High-arched feet affect approximately 10%-15% of the general population. Although the relationship between plantar pressure and bilateral symmetry is well studied, there is limited evidence regarding the use of Symmetry Index and pressure platforms. The objective of the study is to compare dynamic foot pressures and Symmetry Index during gait between subjects with Pes Cavus and subjects with normal feet. The analysis of asymmetric pressure patterns could benefit from studies that compare dynamic foot pressures and Symmetry Index values in subjects with high-arched feet and normal feet. This analysis can promote better clinical understanding of gait alterations and help solve biomechanical problems that may lead to pathologies, as well as prevent and treat them. A descriptive case-control study was developed from October to December 2024 with 82 participants, 41 with Pes Cavus and 41 normal feet and 71 females of 25.52 ± 5.99 years through a consecutive nonrandom technique. For this study, a baropodometry platform (Neo-Plate, Herbitas) was used, which acquired dynamic gait with a 2-step protocol. The inclusion criteria regarding the selection of subjects were age 18-65 years; if both cavus feet, Navicular Drop Test (NDT) < 9 mm; neutral feet and no lower limb problem or surgery. Regarding SI use, the PC demonstrated to have large asymmetries compared to the control group. Left anterior pressure was lower (44.93% ± 4.59% vs. 48.60% ± 3.43%, p = 0.014), left posterior pressure was higher (55.07% ± 4.58% vs. 51.40% ± 3.43%, p = 0.013) and the left Initial Contact Phase (ICP) was prolonged (123.34 ± 51.75 ms vs. 91.30 ± 31.86 ms, p = 0.036); right medial pressure was higher (58.18% ± 4.08% vs. 53.77% ± 4.79%, p = 0.034). SI measurements were greater in normal foot group than in the PC group with SI 94.15% ± 5.00% versus 93.75% ± 4.59%, p = 0.001, respectively; ICP and lateral SI were both p = 0.001. Findings confirmed that subjects with cavus feet tend to present greater alterations in bilateral symmetry, specifically posteromedial pressure movements and altered gait phases, which are indicative of more probability of future injuries. For this reason, pressure platforms are excellent tools for understanding, analysing and therefore applying the correct treatment according to the SI.

ABSTRACTPressure injuries are largely preventable yet remain common in hospital care. This multi‐hospital study assessed nurses' knowledge, attitudes and practices for prevention in governmental, private and charitable hospitals in Nablus, Palestine, and examined links with professional characteristics. A descriptive cross‐sectional study was conducted in six hospitals in Nablus city, Palestine. A total of 231 registered nurses were recruited using convenience sampling and completed a content‐validated, self‐administered questionnaire assessing demographics, knowledge (20 items), attitudes (11 items), and practices (17 items). Data were analysed using descriptive statistics, one‐way analysis of variance with Tukey post hoc tests, and binary logistic regression for adequate knowledge and practice (≥ 80%). Overall, 64.5% demonstrated adequate knowledge, and 58.0% expressed a favourable attitude. Practice adherence averaged 70.9 ± 16.3 out of 100. Only 31.6% achieved ≥ 80%, indicating suboptimal practice in most participants. Key gaps involved massage avoidance and the use of lifting devices. Knowledge was higher with recent PI training (1–2 years vs never: OR = 4.110, 95% CI 1.622–10.414, p = 0.003; 2–3 years vs never: OR = 3.047, 95% CI 1.208–7.687, p = 0.018). Practice adequacy was higher with training < 1 year ago vs never (OR = 4.146, 95% CI 1.636–10.512, p = 0.003). Other adjusted associations were imprecise and treated as exploratory. Nurses showed generally adequate knowledge, whereas routine preventive practice remained less consistent. Recent training was associated with better knowledge and practice, suggesting that targeted education, supervised skills training, unit‐level protocols and audit with feedback may support improvement.

Kidney transplant recipients are at increased risk of surgical site infections (SSIs) due to procedural complexity and immunosuppression. This retrospective single-centre study examines the influence of BMI on SSI risk and identifies common pathogens. A total of 230 renal transplant patients were included in this analysis2017 and 2019. All patients received a cephalosporin for prophylaxis, and wound swabs were taken from those who developed SSIs. SSIs occurred in 45 patients (19.6%) and were not significantly associated with age, sex or donor type. The most common organisms were coagulase-negative staphylococci (26.7%), Staphylococcus epidermidis (24.4%), Enterococcus faecalis (22.2%) and Candida albicans (22.2%). SSIs were significantly linked to surgical revision (p < 0.001) and higher BMI (p = 0.027). A BMI ≥ 28.1 was associated with threefold higher odds of SSIs (OR = 3.0; p = 0.001). Each one-unit increase in BMI was associated with a 7.2% increase in the odds of SSI occurrence (OR = 1.072; p = 0.020). Staphylococcus (p = 0.019) and Enterococcus (p = 0.048) infections were more common in patients with BMI > 28.1. Therefore, SSIs are a frequent complication posttransplant and are strongly associated with high BMI. Standard antibiotic regimens may not cover all relevant pathogens in obese patients, underscoring the need for tailored prophylactic strategies.

Chronic wounds cause a significant burden to affected patients and to society. Effective and objective diagnostic and monitoring methods are needed in wound care, and artificial intelligence offers one promising alternative. In this study, real-world wound images were used to train a convolutional neural network to automatically segment wound area and wound tissues on an image. The study included altogether 362 images of venous, arterial, vasculitis and pyoderma gangrenosum wounds. The model was based on a convolutional neural network architecture U-Net, and fully supervised learning was utilised during the training phase. Wound area reached a Dice Similarity Coefficient (DSC) of 0.927 and Intersection over Union (IoU) of 0.868 using an augmented dataset with pretraining. Fibrinous exudate and granulation performed fairly well with DSC 0.750 and 0.696, and with IoU 0.659 and 0.601, respectively. Necrosis present in only 56 images achieved lower performance with DSC 0.503 and IoU 0.502. In conclusion, this study suggested that it is possible to train a neural network to perform well with images taken for purely clinical purposes. Besides wound area, several wound structures can be identified, but wound structure identification performance is dependent on the number of images featuring the structure.

Calcium sulphate (CS) is a fully synthetic, sterile, bioabsorbable biomaterial extensively applied for the management of infected tissues and postoperative dead spaces resulting from surgical interventions. Residual DS may facilitate hematoma accumulation and bacterial colonisation, thereby heightening the risk of surgical-site infections. Within orthopaedic surgery, CS has been predominantly evaluated as a bone-void filler and an off-label antibiotic delivery vehicle-particularly in arthroplasty revisions, chronic osteomyelitis, and open fractures-yielding high rates of infection prophylaxis, bone regeneration, and low complication profiles. Commercially available as injectable 'pearls' or beads, CS permits local, sustained antibiotic elution while undergoing gradual biodegradation, thus obviating the need for secondary removal procedures. Over the last decade, Calcium Sulphate beads (CSBs) have transcended orthopaedics, gaining traction across general, vascular, and endocrine surgery disciplines for the prevention and treatment of complex wound infections. However, their application in plastic and reconstructive surgery remains underreported, despite the specialty's frequent engagement with complex soft-tissue defects, bone exposure, suture dehiscence, and trauma-related wounds vulnerable to infection. To our knowledge, this represents the first scoping review synthesising current evidence, clinical indications, and emerging roles of CSBs within plastic and reconstructive surgery.

Despite numerous therapeutic approaches, the inhibition of hypertrophic scar formation remains a major challenge. Adipose-derived stem cells (ADSCs) have been shown to improve wound healing, including remodelling, invivo. A systematic review was conducted using the electronic databases PubMed, Web of Science, Embase and Medline. The basic research question was formulated with the PICO framework. The aim of this review is to prove the role of ADSCs in the prevention of hypertrophic scar formation based on invivo studies. Improved macroscopic outcomes with the use of ADSCs have been shown in nine of 10 studies included. Eight studies report inhibition on fibroblast activation, while all studies highlight the efficacy in promoting the extracellular matrix deposition and remodelling process. The immunomodulatory effects of ADSCs during inflammation have been demonstrated in six studies. One study each investigated the effect on adipogenesis or angiogenesis. In all studies the role of ADSCs in the prevention of hypertrophic scarring was conclusive. However, due to their heterogeneity and weighting of disparate outcomes, several investigations only converged upon distinct endpoints. Further research, preferably in pigs, is urgently required in order to assess the role of ADSCs in the prevention of hypertrophic scar.

ABSTRACTExosome therapy has emerged in recent years as a promising acellular approach for the treatment of tissue regeneration and wound healing. Initial preclinical investigations have demonstrated accelerated fibroblast proliferation, improved angiogenesis and reduced scar formation. It is evident that patients are more likely to gain an understanding of these treatments and acquire information from digital platforms as opposed to from peer‐reviewed scientific publications. This study assessed the credibility and instructional merit of exosome therapy content on YouTube, a prominent source of online health information. A cross‐sectional study was performed on the initial 50 videos in English obtained using the keyword ‘exosome therapy’ (15 July 2025). The videos were independently assessed by two plastic surgeons and a dermatologist using three validated scoring systems. The scoring system was based on the Journal of the American Medical Association (JAMA) reference criteria for transparency and reliability, the Global Quality Score (GQS) for overall educational quality and the modified DISCERN tool for content reliability and balance. The median scores obtained were consistently low (DISCERN: 2.67; GQS: 2.67; JAMA: 2.00). However, videos created by doctors exhibited a statistically significant higher average score compared to videos published by patients, companies and YouTubers (p < 0.05). A robust positive correlation was identified between DISCERN and GQS (ρ = 0.95, p < 0.001). Despite the substantial experimental evidence that confirms the efficacy of exosome therapy for acute and chronic wounds, none of the videos addressed the recognised wound healing applications of exosome therapy. In contrast, the contents primarily focus on cosmetic enhancement, anti‐ageing interventions and beauty‐related applications. The discrepancy between the scientific advancements in the fields of regenerative medicine, dermatology and plastic surgery and the accessibility of online educational resources, highlights the necessity for professional health organisations to furnish accessible, evidence‐based materials that accurately demonstrate the therapeutic potential of exosomes in wound healing.

Person-centred care (PCC) has been increasingly promoted in wound management, yet its theoretical foundations and practical application remain unclear. This scoping review aimed to map and synthesise how PCC frameworks, concepts and outcome measures have been used in wound care. Following the Joanna Briggs Institute methodology and PRISMA-ScR guidelines, a systematic search was conducted across major databases for studies published between 2020 and 2025. Eligible sources included empirical research, reviews and conceptual papers addressing PCC in adults with chronic wounds. Data were extracted and analysed descriptively across conceptual and evaluative domains. Fourteen publications met inclusion criteria. Only one explicit framework of person-centred wound care was identified. Most studies referred to patient-centred rather than person-centred approaches and applied principles such as empowerment, shared decision-making and communication without consistent theoretical grounding. Outcome assessment focuses mainly on clinical or functional indicators, with limited attention to relational or experience-based dimensions of care. Some studies used the term person-centred as an unreflected keyword. Person-centred wound management remains conceptually fragmented, methodologically heterogeneous and sometimes unreflected. Greater theoretical precision, consensus on terminology and development of validated frameworks and measurement tools are required to translate person-centred principles into consistent, evidence-based clinical practice.

Wound care in calciphylaxis remains poorly defined without evidence-based consensus on timing and technique of surgical intervention. We demonstrate that surgical debridement and subsequent wound closure are safe and effective in calciphylaxis and describe a systematic multidisciplinary approach to intervention. We retrospectively reviewed a cohort of patients with calciphylaxis at our institution. Those who underwent surgical debridement and wound closure were analysed with emphasis on wound healing, progression to amputation and mortality. Sixty-two patients with calciphylaxis underwent surgical debridement. Twenty patients had wound closure by skin grafting, five were excised with primary wound closure, and 37 were debrided and allowed to heal by secondary intention. There were excellent rates of healing in all groups, and no patients demonstrated wound progression or new lesions following operative intervention. Surgical debridement and wound closure are safe and effective in treating wounds related to calciphylaxis.

There is a significant need for trials that evaluate the treatment of University of Texas (UT) grade 2 and 3 diabetic foot ulcers (bone, joint, or tendon exposed wounds). We undertook a trial looking at the effect of intact fish skin graft (IFSG) on these deep and difficult-to-heal ulcers. 262 patients Intent to Treat (ITT) patients with UT grade 2 and 3 DFUs were randomised to receive intact fish skin graft (IFSG) or a standardised treatment (SOC) that adhered to the International Working Group on the Diabetic Foot (IWGDF) guidelines. The secondary endpoints that were measured included wound area reduction (WAR), healing rates at 20 and 24 weeks; closure rates by UT grade, perfusion, quality of life, pain reduction and IFSG safety. We report ITT (all randomised) (mITT previosly reported) The (WAR) at 12 weeks was 65.53% for IFSG versus 30.82% for SOC (p = 0.007). UT 2 wounds (60% of total) exhibited a closure rate of 47% versus 23% at 16 weeks for IFSG versus SOC (p = 0.0033). Target wound infections were comparable (39 vs. 37) and major outcomes were comparable during the 24 week period (target-limb amputations 8% vs. 7%). Time-to-heal favoured IFSG (restricted mean to 24 weeks 17.31 vs. 19.37 weeks; KM/log-rank significant; Cox HR 1.59). The in the treatment of deep complex diabetic foot wounds the addition of IFSG significantly improved the number of patients with total wound closure as well as the time to wound closure without increased risk of complications. This improvement in total wound closure and time to wound closure was noted across prior amputation status, quality of perfusion, and UT grade.