This literature review assesses the most recent data to summarise the emerging potential uses, benefits and risks of pulsed electromagnetic field therapy (PEMF) in wound healing. Electromagnetic fields have mainly been used as an adjunct therapy for osteoarthritis and other diseases involving joints. However, PEMF has also been shown to influence various signalling molecules involved in wound healing, including MMP‑2, IL‑6 and TGF‑β. Therefore, studies have begun to explore the use of PEMF in other diseases, such as incision wound repair, diabetes-related foot ulcers (DFU) and pressure ulcers. However, the cellular response to PEMF is highly variable and likely influenced by multiple factors – frequency, duration, tissue type, stage of wound repair and field strength. This high degree of variability may explain why PEMF seems to promote cell proliferation under certain conditions and inhibit cell growth with different parameters. This review highlights the need for further research to determine precisely how different variables influence PEMF therapy. Before PEMF can be implemented widely in clinical practice, this review provides a starting point for further controlled trials. This review might also provide a solid base to propose standardised experimental guidelines to investigate PEMF efficacy in wound healing, ulcer treatment and type 2 diabetes.

Background Adequate nutrition is essential for individuals with diabetes and wounds to optimise both wound healing and blood glucose control. Previous systematic reviews have evaluated the effectiveness of nutrition supplementation for wound healing in individuals with diabetes. However, none have reported comprehensively on the range of dietary interventions utilised in this population, despite these being common within clinical practice. Therefore, the aim of this systematic review is firstly to evaluate the effectiveness of dietary interventions for wound prevention and management in people with diabetes, and secondly to describe intervention characteristics.

Methods Using PRISMA-P to guide the review, five databases will be searched for intervention studies (Medline, Embase, CINAHL, Scopus, Cochrane Library) as well as clinical trials registries. The Rob‑2 and ROBINS tools will assess risk of bias. Studies will be described narratively, and a meta-analysis conducted if adequate levels of homogeneity exist between included studies and outcome variables, including study types, and characteristics of the sample including sample size. An appropriate model will be chosen to undertake meta-analysis.

Discussion The systematic review results will inform clinicians on the most effective dietary interventions to optimise wound healing in individuals with diabetes. Study results will inform design and conduct of future nutrition interventions in wound healing.

Background During the past few decades, wound healing has gained major attention. The management of wounds depends on various factors; as such, healing poses numerous challenges. The available treatment approaches for wound healing generally include the use of anti-infective agents. The use of traditional medicines for various pathologies is increasing gradually and its use in the management of wounds is not exceptional.

Aim The present study is carried out to investigate the wound healing activity of Ashwagandha (Withania somnifera (L.) Dunal) leaves in the form of paste and gel in excision and incision wound models on Wistar strain albino rats.

Methods The wound healing effect was assessed considering the percentage of wound closure and epithelialisation period in the excision wound model, while the tensile strength of the healed wounds was assessed through the incision wound model. Excision and incision wounds were inflicted on the dorsal surface of Wistar albino rats by following standard protocols.

Result and conclusion Ashwagandha in both the forms shows a significant increase in percentage wound contraction, reduction in the period of epithelialisation, and increase in tensile strength of skin when compared with the normal control group. The results are encouraging and wider studies may be conceptualised to evaluate the efficacy in different wound models.

Background Insufficient wound care knowledge in nursing students affects confidence and competence. Scarce research on wound care content and delivery leads to curriculum disparities. Integrating essential content is vital for improved wound care education.

Aims This study aimed to determine Australian wound care curriculum content for a 3-year Bachelor of Nursing program and identify the optimal year for introducing each topic, as recognised by experts.

Methodology A three-round Delphi survey involved 17 wound care experts in Australia. The survey used the Standards for wound prevention and management to identify 74 wound care topics within the three categories of anatomy and physiology (A & P), assessment and treatment/therapies, requiring >70% agreement on the year of introduction for each topic.

Results The Delphi process established consensus on the initial introduction year for 65 of the 74 wound care topics. A total of 19 topics garnered consensus exceeding 70% in the first year, 19 in the second year, 15 in the third year, and 12 for postgraduate study. Expert consensus enabled a progressive development of knowledge and skills in wound theory, assessment, care planning, patient education and prevention over the 3-year program.

Conclusion The gathering of this data has allowed for conceptual scaffolding of these topics according to the stage at which wound care topics are recommended for introduction into nursing curricula.

Aim Diabetes is associated with cognitive changes; however, it is unclear whether cognitive changes differ between those with diabetes-related foot ulcers (DFUs), or those with only diabetes-related lower extremity complications (DRLECs) that are risk factors for DFUs. Therefore, it is hypothesised that cognitive changes in people with diabetes are further influenced by the presence of DFU or DRLECs. Hence, this study aims to investigate cognition in people with a DFU compared to those with DRLECs. Secondary aims include investigating cognition over time in people with DFUs, and in those with DFUs who do and don’t heal.

Methods A case control study nested in a longitudinal study will recruit 136 participants – 68 with type 2 diabetes with DFUs (cases) and 68 with DRLECs (controls). Global cognition will be measured using the Montreal Cognitive Assessment test. The 68 cases will be followed up for 12 weeks to investigate cognition outcomes as well as to determine DFU healing.

Results The findings of this study will provide new evidence on whether cognition is further influenced by the presence of a DFU or by other DRLECs.

Conclusion These findings may be important to early detect cognitive changes in people with type 2 diabetes with DFUs or DRLECs.

Obesity rates in nursing homes (NHs) are increasing. Residents with obesity are at risk for poor outcomes such as pressure injuries (PIs) due to special care needs such as bariatric medical equipment and special protocols for skin care. PIs among resident populations is a sign of poor quality NH care. The purpose of this retrospective observational study was to identify characteristics of NHs with high rates of stage 2–4 PIs among their high-risk residents with obesity. Resident assessment data were aggregated to the NH level. NH structure and process of care and antecedent conditions of the residents and environment measures were used in bivariate comparisons and multivariate logistic regression models to identify associations with NHs having high rates of stage 2–4 PIs among high-risk residents with obesity. We identified three characteristics for which the effect on the odds was at least 10% for clinical significance – for-profit status, large facilities, and the hours of certified nursing assistants (CNAs) per patient day (HRPPD). This study identified several NH characteristics that are associated with higher risk for PIs, which can be targeted with evidence-based interventions to reduce the risk of these adverse safety events occurring.

Aim To determine the quality of life (QoL) of clients with venous leg ulcers (VLU) treated in the community and investigate if age-related frailty or disability posed an additional impact on QoL.

Methods Clients with VLUs receiving wound care on 7 November 2019 from a community nursing service in Perth, Western Australia were invited to participate. Data was collected from an electronic management system on client demographics, comorbidities, key assessments and wound outcomes. A nurse-administered survey was used to collect data on clients’ current health status and VLU health experience, frailty via the FiND (Frail Non-Disabled tool), and QoL via the Wound-QoL tool.

Results There were 262 clients with VLUs who were invited to participate; 253 were considered eligible and 244 eligible clients completed the survey (96.4%). Common client comorbidities included obesity (48.9%), heart disease (34.5%), diabetes (24.2%), history of deep vein thrombosis (DVT) (19.7%) and varicose veins (44.7%), and 30% had their ulcer for ≥12 months. All but five clients (98%) reported the VLU had impacted their QoL. A total of 54% were classified as ‘disabled’ and 23.7% as ‘frail’. Independent predictors of poor QoL included a previous hospital admission, obesity and FiND classification of frail or disabled. Increasing age was protective of poor QoL.

Conclusion Almost all VLU clients reported an impact on their QoL. They also demonstrated high levels of frailty and had significant comorbidities. Interventions to improve QoL for these clients must be considered.