Tophaceous wound represent a severe complication of end-stage gout, characterized by the deposition of monosodium urate (MSU) crystals leading to localized tissue ischemia, chronic inflammation, and non-healing ulcers. The pathological mechanism involves the formation of MSU crystals under persistent hyperuricemia, inflammatory encapsulation, and mechanical compression of the vascular system due to tophus enlarge-ment, ultimately resulting in chronic non-healing ulcers. This article consolidates current evidence to outline an integrated management strategy for such wounds, combining systemic metabolic control with localized interventions. Effective treatment depends on maintaining serum uric acid levels below 300 μmol/L through urate-lowering agents, including conventional drugs and novel urate transporter 1 inhibitors such as AR882, complemented by anti-inflammatory medications such as nonsteroidal anti-inflammatory drugs and glucocorticoids to alleviate pain and reduce inflammation. Topical agents and advanced dressings are utilized to support healing and manage exudate. Debridement, which encompasses sharp, ultrasonic, and micro-techniques, is essential for removing necrotic tissue and MSU deposits, with efficacy assessed via local uric acid monitoring. Surgical reconstructions, including skin flap grafting and tendon or ligament reconstruction, are indicated for significant tissue loss or functional impairment. Long-term management emphasizes continuous metabolic control, personalized rehabilitation, and lifestyle modification. The comprehensive treatment of tophaceous wounds requires multidisciplinary collaboration to balance local repair and systemic regulation for improved prognosis. Future research directions include gene therapy to regulate purine metabolism and artificial intelligence-assisted personalized treatment plans, to achieve precision medicine for tophaceous wounds.

BACKGROUND:The endoscopic evaluated classification known in China as the China-Lu classification is a morphological and pathological feature-based classification for chronic wound with sinus tract (CWST). OBJECTIVE:To investigate the closure rate for different types of CWST according to the endoscopic evaluated classification. MATERIALS AND METHODS:This prospective case series study enrolled patients with CWST who were admitted to the Wound Healing Center of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China, between November 2017 and October 2021. RESULTS:A total of 89 patients were enrolled (46 males [51.7%], 43 females [48.3%]). The CWST was classified as simple in 46 patients, morphologically complex in 13, pathologically complex in 23, and refractory in 7. After standard treatment, the overall closure rate was 86.52%. The closure rate was 97.83% for the simple type, 84.62% for the morphologically complex type, 86.96% for the pathologically complex type, and only 14.29% for the refractory type. CONCLUSIONS:The closure rate of CWST may vary by classification and may be favorable in most cases. However, a high proportion of patients with refractory wounds have a poor prognosis.

The objective of this study is to clarify whether the omental coating can effectively attenuate foreign body reaction (FBR) induced by implanted materials. Male Sprague-Dawley rats were injected with polydextran particle slurry intraperitoneally to activate the omentum. 7 days later, polyether polyurethane sponge discs were implanted subcutaneously on each side of the rat's back as the foreign implants to induce FBR. The next day, omental transposition were performed. The disc on the left side of each rat's back was wrapped with omental flap (omental group); the disc on the right side was untreated (control group). All discs were removed 21 days after implantation and assessed by determining the components of the fibrovascular tissue (angiogenesis, inflammation, foreign body giant cells (FBGCs) aggregation and fibrogenesis). In implants in omental group, micro vessel density (MVD), Hemoglobin (Hb) content and VEGF levels (pro-angiogenic cytokine) were increased when compared with implants from control group. Inflammatory parameters (IL-1β; macrophage accumulation-NAG activity; neutrophil accumulation- MPO levels) were decreased in implants after omental coating. Also, collagen deposition, fibrous capsule thickness, and FBGCs decreased in implants from omental group. However, intra-implant levels of TNF-α and TGF-β1 were not different after omental coating. Our findings showed for the first time that the omental coating around the implants attenuate the adverse FBR, it may be critical in developing new strategies to control FBR and improve the function and performance of the implanted materials.

During acute wound (AW) healing, a series of proper communications will occur between different epidermal cells at precise temporal stages to restore the integrity of the skin. However, it is still unclear what variation happened in epidermal cell interaction in the chronic wound environment. To provide new insights into chronic wound healing, we reconstructed the variations in the epidermal cell-cell communication network that occur in chronic wound healing via single-cell RNA-seq (scRNA-seq) data analysis. We found that the intricate cellular and molecular interactions increased in pressure ulcer (PU) compared to AW, especially the PARs signaling pathways were significantly upregulated. It shows that the PARs signaling pathways’ main source was melanocytes and the CTSG-F2RL1 ligand-receptor pairs were its main contributor. Cathepsin G (CatG or CTSG) is a serine protease mainly with trypsin- and chymotrypsin-like specificity. It is synthesized and secreted by some immune or non-immune cells. Whereas, it has not been reported that melanocytes can synthesize and secrete the CTSG. F2R Like Trypsin Receptor 1 (F2RL1) is a member of proteinase-activated receptors (PARs) that are irreversibly activated by proteolytic cleavage and its stimulation can promote inflammation and inflammatory cell infiltration. In this study, we found that melanocytes increased in pressure ulcers, melanocytes can synthesize and secrete the CTSG and may promote inflammation in chronic wounds through CTSG-F2RL1 pairs, which may be a novel potential target and a therapeutic strategy in the treatment of chronic wounds.

近二十年来,随着疾病谱的改变,我国住院患者中创面形成的原因出现明显改变,呈现由创伤性创面转化为疾病性创面为主的特征.这种疾病性创面由于病因较多,发生机制各不相同;因此,需要建立一个专科以应对各类创面治疗的需求.为此,国家卫生健康委办公厅于2019年11月29日下达了《国家卫生健康委办公厅关于加强体表慢性难愈合创面(溃疡)诊疗管理工作的通知(国卫办医函[2019]865号)》,要求在有条件的医疗机构成立创面修复科.由于创面修复是一个新兴学科,在医学基本教育中缺少慢性创面发生机制和诊疗行为的相关内容;因此,国家卫生健康委主持编写了针对创面修复专业医护人员的教学大纲及系列教材,设置了多形式的教学模式,以提高专科医护人员诊疗能力,并对学科建设的各类配置提出了规范化标准,以期探索性地在我国建立一批在创面修复学科上能够代表国家水平的医疗团队和医疗机构.

Objective:To compare the anti-blocking performance between the new silicone rubber negative pressure drainage instillation system and traditional polyurethane negative pressure drainage system in vitro.Methods:An in vitro anti-blocking experiment was designed. Established an wound vacuum sealing drainage model in vitro and simulated the wound surface with PVC plates. Liquid 1 (0.9% saline), liquid 2 (raw egg white mixed evenly), liquid 3 (20 g egg white mixed in 200 ml of 100 ℃ water) and liquid 4 (liquid 2 and liquid 3 mixed in 1∶1) were used to simulate different exudates and necrotic tissues of the wound, and the blockage of the two groups of negative pressure materials after being irrigated by four kinds of liquids under negative pressure of -50 mmHg to -300 mmHg was detected.Results:The viscosities of liquid 1 to liquid 4 were (1.16±0.01) mPa.S, (4.27±0.01) mPa.S, (1.26±0.02) mPa.S, (3.26 ± 0.01) mPa.S. After the two negative pressure materials were irrigated with four kinds of liquids, they were both blocked, and the negative pressure was significantly reduced (P<0.05). In the liquid 1 group, under the conditions of -50 mmHg to -175 mmHg, there was no statistically significant difference in the blocking degree of the two kinds of negative pressure materials (P>0.05), but under the conditions of -200 mmHg to -300 mmHg, the blocking degree of the polyurethane negative pressure material was more serious than that of the anti-blocking negative pressure drainage tube with instillation (P<0.05). In the liquid 2-4 groups, the traditional polyurethane negative pressure material was significantly higher than the anti-blocking negative pressure drainage tube with instillation (P<0.05).Conluusion:The new silicone rubber negative pressure drainage instillation system invented and designed by our group has good anti-blocking effect and can be applied to wounds with thick exudate and nonviable tissue.

BackgroundThe small number of existing integrative studies on the global distribution and burden of all types of skin and subcutaneous diseases hinders relevant comparisons.ObjectiveThis study aimed to determine the latest distribution, epidemiological differences, and factors potentially influencing each skin and subcutaneous disease and the policy implications.MethodsData on the skin and subcutaneous diseases were obtained from the Global Burden of Disease Study 2019. The incidence, disability-adjusted life years (DALYs), and deaths due to skin and subcutaneous diseases in 204 countries and regions from 1990 to 2019 were analyzed and stratified by sex, age, geographical location, and sociodemographic index (SDI). The annual age-standardized rate of change in the incidence was obtained to evaluate temporal trends.ResultsOf 4,859,267,654 (95% uncertainty interval [UI], 4,680,693,440–5,060,498,767) new skin and subcutaneous disease cases that were identified, most were fungal (34.0%) and bacterial (23.0%) skin diseases, which accounted for 98,522 (95% UI 75,116–123,949) deaths. The burden of skin and subcutaneous diseases measured in DALYs was 42,883,695.48 (95%UI, 28,626,691.71-63,438,210.22) in 2019, 5.26% of which were years of life lost, and 94.74% of which were years lived with disability. The highest number of new cases and deaths from skin and subcutaneous diseases was in South Asia. Globally, most new cases were in the 0–4-year age group, with skin and subcutaneous disease incidence slightly higher in men than in women.ConclusionFungal infections are major contributors to skin and subcutaneous diseases worldwide. Low–middle SDI states had the highest burden of skin and subcutaneous diseases, and this burden has increased globally. Targeted and effective management strategies based on the distribution characteristics of each country are, thus, required to reduce the burden of skin and subcutaneous diseases.

Background Burns is a type of injury, caused by unintentional exposure to substances of high temperature, including hot liquid, solid, and objects radiating heat energy, placing a high burden not only on patients’ families but also on national healthcare systems globally. It is difficult for policymakers and clinicians to formulate targeted management strategies for burns because data on current epidemiological patterns worldwide are lacking. Methods Data on burns were obtained from the Global Burden of Disease (GBD) 2019 Study. The incidence, disability-adjusted life years (DALYs), and deaths of burns in 204 countries and regions from 1990 to 2019 were calculated and stratified by sex, age, geographical location, and sociodemographic index (SDI). The estimated annual percentage change (EAPC) of incidence, DALYs, and deaths was calculated to evaluate the temporal trends. All analyses were performed using R software, version 4.1.1, with 2-sided P -values < .05 indicating a statistically significant difference. Results A total of 8,378,122 new cases (95% UI, 6,531,887–10,363,109cases) of burns were identified globally in 2019, which is almost evenly split between men and women, and most of the new cases were concentrated in the 10–19-year age group. Besides, burns account for 111,292 deaths (95% UI, 132,392–88,188) globally in 2019, most of which were concentrated in those aged 1–4 years. The burden of burns measured in DALYs was 7,460,448.65 (95% UI, 5,794,505.89–9,478,717.81) in 2019, of which 67% and 33% could be attributed to YLLs and YLDs, respectively. The EAPC of incidence, DALYs, and deaths were negative, the age-standardized rate (ASR) of incidence, DALYs, and deaths were considered to be decreasing in most of the regions, and the EAPCs were negatively correlated with SDI levels, universal health coverage (UHC), and gross domestic product (GDP). Conclusion Globally, the age-standardized rates of burn incidence, DALYs, and mortality, as well as the number of burn DALYs and death cases will continuously decrease, but the number of new burn cases has an increasing tendency globally. In addition, the EAPCs of burns in incidence, DALYs, and deaths indicated that the burden of burns was considered to be decreasing in most of the regions. And from the relationship of EAPCs with SDI, UHC index, and GDP, indicate that prevention burns not only depend on health spending per capita but also depend on the education level per capita and healthcare system performance, but it does not mean higher health spending corresponds to higher UHC index, which needs high efficiency of translating health spending into individuals health gains.

Pressure ulcer (PU) is a type of chronic ulcer, placing a high burden not only on patients' families but also on national healthcare systems globally. To determine the level, trends, and burden of PU worldwide and to provide an essential foundation for building targeted public policies on PUs at the national, regional, and global levels, data on PU were obtained from the Global Burden of Disease (GBD) 2019 Study. The incidence, disability-adjusted life years (DALYs), and deaths of PUs in 204 countries and regions from 1990 to 2019 were calculated and stratified by sex, age, geographical location, and sociodemographic index (SDI). The estimated annual percentage change (EAPC) of incidence, DALYs, and deaths was calculated to evaluate the temporal trends. A total of 3,170,796 new cases (95% uncertainty interval (UI), 3,499,729-2,875,433 cases) of PU were identified globally in 2019, more than 55% of which were among male individuals, and most of the new cases were concentrated in those 75-90 years of age. The burden of PU measured in DALYs was 481 423 (95% UI, 583 429-374 334) in 2019, 73% and 27% of which could be attributed to years of life lost (YLLs) and years lived with disability (YLDs), respectively. The burden increased gradually from 1990 to 2019 (from 267 846 [360 562-211 024] to 481 423 [95% UI, 583 429-374 334]). A total of 24 389 deaths were attributed to PU (95% UI, 31 260.82-17 299). The EAPC of incidence, DALYs, and deaths were negative in most regions, the age-standardized rate (ASR) of incidence, DALYs, and deaths were considered to be decreasing in most of the regions, and the EAPCs were negatively correlated with the SDI levels, universal health coverage (UHC), and gross domestic product (GDP), which shows that the ASRs of PU decreased as the economy developed and countries' healthcare system performances improved.

Background Wound healing is a complex, highly regulated process that is critical for restoring the anatomic and functional integrity of the skin after injury, which requires the interaction of various cell types. During acute wound healing, epidermal cells will activate at precise temporal stages, and proper communication will occur between different cells and will restore the skin integrity eventually. However, why the chronic wounds stagnate in an undefined non-healing state and how the epidermal cells interact with each other in the chronic wound environment is still unclear. To provide new insights into chronic wound healing, we reconstructed the variations in the epidermal cell-cell communication network that occur in chronic wound healing via single-cell RNA-seq (scRNA-seq) data analysis. Methods We used the count matrix of scRNA-seq data to create a Seurat object with the R package “Seurat” which was analyzed using default parameters. GO analysis was performed for the differentially expressed genes with Enrichr by R package “Cluster Profiler”. Then we created a CellChat object with the R package “CellChat” from Seurat and reconstructed the cell-cell autocrine and paracrine signaling interactions through CellChatDB. Results Six cell types are annotated in each wound type and through comparing the acute and chronic wounds we found that cellular and molecular interactions of epidermal cells are enhanced in chronic wounds. Especially, the PTN and PAR signaling pathways were significantly changed in chronic wounds. Then we found the melanocyte cell population was the dominant sender of PTN and PAR signaling pathways and the most contributing ligand-receptor pairs of the PTN and PAR signaling pathways were PTN-SDC1 and CTSG-F2RL1 respectively. Conclusions In this study, we used CellChat to reconstruct the epidermal cell-cell autocrine and paracrine signaling networks and try to understand the underlying molecular and physiological perturbations in non-healing wounds. we speculate that melanocytes may play a key role in skin regeneration, and that the absence of the PTN pathway and increasing PAR signaling pathways may disrupt the healing in chronic wounds. In addition, we identified that CTSG and PTN may respectively be a novel potential target and a therapeutic strategy in the treatment of chronic wounds.

OBJECTIVE:To further examine the feasibility of using pigs as an animal model for the study of dermal fibroblast heterogeneity and to explore the proliferative capacity of dermal fibroblasts from different layers of pig skin in vitro and in vivo.MATERIAL AND METHODS:Cultured superficial and deep dermal fibroblasts were subjected to cell growth assay, cell cycle analysis, immunocytochemical staining and western blotting for proliferating cell nuclear antigens. Moreover, skin samples autografted with superficial/deep dermal fibroblasts were subjected to immunohistochemical staining and western blotting for proliferating cell nuclear antigen.RESULTS:The cell growth assay showed that the growth curve of the superficial dermal fibroblast was progressively higher than that of the deep layer. The cell cycle analysis showed that the (G2+S) percentage of the superficial dermal fibroblasts was significantly higher than that of the deep layer fibroblasts. The immunocytochemical staining and western blotting showed that the expression of proliferating cell nuclear antigen in the cultured superficial dermal fibroblast was significantly higher than that of the deep layer cells. The immunohistochemical staining showed that the positive rate of proliferating cell nuclear antigen in the skin samples autografted with the superficial dermal fibroblast was significantly higher than that of the deep layer.CONCLUSIONS:This study has demonstrated that similar to human dermal fibroblasts, dermal fibroblasts from different layers of pig skin exhibit distinct proliferative capacity, which increases the feasibility of using pigs as an animal model for future studies on the heterogeneity of dermal fibroblasts.

Skin erosion is a common skin-related complication in patients underwent deep brain stimulation. Traditionally, treatment of these skin-related complications has required removal of the entire deep brain stimulation system, which may cause considerable consequences. We aimed to evaluate the efficacy and safety of pedicled omental transposition in the treatment of recurrent skin erosion following deep brain stimulation. This study was conducted on patients with recurrent skin erosion following deep brain stimulation, between August 2019 and August 2021 at Shanghai Ruijin Hospital. The patients were grouped into the pedicled omental transposition group (OT group) and the routine group based on the surgical methods, for comparison of surgical outcomes. The study included 9 patients (5 in the OT group and 4 in the routine group). Four patients in the OT group were asymptomatic throughout 6–11 months of follow-up. All 4 patients in the routine group received hardware removal because of severe wound re-erosion within 4 months after discharge. The OT group exhibited significantly lower recurrence and explanation rates at 6 months after discharge ( p < 0.05). No adverse events were observed. Our study showed that recurrent skin erosion following deep brain stimulation can be effectively and safely treated with pedicled omental transposition. This whole new surgical method may offer the neurosurgical community a last solution for saving deep brain stimulation systems in patients with skin erosions.

The sinus tract of the ischial tuberosity is often caused by pressure injury. It has the characteristics of difficult treatment and high cost, which increases the anxiety of patients and reduces the quality of life of patients. This case report is to describe an effective method to treat sinus wound at the ischial tuberosity. A 53-year-old male suffered pressure ulcer with sinus wound at the left ischial tuberosity due to inadequate walking and sedentary activity. On the basis of pressure relief and immobilization, the patient was treated with CO2 laser debridement and negative pressure wound therapy under endoscope support 3 times, the deep of the sinus wound was completely closed, and then the residual superficial wound was treated by skin grafting. Follow-up of 1 year after healing showed no recurrence of wound.

OBJECTIVE Regular retrospective analysis is necessary for potential improvement in clinical practice for the treatment of hard-to-heal wounds. Comorbidities and outcomes have demonstrated spatial and temporal diversity, emphasising the importance of updates in epidemiology. The complexity of healing hard-to-heal wounds has long been known, and so we sought evidence-based improvement on the current principles of treatment. METHOD Demographic and clinical information of patients from the WoundCareLog database was collected. Patients who met the inclusion criteria and completed follow-up after treatment were included. Comorbidities were diagnosed and classified into eight categories based on ICD-10. We compared the demographic and aetiological characteristics between patients with and without comorbidities by t-test and Chi-squared test. The impact of comorbidities on wound healing were evaluated with a multivariate Cox model. RESULTS A total of 2163 patients met the inclusion criteria and were enrolled, of whom 37.0% were aged 61-80 years, 36.0% were aged 41-60 years and 60.8% were male. The lower extremities and buttocks were the most commonly affected areas with hard-to-heal wounds. Non-traumatic wounds accounted for 66.6% of cases, and infection, pressure and diabetes were the most common causes. Paralysis and diabetes were the most important factors which led to a prolonged healing process and inferior clinical outcomes. CONCLUSION Comorbidities of hard-to-heal wounds were treated as separate contributors and their weighted effect on outcome was calculated through correlation analysis. Paralysis and diabetes were the most unfavourable comorbidities affecting the treatment of non-traumatic hard-to-heal wounds. Our study highlighted the priority of comorbidity treatment through data-driven approaches. It provides potential value in developing better public health strategies and preventive medicine.

The purpose of our study is to predict the occurrence and prognosis of diabetic foot ulcers (DFUs) by clinical and lower extremity computed tomography angiography (CTA) data of patients using the artificial neural networks (ANN) model. DFU is a common complication of diabetes that severely affects the quality of life of patients, leading to amputation and even death. There are a lack of valid predictive techniques for the prognosis of DFU. In clinical practice, the use of scales alone has a large subjective component, leading to significant bias and heterogeneity. Currently, there is a lack of evidence-based support for patients to develop clinical strategies before reaching end-stage outcomes. The present study provides a novel technical tool for predicting the prognosis of DFU. After screening the data, 203 patients with diabetic foot ulcers (DFUs) were analyzed and divided into two subgroups based on their Wagner Score (138 patients in the low Wagner Score group and 65 patients in the high Wagner Score group). Based on clinical and lower extremity CTA data, 10 predictive factors were selected for inclusion in the model. The total dataset was randomly divided into the training sample, testing sample and holdout sample in ratio of 3:1:1. After the training sample and testing sample developing the ANN model, the holdout sample was utilized to assess the accuracy of the model. ANN model analysis shows that the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and area under the curve (AUC) of the overall ANN model were 92.3%, 93.5%, 87.0%, 94.2% and 0.955, respectively. We observed that the proposed model performed superbly on the prediction of DFU with a 91.6% accuracy. Evaluated with the holdout sample, the model accuracy, sensitivity, specificity, PPV and NPV were 88.9%, 90.0%, 88.5%, 75.0% and 95.8%, respectively. By contrast, the logistic regression model was inferior to the ANN model. The ANN model can accurately and reliably predict the occurrence and prognosis of a DFU according to clinical and lower extremity CTA data. We provided clinicians with a novel technical tool to develop clinical strategies before end-stage outcomes.

目的·开发用于烧伤急救的、可快速降低皮肤温度并且对皮肤组织无刺激性的医疗用品——制冷喷雾剂和聚合物水凝胶.验证联合应用两者是否可快速阻断热源对皮肤组织的持续伤害,是否有利于创面的早期修复及降低烧伤创面的面积及深度.方法·将制冷液灌入高压罐中,评估制冷喷雾剂的制冷效果;制备水凝胶敷料,评估敷料的制冷时长;评估在大鼠背部皮肤连续使用制冷喷雾剂和水凝胶72 h后,对皮肤组织的刺激作用;建立大鼠烫伤模型,随机分为2组,每组6只,采用背部皮肤组织互相对比的方法,在烫伤区域使用制冷喷雾剂和水凝胶联合处理创面,分别与无处理组和自来水处理组做比较,24 h后评估烫伤部位的面积和创面炎症反应情况.结果·与普通自来水相比,15％浓度的制冷喷雾剂的制冷效果最好,在3min内,降温速度明显高于自来水对照组(P＜0.05);水凝胶的冷却效果可维持8 h,可以在2h内将70aC水的温度降至室温(22±2)℃,且水温全程低于对照组;2种材料对皮肤组织均无刺激性作用,未导致皮肤组织红斑、水肿等过敏反应.经制冷喷雾剂和水凝胶联合处理的烧伤创面,其焦痂面积显著减少,与无处理组及自来水处理组相比,均有统计学差异(P＜0.05);H-E染色显示,与无处理组及自来水组相比较,联合应用制冷喷雾剂和水凝胶组的创面中,炎症细胞浸润的数量显著减少(P＜0.05).结论·制冷喷雾剂与聚合物水凝胶联合应用显示出良好的冷却效率,可减少焦痂面积、防止创面的不断加深及炎症细胞的聚集,有利于后期创面尽快愈合,且不会造成皮肤组织的过敏反应,可以作为烧伤患者急救管理的一种有效和方便的工具.

Nephrocutaneous fistula (NCF) is a rare and severe complication of renal disease and surgical procedures. Treatments for NCF are based on the renal function, and can include nephrectomy, heminephrectomy, nephroureterectomy, endourological maneuvers or antibiotic therapy alone. Here we report a case of a chronic NCF which occurred 5 years after partial nephrectomy. In this report, we describe a new surgical approach for the management of a patient with postoperative NCF. In the present case, in addition to removing the fistulous tract, we also performed an omental flap grafting to tightly cover the kidney. In addition to limiting and controlling the local inflammation, the omental flap prevents contact between the kidney and the flank muscle on its posterior rim. No recurrence or complications occurred throughout 10 months of follow-up. The NCF was successfully treated with completely removal of the sinus tract and omental flap grafting, without nephrectomy. This case adds new aspects to the treatment of NCF.

Background: To determine the distribution and antimicrobial susceptibility pattern of pathogenic bacteria in patients with chronic cutaneous wounds on a national scale. Methods: A retrospective study was conducted using the data recorded between January 1, 2018 and January1, 2020 in 195 hospitals across China. After screening the data, 815 patients with chronic wounds were finally analyzed. The data collected included information about the patients' general condition and local cutaneous wound assessments, especially microbial culture and antibiotic susceptibility tests. The analyses were performed using SPSS Version 26. Results: The study included 815 patients (290 [35.6%] females; 63 [50–74] years). The most common causes of chronic cutaneous wounds were diabetes (183, 22.5%), infection (178, 21.8%), and pressure (140, 17.2%). Among these, 521(63.9%) samples tested yielded microbial growth, including 70 (13.4%) polymicrobial infection and 451 (86.6%) monomicrobial infection. The positive rate of microbial culture was highest in wound tissue of ulcers caused by infection (87.6%), followed by pressure (77.1%), diabetes (68.3%), and venous diseases (67.7%). Bates-Jensen wound assessment tool (BWAT) scores >25 and wounds that lasted for more than 3 months had a higher positive rate of microbial culture. BWAT scores >25 and wounds in the rump, perineum, and feet were more likely to exhibit polymicrobial infection. A total of 600 strains were isolated, of which 46.2% (277 strains) were Gram-positive bacteria, 51.3% (308 strains) were Gram-negative bacteria, and 2.5% (15 strains) were fungi. The most common bacterial isolates were Staphylococcus aureus (29.2%), Escherichia coli (11.5%), Pseudomonas aeruginosa (11.0%), Proteus mirabilis (8.0%), and Klebsiella pneumoniae (5.8%). The susceptibility tests showed that 116 cultured bacteria were Multidrug resistant (MDR) strains. The resistance rates of S. aureus were 92.0% (161/175) to penicillin, 58.3% (102/175) to erythromycin, and 50.9% (89/175) to clindamycin. Vancomycin was the most effective antibiotic (0% resistance rate) against all Gram-positive bacteria. Besides, the resistance rates of E. coli were 68.1% (47/69) to ampicillin, 68.1% (47/69) to ciprofloxacin, 60.9% (42/69) to levofloxacin. However, all the isolated Gram-negative bacteria showed low resistance rates to tigecycline (3.9%) and amikacin (3.6%). Conclusions: The distribution of bacteria isolated from chronic cutaneous wounds varies with the BWAT scores, causes, duration, and the location of wounds. Multidrug resistance is a serious health issue, and therefore antibiotics used in chronic wounds must be under strict regulation. Our findings may help clinicians in making informed decisions regarding antibiotic therapy.