the microenvironment, reducing pathological load and restoring a ‘healable state’, has emerged as the crucial bridge between inflammation control and regenerative therapies. This review systematically explains the theoretical basis and clinical value of maintenance debridement and explores the future direction of AI-assisted precision debridement management.
High-arched feet affect approximately 10%–15% of the general population. Although the relationship between plantar pressure and bilateral symmetry is well studied, there is limited evidence regarding the use of Symmetry Index and pressure platforms. The objective of the study is to compare dynamic foot pressures and Symmetry Index during gait between subjects with Pes Cavus and subjects with normal feet. The analysis of asymmetric pressure patterns could benefit from studies that compare dynamic foot pressures and Symmetry Index values in subjects with high-arched feet and normal feet. This analysis can promote better clinical understanding of gait alterations and help solve biomechanical problems that may lead to pathologies, as well as prevent and treat them. A descriptive case–control study was developed from October to December 2024 with 82 participants, 41 with Pes Cavus and 41 normal feet and 71 females of 25.52 ± 5.99 years through a consecutive nonrandom technique. For this study, a baropodometry platform (Neo-Plate, Herbitas) was used, which acquired dynamic gait with a 2-step protocol. The inclusion criteria regarding the selection of subjects were age 18–65 years; if both cavus feet, Navicular Drop Test (NDT) < 9 mm; neutral feet and no lower limb problem or surgery. Regarding SI use, the PC demonstrated to have large asymmetries compared to the control group. Left anterior pressure was lower (44.93% ± 4.59% vs. 48.60% ± 3.43%, p = 0.014), left posterior pressure was higher (55.07% ± 4.58% vs. 51.40% ± 3.43%, p = 0.013) and the left Initial Contact Phase (ICP) was prolonged (123.34 ± 51.75 ms vs. 91.30 ± 31.86 ms, p = 0.036); right medial pressure was higher (58.18% ± 4.08% vs. 53.77% ± 4.79%, p = 0.034). SI measurements were greater in normal foot group than in the PC group with SI 94.15% ± 5.00% versus 93.75% ± 4.59%, p = 0.001, respectively; ICP and lateral SI were both p = 0.001. Findings confirmed that subjects with cavus feet tend to present greater alterations in bilateral symmetry, specifically posteromedial pressure movements and altered gait phases, which are indicative of more probability of future injuries. For this reason, pressure platforms are excellent tools for understanding, analysing and therefore applying the correct treatment according to the SI.
Diabetes mellitus represents a major global health challenge, with over 537 million adults currently affected worldwide. Among its complications, diabetic foot ulcers remain a leading cause of morbidity, hospitalization and amputation, imposing a significant socioeconomic burden. Effective management requires a multidisciplinary approach integrating surgical, medical and rehabilitative expertise. Negative pressure wound therapy has demonstrated clinical efficacy in promoting granulation tissue formation, accelerating wound healing, and reducing infection rates compared with conventional dressings. This case series presents the management of four frail, septic patients with severe diabetic foot ulcers treated between 2023 and 2025 in an academic surgical department. All patients required surgical intervention, including debridement or partial amputation, combined with negative pressure wound therapy and, in selected cases, revascularization or skin grafting. One case utilized an electrospun nanofiber dressing which enhanced wound granulation and shortened healing time. Outcomes varied according to systemic comorbidities, vascular status and glycemic control; however, NPWT consistently supported wound stabilization and preparation for definitive closure. These findings reinforce the essential role of interdisciplinary collaboration and advanced wound technologies in the treatment of complex diabetic foot infections, particularly in frail or septic patients, and highlight the potential of nanofiber-based dressings as adjunctive therapies in comprehensive diabetic foot care.
Pressure ulcers remain a major cause of morbidity in skilled nursing facility populations, where frailty and comorbid conditions hinder healing. Numerous studies have established Nitric oxide's role in tissue repair, angiogenesis, and infection control, suggesting therapeutic potential for nitric oxide in chronic wound healing. A retrospective observational cohort study was conducted using de-identified data from skilled nursing patients presenting with pressure ulcers. Two matched cohorts (200 patients per group) were compared: Those treated with a nitric oxide–delivering foam and historical controls receiving standard of care. Propensity score matching accounted for baseline wound size, stage, sex, comorbidities, and treatment start date. The primary endpoint was complete closure (epithelialized or had an area of zero) within 12 weeks. Bayesian hierarchical hurdle–gamma regression estimated treatment effects using posterior means and 95% credible intervals. Within 12 weeks, closure or resolution rates had a significant benefit in the treatment group across most stages: 94% versus 79% for Stage 1, 80% versus 45% in Stage 2, 64% versus 28% in Stage 3, 39% versus 12% in unstageable, 34% versus 10% in Stage 4, and 67% versus 31% for Deep Tissue Pressure Injuries. Overall, 63% (95% CrI 50%–75%) of NODF-treated wounds healed compared with 34% (21%–47%) of SOC wounds. Posterior probabilities of superior healing with NODF exceeded 99% for most comparisons.
To study the risk factors associated with multidrug-resistant bacteria (MDRB) infection in diabetic foot (DF) wounds and to develop a nomogram model to predict the risk of MDRB infection in patients with DF. A total of 157 patients with DF between January 2013 and December 2023 were included in this study. A retrospective analysis was conducted to examine the characteristics of MDRB infections. Univariate and multivariate logistic regression analyses were performed to identify risk factors associated with MDRB infection. Based on these risk factors, a predictive model was built using R software and a nomogram was constructed. Multivariate logistic regression analysis revealed that the wound area, previous hospitalization, prior use of antibacterial agents, lower extremity ischaemia grade, and hypoproteinaemia were independent risk factors for MDRB infection in DF wounds (p < 0.05). Construction of the nomogram model for MDRB infection in DF wounds: A nomogram model was developed using five identified risk factors—wound area, previous hospitalization, previous use of antibacterial drugs, lower extremity ischaemia grade and hypoproteinaemia—as predictors. The area under the receiver operating characteristic (ROC) curve (AUC) was 0.863. The model has a good ability to predict MDRB infections in DF wounds. Wound area, previous hospitalization, previous use of antibacterial drugs, lower extremity ischaemia grade and hypoproteinaemia were identified as independent risk factors for MDRB infections in DF wounds. The nomogram model constructed on the basis of these five factors demonstrated good predictive performance for MDRB infection.
Acute, chronic, and hard-to-heal wounds pose a growing challenge due to reduced patient quality-of-life, higher cost and increased hospital admissions. Although there is no gold standard for wound care, there is a trend toward simple, outpatient-compatible treatment options. Acellular dermal fish skin derived from Gadus morhua (Atlantic cod) is a promising alternative. This retrospective study evaluated the surgical procedures and outcomes associated with fish-skin graft transplantation for difficult-to-treat wounds. Forty-four patients (33 male and 11 female; mean age: 72.4 years; mean wound area: 84.5 cm2) were treated with acellular fish skin graft. Wound healing was assessed by photographic documentation, confocal microscopy and clinical evaluation. Patient satisfaction was assessed using a structured questionnaire. A positive effect on wound healing, defined as a reduction in wound size, was observed in 88.6% of cases, with complete wound closure in 45.45% of cases. Most patients reported that the procedure was neither painful nor time-intensive; 95% stated that they would opt for treatment again. Fish skin grafting has also shown beneficial outcomes in complex cases, such as in wounds secondary to pyoderma gangrenosum and wounds with exposed bone. Fish skin graft transplantation represents a safe, well-tolerated and effective option for managing chronic wounds as well as challenging postoperative wounds, such as those at anatomically challenging sites.
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