Aim To evaluate an evidence-based pathway of care for people with venous leg ulcers (VLUs) which covered assessment, management and referrals incorporating a venous leg ulcer risk assessment (VLURA) tool for early detection of those at risk of delayed venous leg ulcer healing in general practice.

Method A pilot quasi-experimental design with pre- and post-intervention measures. This included pre and post health professional surveys along with pre and post lower limb surveys of people with VLUs attending two general practice clinics.

Results The trend was that at both the intervention and non-intervention sites, staff reported increases in levels of confidence in identifying, assessing, managing, and implementing evidence based VLU prevention strategies, management and use of clinical pathways for assessment of VLUs. Documentation improved at both sites although client education, peri-wound care and pain management showed little improvement.

Conclusion Results from this pilot study concluded that a pathway of care, incorporating a risk assessment tool for early detection of those at risk of delayed healing, could provide benefits to the health organisation, health care professional staff and people with VLUs, although no significant results could be determined due to a small sample size. A larger study is warranted to further explore the impact of this pathway of care.

Verrucous squamous cell carcinoma is a variant of a cutaneous squamous cell carcinoma. The most common anatomical location for the lesion is the soles of the feet, particularly over previous amputated sites, oropharynx and genitalia. The lesions slowly increase in size taking on a wart-like appearance. There is local invasion of the soft tissue, bony involvement is rare and the lesions rarely metastases. The reported incidence is most commonly in Caucasian males, in their sixth to seventh decade. Human papilloma virus and abnormal expression of the p53 tumor suppressor protein are a potential cause for the pathogenesis. It is often diagnosed as verrucous hyperplasia resulting in a delay in appropriate treatment. Our case report highlights the complexity of managing patients with a high-risk foot. This gentleman had previous minor amputations, life-threatening infections including a disseminated multisite methicillin-susceptible Staphylococcus aureus (MSSA) bacteremia requiring intensive care support, and five burrhole procedures for drainage of an intercranial abscess. The verrucous carcinoma developed over a previous amputation site. There was a delay in appropriate biopsy and treatment. This case was unique in our clinical setting, as it was the first time we have seen a case of a verrucous squamous cell carcinoma. This case may increase awareness of usual pathogenies for non-healing wounds within the high-risk foot setting.

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.

Aim Hypertrophic scars occur due to overactivity of fibroblasts, leading to increased collagen deposition and the formation of new blood vessels. Existing therapies have limitations, underscoring the need for alternative options. Pimecrolimus, a calcineurin inhibitor, exhibits immunomodulatory effects; however, its influence on hypertrophic scars remains unclear.

Methods This study explored the impact of pimecrolimus on scar development in vivo. We used 10 female New Zealand rabbits. Round full-thickness dermal wounds were created on each ear. Pimecrolimus 1% cream was applied to the wounds on the left ear, while the right ear received a placebo (Vaseline), applied daily for six weeks. Scar diameter (mm) was measured weekly using calipers. At the conclusion of the study, histopathological assessment was conducted to evaluate fibroblast density, vascularisation and collagen deposition.

Results Scar diameter decreased progressively in both groups, with a significantly greater reduction observed in the Pimecrolimus-treated group by week 6 (p<0.05). Histological analysis also indicated significant reductions in fibroblast density (p<0.01), vascularisation (p<0.001), and collagen deposition (p<0.05) in the pimecrolimus group relative to controls.

Conclusion Pimecrolimus reduced hypertrophic scar formation, presumably by influencing fibroblast proliferation, angiogenesis and collagen remodeling. Further trials are necessary to validate its therapeutic potential as a non-invasive treatment for hypertrophic scars.

Aim To investigate the impact of nutritional factors on chronic wound care and explore the challenges and potential benefits of integrating nutritional interventions into wound management.

Methods This review investigates the influence of macronutrients, micronutrients, and hydration on chronic wound care, evaluating the impact of malnutrition on wound healing and the efficacy of nutritional interventions. A comprehensive literature search was conducted in PubMed, Scopus, and Web of Science using keywords pertinent to nutrition and chronic wound care. Studies published in English from 2010 onwards were prioritised, with earlier landmark studies considered when relevant.

Results Nutritional assessment tools are crucial for identifying deficiencies in patients with chronic wounds. Multi-nutrient oral formulations enriched with protein, arginine, zinc, and antioxidants, along with vitamin C and D supplements, have demonstrated efficacy in enhancing wound healing outcomes. The benefits include reduced healing times, decreased ulcer size, and increased closure rates. However, implementation faces challenges related to systemic barriers, resource constraints and patient adherence.

Conclusion Addressing implementation challenges requires strategies. Future research should focus on developing personalised nutritional strategies for individuals with chronic wounds. Integrating evidence-based nutritional interventions into wound care protocols can significantly improve healing outcomes, reduce healthcare costs and enhance patients’ quality of life.

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.

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.

Wound management is an integral component of healthcare professionals’ practice. Incorporating artificial intelligence into healthcare professionals’ bedside practice will revolutionise wound care management approaches. Artificial intelligence is rapidly being tested and integrated inconsistently across health services globally, with healthcare professionals and policymakers struggling to keep pace with the evolving clinical environment in wound care. This protocol outlines the steps of a scoping review that aims to synthesise available data on healthcare professionals’ experiences of the barriers and enablers to artificial intelligence-assisted wound management. Data charting will focus on wound assessment, diagnosis, and management plans in various care settings, and healthcare professionals’ awareness of clinical practice guidelines and policies. Searches will be conducted in Scopus, Ovid MEDLINE, Embase, CINAHL Complete, PubMed, Web of Science, ProQuest, Connected Papers, Google Scholar, and Google Advanced for relevant studies. The Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist will be referred to throughout the review’s development. Selected articles matching the inclusion criteria will be evaluated using the appropriate quality and critical appraisal tools. This scoping review will be informed by the Theoretical Domains Framework. The identified barriers and enablers will be mapped to the framework’s constructs and domains.

Age-related changes in skin barrier integrity increase vulnerability to skin damage and breakdown, often leading to conditions such as xerosis, marked by excessive dryness and itching/pruritus, and chronic wounds like venous leg ulcers (VLUs), which are characterised by compromised periwound skin and delayed healing. Regular use of moisturising creams, especially those containing ceramides as a dominant ingredient can help support and restore skin barrier integrity. While scientific evidence is limited regarding the role of ceramide-dominant moisturisers in supporting an optimal microenvironment for wound healing, a recent case study involving an 88-year-old woman who presented with a VLU on her left lower leg, exhibiting extensive slough, inflamed wound margins, maceration and significant periwound skin breakdown extending beyond the wound edge, demonstrated successful wound healing. Initial wound care further compromised the periwound skin, leaving it dry, fragile and vulnerable. Introduction of a ceramide-dominant moisturising cream applied adjunctively to the periwound area over a four-week period resulted in noticeable improvement in protecting the dry and fragile periwound skin by maintaining a favourable microenvironment for efficient wound healing. However, further research is needed to clarify the benefits of ceramide-dominant moisturisers in wound and periwound skincare.