Wound Practice and Research

Aboriginal and Torres Strait Islander people face persistent health disparities that arise from structured marginalisation and prejudice as a result of dispossession and genocide promoted by colonisation. The significantly increased prevalence of chronic diseases, particularly diabetes mellitus (DM) and cardiovascular disease (CVD) among Aboriginal and Torres Strait Islander peoples, is a major contributor to the development of chronic wounds and related complications, including amputations and premature mortality. In Australia, Aboriginal and Torres Strait Islander people face a 5–6 times higher risk of developing chronic wounds and a 32.5 times higher risk of suffering an amputation compared to non-Indigenous Australians, revealing a disproportionate burden. Inequalities in social determinants of health, including inadequate nutrition, transgenerational trauma and varied healthcare systemic barriers, contribute to the perpetuation of health disparities. This review highlights recently reported data on the risk of chronic wound development in Aboriginal and Torres Strait Islander peoples and correlated factors, emphasising the critical need for targeted research into chronic wound management, comprehensive data collection, and tailored healthcare to unique social, cultural and geographical contexts, as efforts to mitigate the current disparities in health in relation to wound care.

Diabetic foot ulcers (DFUs) are serious diabetes complications that may lead to amputation if not properly managed. In West Sulawesi, the Mandar ethnic community continues to use traditional medicine for DFU treatment.

Objective This study explores local knowledge and traditional practices in DFU management among the Mandar ethnic group in West Sulawesi, Indonesia.

Methods A descriptive qualitative design with a phenomenological approach was applied. Eighteen participants with DFU experience who had used traditional treatments were recruited purposively. Data were collected through semi-structured online interviews and analysed thematically using MaxQDA. Relational patterns among ingredients, outcomes, and information sources were visualised using Gephi.

Results Turmeric was the most frequently used ingredient, followed by honey, guava leaves, coconut oil and castor leaves. Most materials were applied in raw, unstandardised forms. Some participants experienced positive early effects, while others reported worsening symptoms. Information was primarily transmitted through families and traditional figures. The network map revealed strong cultural and spiritual influences on treatment decisions.

Conclusion Traditional DFU care displays empirical understanding and cultural values, but its unregulated use poses scientific risks, highlighting the want for evidence-based, culturally-sensitive healthcare integration.

Aims To compare the effectiveness of distilled water (aquadest) and 0.9% sodium chloride (NaCl) in promoting wound healing, based on wound diameter, re-epithelialisation, granulation formation, neovascularisation and inflammatory response.

Methods An in vivo experimental study was conducted using 27 male Wistar rats (Rattus norvegicus), randomly assigned into three groups (control, aquadest, and NaCl). Full-thickness wounds were created on the dorsum of each rat and treated daily for 14 days. On days 2, 7 and 14, the wounds were assessed macroscopically and histologically, quantitively and semi-qualitatively. Statistical analysis included Friedman and Wilcoxon tests, along with effect size calculations (Cohen’s d and 95% confidence intervals).

Results Aquadest significantly improved reepithelialisation (p=0.018), granulation tissue formation (p=0.022), and reduced inflammation (p= 0.039) compared to baseline. NaCl did not demonstrate statistically significant improvements across any parameter. Although wound diameter reduction in the aquadest group was not statistically significant (p=0.117), it showed a moderate-to-large effect size (d=0.78), with qualitative analysis showing the reduction of inflammatory cells and increase of neovascular count and epithelial thickness (p=0.040).

Conclusions Distilled water showed superior performance to 0.9% NaCl in supporting multiple aspects of wound healing in a rat model.

Summary of aims In the quest for restorative healing and a better quality of life, the ancient wisdom of herbal remedies is emerging as a beacon of hope for effective wound management.This study investigated the wound-healing capabilities of a novel gel combining propolis resin (PR) and green tea (GRT) extract, seeking a natural alternative for wound care. Methods: The PR+GRT gel was formulated and tested for sensory attributes and stability through various methods. Its efficacy was then compared in vivo against a positive control (CICALFATE^™) and negative controls (sodium chloride and base gel). On day 9 post-wounding, histopathological analyses were conducted using Hematoxylin and Eosin (H&E) and trichrome staining to evaluate tissue regeneration and collagen deposition.

Results: The PR+GRT gel possessed favorable sensory characteristics and stability. Significantly, it improved wound healing compared to negative controls and performed comparably to CICALFATE^™. Histopathological examination highlighted significant differences between treatment groups, particularly in membranous nephropathy, where PR+GRT and CICALFATE^™ outperformed the controls.

Conclusions: the PR+GRT gel holds promise as a wound-healing agent, demonstrating effectiveness on par with CICALFATE^™. Further research is recommended to explore its synergistic potential and refine histological evaluations for more quantitative analysis. Study limitations include small sample sizes and qualitative histopathological assessments.

Aboriginal and Torres Straight Islanders are at an increased risk of developing diabetic foot complications including ulceration, infection and amputation with a three-to-six-fold increase when compared with non-Indigenous Australians. With limited health services available in regional areas, this problem is exacerbated. The case reports follow the journey of two Aboriginal patients from remote Western Australia who develop diabetic foot complications requiring transfer from their remote communities to receive treatment in a tertiary metropolitan hospital by the Multidisciplinary Foot Ulcer service. There are many challenges faced by wound management clinicians when caring for this population with diabetic foot complications including late presentation to receive care; lack of resources and staff experienced in the management of the high-risk foot; and obstacles of treating a patient via a telehealth service in rural and remote areas. The aim of the case studies is to highlight the challenges faced by wound management clinicians in the management of rural and remote Aboriginal patients with diabetic foot complications while striving to deliver culturally safe and holistic care.