ABSTRACT This systematic review synthesized evidence on digital, mobile and artificial intelligence‐supported interventions for pressure injury prevention and management in adult healthcare populations. Empirical studies published between 2015 and 2025 were searched in PubMed, Cochrane Library, Medical Literature Analysis and Retrieval System Online through Ovid, Scopus, Web of Science and Cumulative Index to Nursing and Allied Health Literature, with additional reference list, citation tracking, manual journal and trial registry searches. Eligible studies evaluated digital, mobile or artificial intelligence‐supported approaches, including telehealth, wearable, remote monitoring and communication‐based technologies, for adults at risk of or living with pressure injuries. Study selection, data extraction and quality appraisal were conducted independently by two reviewers. Findings were synthesized narratively because of heterogeneity across interventions, populations, settings and outcomes. Twelve studies published between 2017 and 2025 were included. The most consistent benefits were improved adherence to repositioning, monitoring visibility, documentation and caregiver or staff engagement. Evidence for reducing the incidence of pressure injuries and improving healing was less consistent. Implementation depended on workflow fit, usability, staff training, technical support, documentation systems, organizational ownership and sustainability planning. These interventions may strengthen pressure injury care by improving visibility, timeliness, documentation and coordination; however, evidence for sustained clinical effectiveness, cost‐effectiveness and long‐term implementation remains limited.
ABSTRACT Accurate identification of pathogens in clinically infected skin ulcers is essential for targeted antimicrobial therapy. Although expert consensus recommends mechanical cleansing of the ulcer bed prior to swabbing, there is a lack of empirical evidence to support this practice. This study investigated the impact of mechanical cleansing with sterile cotton gauze pads saturated with isotonic saline or clean water on microbiological results. Triple swabs were collected from 106 patients with skin ulcers at two distinct time points: prior to cleansing (baseline) and immediately following mechanical cleansing. All specimens were analysed using both conventional culture and point‐of‐care nucleic acid amplification tests (NAAT) for Staphylococcus aureus , methicillin‐resistant S. aureus (MRSA), and Streptococcus pyogenes . S. aureus was the most prevalent isolate, with detection rates of 23%–24% by culture and 44%–45% by NAAT. The prevalence and specific bacterial findings remained highly consistent before and after mechanical cleansing, with high levels of concordance across both diagnostic modalities. A sensitivity analysis excluding patients with recent antibiotic use confirmed these findings. Our results demonstrate that mechanical cleansing of the ulcer does not significantly alter the microbiological yield or improve the detection of key pathogens. These findings suggest that the traditional requirement for pre‐sampling cleansing may be unnecessary for routine diagnostic swabbing.
ABSTRACT Diabetic foot infection (DFI) is a major cause of lower‐extremity amputation. Evidence on optimal management remains inconsistent, and real‐world data from multidisciplinary centres are limited. This study describes the characteristics, treatment patterns, and outcomes of patients with DFI at a tertiary referral centre. This retrospective cross‐sectional study included all patients with diabetes and confirmed DFI presenting since 2022. Demographic, clinical, laboratory, radiologic, and wound‐related data were recorded, and wounds were classified using the Wound, Ischemia, and foot Infection (WIfI) system. Correlation and multiple linear regression analyses identified predictors of healing duration. 69 patients were included (mean age 56.4 ± 13.2 years; 58% male). Most wounds were deep (88.2%); osteomyelitis occurred in 42.2%. Conservative wound care was used in 73.9%, and 79.7% underwent bedside debridement. Minor and major amputation rates were 16.2% and 1.4%. The median healing time was 45 days (interquartile range [IQR] 54), and the mean healing time was 56.0 ± 44.9 days. Healing duration correlated with wound grade, WIfI stage, infection severity, erythrocyte sedimentation rate (ESR), white blood cell (WBC) count, international normalized ratio (INR), wound area, and delay to specialist assessment. Wound grade was the only independent predictor of healing time ( β = 0.606, p = 0.001). Limb‐preserving management was associated with a low major amputation rate. Wound severity was the strongest determinant of healing duration, underscoring the importance of early referral and structured risk stratification in DFI care.
ABSTRACT To describe recorded outcomes of diabetic foot ulcers treated with topical recombinant human epidermal growth factor as part of routine care. This retrospective, single‐centre cohort study included 150 consecutive patients receiving Regen‐D 150 without a control group. We added treatment when standard care did not produce adequate granulation. We defined the primary outcome as complete healing of the index ulcer without amputation. The primary outcome occurred in 101/150 patients (67.3%; 95% confidence interval 59.5–74.3). Sixteen underwent amputation (11 minor, 5 major), 27 had ongoing status at last follow‐up, three died and three were lost to follow‐up. Ongoing status included open wounds and closed but unconfirmed wounds. Median recorded time to healing was 13 weeks (interquartile range 10–16). Wound area analyses were exploratory because of unresolved timing inconsistencies. We could not confirm healing for all recorded healings. About two‐thirds had recorded healing without amputation during variable follow‐up. These uncontrolled, descriptive findings do not establish efficacy, superiority or amputation prevention.
ABSTRACT Surgical wounds healing by secondary intention are often complex, costly and slow to heal. Consistent outcome reporting ensures that interventional trials are directly comparable and less vulnerable to reporting bias, thereby enhancing the efficiency of evidence generation. Currently, no framework for outcome reporting from interventional studies of SWHSI exists. We present a national survey of clinicians as the first step to producing a core outcome set for studies involving interventions for this wound type. A pre‐piloted online survey was administered in September 2024 via the Qualtrics system, comprising three sections: perceptions, decision‐making and key outcomes in SWHSI management. Recruitment was via professional organisations, membership mailing lists and social media. One hundred and two clinician responses were received. The most common reasons reported for choosing secondary intention healing were concerns about infection (46%, 35/76), primary wound closure (48.7%, 37/76) and potential reintervention (89.5%, 68/76). All‐cause mortality at 30 days (73%, 49/67) and 1 year (70%, 47/67), wound healing at 30 days (100%, 67/67), surgical site infection (98%, 66/67), pain score (94%, 63/67), wound size (94%, 63/67), quality of life (99%, 66/67), length of hospital stay (85%, 57/67) and reintervention requirement (90%, 60/67) were reported to be important clinical trial outcomes in this population. This survey explored the main decision‐driving factors in choosing secondary intention healing and identified important trial outcomes for clinicians in this research area.
