Abdominal tuberculosis (TB) is the common site of extrapulmonary tuberculosis (EPTB) and has an incidence rate of around 15% globally. Abdominal tuberculosis can cause severe complications, such as intestinal obstruction or perforation, if this illness is diagnosed late, misdiagnosed, or has an inappropriate treatment. These are the indications for abdominal surgery. Postoperative complications from abdominal surgery include wound infection and dehiscence, and enterocutaneous fistula. Therefore, Negative Pressure Wound Therapy (NPWT) and split-thickness skin graft (STSG) can enhance the recovery.

This study is a case report describing a 54-year-old man with abdominal tuberculosis with complications of deep wound dehiscence and enterocutaneous fistula after surgery. The patient was treated with NPWT and STSG to enhance recovery of the wound and fistula.

After the patient underwent NPWT and STSG the wound healed perfectly (95%) with complications of graft infection and necrosis (5%) after 20 days of STSG, with a total of 46 days from the first NPWT and 16 days gap between the end of NPWT treatment and STSG.

Background wound healing involves inflammation, proliferation and remodeling, with prolonged healing times posing significant challenges. Beta-glucans, natural polysaccharides, may enhance this process.

Objective To evaluate the impact of beta-glucan on wound healing.

Method A systematic review of MEDLINE, Embase, Scopus, and Cochrane Central databases was conducted. Eligible studies included randomised controlled trials, clinical trials, cohort, and case-control studies comparing beta-glucan to other treatments. Only English-language studies were included, with no time restrictions. Screening and assessment were independently performed by two reviewers using Rayyan. The risk of bias was evaluated using the ROB-2 tool and the Newcastle-Ottawa Scale (NOS). A meta-analysis was performed on the included studies.

Result Beta-glucans promote immune cell activation and tissue repair, accelerating inflammation resolution. The meta-analysis of chronic wounds included two studies comprising a total of 354 participants, demonstrating a twofold increase in chronic wound healing rates at 12 weeks with the application of topical beta-glucan. In contrast, the analysis of acute wounds included two studies with a combined sample size of 290 participants. However, the findings for acute wounds were inconclusive.

Conclusion Beta-glucan demonstrates potential as an adjunctive therapy for chronic wounds, significantly accelerating healing rates. Its clinical utility warrants further exploration.

Registration PROSPERO CRD42024464191

The continuing development of antimicrobial resistance (AMR) is a growing global health threat characterised by the ability of microorganisms to withstand the effects of antimicrobial agents. AMR is of such global concern that the World Health Organization (WHO) has developed a global strategy called Antimicrobial Stewardship to combat this threat. This article presents a scoping review designed to identify what impact the introduction of the AMS has had on working practice. The results of the literature search identified 2458 potential articles, 13 articles identified from other sources, thus a total of 2471 articles to screen. Following screening 120 articles were identified for full-text review and finally 80 articles were retrieved and included in the narrative review. All studies indicated the introduction of specific AMS guidelines and/or protocols that affected treatment regimens with a reduction in surgical site infections and a reduction in antimicrobial resistance development being key clinical outcomes of the introduction of antimicrobial stewardship programmes. Forty percent of studies specifically indicating training/education and 43.8% studies indicating some form of audit/feedback as part of the AMSPs. Additionally, antimicrobial usage was reported in most studies resulting in a de-escalation of antimicrobial use (e.g., intravenous vs. oral, broad- or narrow-spectrum), changes in antimicrobial dosage or duration 25.0% and 46.3% respectively. Overall, this review demonstrates that implementation of AMS does have several positive clinical patient outcomes.

Aims This study aimed to assess patient and caregiver satisfaction with virtual wound care services in Saudi Arabia.

Methods A cross-sectional survey was conducted among 4190 respondents, comprising 2300 patients and 1890 caregivers who had used virtual wound care services from April to December 2024. The survey captured socio-demographic details, satisfaction levels and experiences with various wound care system domains.

Results Results revealed that patients reported significantly higher satisfaction levels compared to caregivers. Younger participants, males, and individuals with higher education or full-time employment were more likely to report high satisfaction. Domains such as voice and visual quality, personal comfort, and team courtesy were rated higher by patients, while caregivers expressed concerns regarding accessibility and communication. Approximately half of patients (42.2%) indicated a strong willingness to reuse telehealth services and recommend them, reflecting positive acceptance of virtual wound care in Saudi Arabia.

Conclusion Virtual wound care services are generally well-received in Saudi Arabia, with patients showing greater acceptance than caregivers. Findings highlight the importance of targeted support and training to address caregiver needs, improve accessibility, and promote equitable telehealth satisfaction.

Background Gas gangrene, a life-threatening complication, requires early detection for effective intervention. This study emphasises the crucial role of point-of-care ultrasonography (POCUS) in detecting gas gangrene within a closed diabetic foot ulcer (DFU).

Case Presentation A 61-year-old male with an undiagnosed diabetic foot ulcer presented with pain and swelling on the right leg. Ultrasonographic images revealed subcutaneous gas gangrene extending to the Achilles tendon and calf. Despite extensive gas invasion, no significant tissue damage or pus collection was observed. Prompt wound debridement and antibiotic therapy were administered.

Conclusion The study underscores the crucial importance of POCUS in unraveling hidden threats, specifically emphasising its ability to identify gas gangrene before apparent tissue damage. The timely and precise nature of POCUS in gas gangrene detection, especially before visible tissue damage, positions it as an indispensable asset in the clinical management of DFUs.

Aim To map interventions for the treatment of epibole on wound edges.

Methods This is a scoping review following the Joanna Briggs Institute method. There were no time or language limitations when conducting the searches. Researchers searched the databases between May 2022 and May 2024. Studies that presented at least one intervention for wound edge epibole were included.

Results 2753 studies were identified, nine of which were selected for the final sample, in which the following interventions were found: topical hyperbaric oxygen associated with high-voltage pulsed electrical stimulation, polymeric membrane dressing applied in firm contact with the wound edges, the use of silver nitrate, sharp instrumental debridement with scarification, edge trenching and soap scrap techniques.

Conclusions Different types of interventions were found, but in studies with low evidence for clinical practice. More research is needed.

Aims This study aims to evaluate the efficacy and safety of polyhexanide or polyhexamethylene biguanide (PHMB) for management of various wound types compared to other dressings.

Methods A literature search was conducted in journal databases including PubMed, Google Scholar, ScienceDirect, Cochrane, CENTRAL, and Clinicaltrials.gov. We included intervention studies that evaluated the use of polyhexanide topical preparations in wound healing until November 2024. Risk of bias was assessed using Cochrane Risk-of-Bias tool 2 (RoB2) and ROBINS-I. Quantitative analysis was carried out using Review Manager version 5.4.

Results Eighteen studies were included, comprising randomised controlled trials and cohort studies with sample sizes ranging from 12 to 146 patients. Five studies were eligible for meta-analysis. Healing time was significantly faster in polyhexanide group compared to controls (MD –14.84 days; 95% CI –31.30, 1.62; p=0.08). While there was no significant difference (Odds ratio 0.76; 95%, CI 0.23, 2.48; p=0.65), the bacterial burden reduction was higher in PHMB-treated wounds (p=0.04).

Conclusion Polyhexanide demonstrated significantly faster healing time in treatment of various types of wounds. It also had multiple advantages, such as its transparent properties, antimicrobial activity, and reduced pain compared to other treatments. Further studies may be needed to assess long-term efficacy and safety of PHMB for various wound types.

Aim This scoping review aims to identify and map current primary studies relating to key terminology, definitions and measurement methods used in chronic wound research. The review of chronic wound research terminology from the studies will identify areas of consistency and inconsistency in definitions and measurement methods of key terms in chronic wound research.

Method This review will follow the Joanna Briggs Institute (JBI) methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews guidelines. The electronic databases: MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, Cochrane Library, and the JBI Library will be searched using an agreed search strategy. Unpublished and grey literature sources will also be searched. Data from studies included will be extracted using a standardised form and the findings will be narratively synthesised.

Discussion This review will be the first stage of developing consensus on research terms by providing a detailed understanding of chronic wound research terminology, addressing inconsistencies in definitions and measures. By mapping range, use, and definitions of key terms, the findings aim to provide information from which to standardise terminology, enhance communication, and improve both research and clinical outcomes in wound care.

Background Community pharmacists play a vital role in primary care, including minor wound management. However, their formal training and involvement in wound care in Saudi Arabia remains underexplored.

Objective This study aimed to assess the current practices, knowledge and training needs related to wound care among community pharmacists in Saudi Arabia.

Methods A cross-sectional survey was conducted among licensed community pharmacists across several regions in Saudi Arabia during September 2024. A self-administered questionnaire was used to collect data on demographics, wound care experience, confidence levels and preferred training methods. Descriptive statistics and chi-square tests were applied.

Results Of the 203 respondents, most were male (71.9%) and had 1–3 years of experience. While 62% encountered wound cases sometimes or rarely, 96% reported no formal wound care training. Pharmacists expressed interest in certified workshops and practical courses. A significant association was observed between training and confidence in providing wound care recommendations (p<0.01).

Conclusion Community pharmacists in Saudi Arabia are moderately involved in wound care but lack structured training. Enhancing their role through interprofessional collaboration and targeted education may improve patient-centered wound management.

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.

Aims To investigate patient and carer experiences of care at two interdisciplinary specialist services for the management of diabetes-related foot ulceration (DFU).

Methods Semi-structured interviews were conducted with patients experiencing DFU who attended a minimum of four appointments over three months, and their carers who attended at least two appointments. Purposive sampling was used to identify patients based on: gender; employment status; cultural and linguistic background; carer support; end-stage renal disease; and mental health diagnosis. Audio recordings were transcribed verbatim and analysed thematically.   

Results We invited 25 patients to participate. Thirteen consented and were interviewed, along with three carers. Data sufficiency was achieved. Three themes and two subthemes were identified: confident in care; care considered comprehensive (subthemes: education benefits and access is complex); and DFU is life changing.

Conclusions This study adds to a limited body of previous evidence regarding DFU care experiences. The importance of feeling confident and care being comprehensive were highlighted. New insights were gained, including that receiving care for and living with DFU are part of the same experience which cannot be separated. These findings may guide interdisciplinary service planning and future research to improve care for people living with DFU.