Search Results (153)

Background: Post-sternotomy mediastinitis remains a devastating complication of cardiac surgery. Although most cases are bacterial, fungal mediastinitis due to Candida albicans is rare, aggressive, and particularly difficult to treat because of biofilm formation, prosthetic involvement, and limited penetration of systemic antifungal agents into infected tissues. Taurolidine is a taurine-derived antimicrobial compound with broad antibacterial, antifungal, and anti-biofilm properties that has shown promising results in catheter-related infection prevention and cardiac implantable electronic device surgery. Case summary: We report, to our knowledge, the first intramediastinal use of taurolidine for Candida albicans mediastinitis after biological Bentall surgery. Following urgent resternotomy and extensive debridement, 200 mL of taurolidine solution was instilled into the mediastinum for 60 min, then aspirated. Postoperatively, taurolidine irrigation via mediastinal drainage was combined with negative-pressure wound therapy and systemic antifungal treatment. Results: Rapid microbiological sterilization was achieved, inflammatory markers normalized, and follow-up computed tomography demonstrated complete resolution of mediastinal infection. Delayed sternal closure was then performed successfully without recurrence at 6-month follow up. Conclusion: To our knowledge, this represents the first reported use of intramediastinal taurolidine irrigation for fungal mediastinitis following cardiac surgery. Intramediastinal taurolidine irrigation may represent a promising adjunctive strategy for mediastinitis after cardiac surgery in high-risk patients. Further clinical evaluation is warranted. Full article

Background and Objectives: Extensive burns are devastating injuries, especially in children, associating high risk of morbidity and mortality in the absence of immediate and appropriate treatment. Negative-pressure wound therapy (NPWT) has emerged as a versatile tool for the local treatment of burn wounds. This study aims to present our approach in using NPWT for extensive burns in children, emphasizing the indications and outcomes of these very challenging cases, and proposing an algorithm for NPWT use for extensive burn patients, even in low-resource settings. Materials and Methods: We retrospectively analyzed pediatric burn patients admitted between January 2020 and December 2024, selecting the cases with at least 20% TBSA burn and the application of NPWT during treatment, recording indications and parameters of use, treatment period, and results. Results: We identified 12 patients with a burn surface ranging from 20% to 80% TBSA, caused by high-voltage electrical current (6 cases), flame (4 cases), and scalds (2 cases). NWPT was used for 3–25% TBSA for obtaining granulation tissue in very deep burn wounds with bone and tendon exposure, for reducing edema and enhancing spontaneous re-epithelialization in intermediate circumferential burns, and for preparing the wound bed for re-grafting after local infection and graft failure. There were no complications related with the NPWT use and no fatalities. Conclusions: NPWT represents a reliable option for several clinical situations in local burn treatment, for temporary closure of burn areas, graft fixation, burn wound preparation, local infection control, or enhancing re-epithelialization. The proposed algorithm offers a comprehensive overview of indications of NPWT for burn local management and may guide clinical decisions, easing the identification of the best situation and moment to use the device. Our study contributes to the body of knowledge that enforces the evidence of the safe and effective use of NPWT for burn management in the pediatric population. Full article

Background and Objectives: Diabetes mellitus (DM) is a major global health concern, with diabetes-related foot disease (DFD) representing one of its most severe complications, often resulting in chronic infection, osteomyelitis, and limb amputation. Conventional therapies frequently fail in refractory cases, necessitating novel adjunctive strategies. Ozone therapy (OT) possesses antimicrobial, immunomodulatory, and oxygen-enhancing properties, while negative pressure wound therapy (NPWT) facilitates granulation, exudate removal, and tissue perfusion. This study explored the combined efficacy of OT and NPWT in advanced DFD. Materials and Methods: An exploratory, retrospective, observational cohort study was conducted at a specialized wound care center in Gdańsk, Poland, between 2019 and 2022. The study included 30 patients (n = 30) with refractory DFD involving both soft tissue and bone infection who had not responded to previous conventional treatment. The analyzed treatment approach consisted of surgical debridement, application of topical ozonated preparations, and (NPWT) with instillation of ozonated saline administered over a six-week period. Clinical outcomes included wound healing assessed using the Wagner classification and wound volume reduction, pain intensity measured using the Numeric Rating Scale (NRS), inflammatory biomarkers (C-reactive protein [CRP] and procalcitonin [PCT]), and microbiological characteristics of wound cultures. Statistical analyses were performed using the Wilcoxon signed-rank test and the chi-square test, and regression modeling was applied to identify potential predictors of therapeutic response. Statistical significance was defined as p < 0.05. Results: By week six, 100% of ulcers improved to Wagner stage ≤1, with 26.7% achieving stage 0. Median wound volume decreased from 5.5 cm³ to 0 cm³ (p < 0.001). Pain scores declined from 7.2 ± 0.96 points to 0.2 ± 0.5 points (p < 0.001). CRP and PCT levels decreased significantly (p < 0.001), and microbiological clearance was observed in all cases. Higher body mass index (BMI) was associated with poorer pain reduction. Conclusions: The combination of standard wound care with OT and NPWT was associated with clinically relevant improvements in wound healing, infection control, systemic inflammation, and pain reduction in patients with refractory DFD. Although limited by a non-controlled design and small cohort size, these findings support further randomized controlled trials to define the role of this combined approach in integrated diabetic foot care. Full article

Background/Objectives: Chronic wounds are a major source of morbidity in patients with paraplegia, often resulting in repeated treatment, prolonged hospitalization, and reduced quality of life. Reconstruction becomes particularly challenging when a wound arises in a scarred trunk region and is further complicated by deep infection, osteomyelitis, or enteric fistula. We describe the staged management of a complex left flank wound in a paraplegic patient, initially reconstructed with a quadrilateral pinwheel flap and later requiring multidisciplinary salvage for recurrence associated with rib osteomyelitis and a colocutaneous fistula. Methods: A paraplegic man in his 50s presented with a chronic left flank wound after repeated full-thickness skin graft failure and persistent Pseudomonas aeruginosa infection. After wide debridement, the approximately 7 × 7 cm defect was reconstructed with a quadrilateral pinwheel flap composed of four Limberg-style rhomboid fasciocutaneous flaps positioned at the 12, 3, 6, and 9 o’clock orientations, elevated at the level of the deep fascia, and transposed into the central defect, with adjunctive negative-pressure wound therapy (NPWT). Approximately 1 year later, recurrence with rib osteomyelitis required rib resection. During NPWT, feculent drainage led to the diagnosis of a colocutaneous fistula. Subsequent multidisciplinary treatment included fistula tract resection, colonic repair with omental patching, transposition of vascularized omentum into the chest wall cavity to obliterate dead space, continued NPWT, and delayed primary closure. Results: Initial local flap reconstruction achieved wound coverage, and immediate postoperative clinical assessment, including pinprick and refill testing, confirmed satisfactory flap perfusion; however, delayed recurrence developed in association with rib osteomyelitis. After definitive fistula surgery, dead-space management with vascularized omentum, wound conditioning with staged NPWT, and delayed primary closure, the wound healed completely. At 6 months after delayed closure, no recurrence of fistula, osteomyelitis, wound dehiscence, or soft-tissue breakdown was observed, and the patient’s daily comfort and functional independence were improved compared with the preoperative condition. Conclusions: A quadrilateral pinwheel flap may provide an effective tension-dispersing local fasciocutaneous option for selected scarred trunk defects in high-risk patients. However, when chronic wounds are compounded by deep infection and enteric fistula, durable healing depends not on flap design alone but on staged multidisciplinary management incorporating definitive source control, vascularized tissue transfer for dead-space elimination, NPWT, and appropriately timed closure. Full article

Background: Diabetic foot ulcers (DFUs) represent a major chronic complication of diabetes mellitus, often leading to severe infection, amputation, and reduced quality of life. Among various factors affecting DFUs, plantar pressure plays a pivotal role in ulcer formation and recurrence. Despite growing interest in this domain, few studies have comprehensively evaluated the research landscape concerning plantar pressure in the context of DFUs from a bibliometric perspective. Aim: To conduct a comprehensive bibliometric analysis and visualization of global research trends, hotspots, and collaborative networks in the field of plantar pressure-related diabetic foot studies from 2000 to 2024. Methods: A systematic search was conducted in the Web of Science Core Collection (WoSCC) on 16 February 2025, for articles published between 2000 and 2024 using terms related to “diabetic foot” and “plantar pressure”. A total of 2518 records were retrieved, from which 2110 English-language articles and reviews were included. Bibliometric and visual analyses were performed using Microsoft Excel 2021, VOSviewer (v1.6.20), CiteSpace (v6.4.R1), Charticulator, and Scimago Graphica. Analyses included publication trends, country/institution/author collaborations, journal distributions, keyword co-occurrence and clustering, citation bursts, and reference co-citation networks. Results: A total of 2110 publications were identified, showing an overall increase in annual publication output from 2000 to 2024, with some year-to-year fluctuations. The United States led in publication volume (678 articles), citation frequency, and H-index, followed by the United Kingdom and China. Armstrong, David was the most prolific and also had the highest H-index among the listed authors, while the University of Amsterdam was the leading institution. “Journal of Wound Care” had the highest publication count, whereas “Diabetes Care” ranked first in citation frequency. Keyword analysis revealed major research clusters including “diabetic foot”, “plantar pressure”, “wound healing”, “offloading”, and “negative pressure wound therapy”. Recent trends show an increased focus on microcirculation, regenerative medicine, customized footwear, and wound care technologies. Conclusions: The bibliometric analysis reveals research trends and current hotspots in plantar pressure management for diabetic foot ulcers, with a particular focus on managing plantar pressure through personalized offloading strategies and custom footwear. These findings highlight the practical value of tailoring interventions to individual patient needs, emphasizing the importance of biomechanical factors in ulcer prevention and healing. Full article

A 2-year-old female Labrador Retriever, with a body condition score of 6/9, underwent ovariohysterectomy 24 h prior at another center and was urgently referred for a possible exploratory laparotomy. The dog presented with lethargy, abdominal pain, and a haematoma with active bleeding in the surgical wound, indicating a possible haemoabdomen. An abdominal-Focused Assessment with Sonography for Trauma (A-FAST) revealed fluid in all four quadrants (abdominal fluid score-AFS 4/4) without abdominal distension, corresponding to an effusion with a packed cell volume of 15% and 4 g/dL of protein. Haematological analysis showed a slight decrease in haematocrit (HCT) and red blood cells, with neutrophilia, while the rest of the blood tests were within normal limits. Physical examination parameters were mostly normal, except for cardiac auscultation where tachycardia, irregular rhythm, and pulse deficit were noted, with normal blood pressure. The electrocardiogram (ECG) indicated both monomorphic and polymorphic ventricular tachycardia with isolated episodes of sinus tachycardia. Treatment included the administration of metamizole, methadone, and maintenance fluid therapy, along with compressive abdominal bandaging. Lidocaine and continuous infusion of fentanyl therapy were initiated. The dog’s HCT, platelets, temperature, and blood pressure remained in the normal range. During the first 8 h, both the ECG and A-FAST showed no relevant changes. From the 9th hour onward, there was a predominance of sinus rhythm, the free fluid decreased to AFS 1/4, allowing for the gradual suspension of lidocaine. Tests for Leishmania, Ehrlichia, Anaplasma, Babesia, and Dirofilaria were negative. The evolution remained favorable, and the dog was discharged after 72 h, showing a good outcome in the cardiology follow-up 5 days later. Full article

Background: Postoperative wounds may arise from several etiologies, including open partial pedal amputation, postoperative infection, and dehiscence of surgical sites from wound failure or patient compliance issues. If negative pressure wound therapy is the gold standard, its application in the toes area could be challenging, and as a consequence, standard care is most likely used. The control of the wound microenvironment, both in terms of pH levels and presence of reactive oxygen species, is a key part of the normal wound-healing process. This study evaluated the effectiveness of an oxygen-enriched oil-based device (OEOd) in post-surgical diabetic foot ulcers (DFUs). Methods: This prospective controlled comparative pilot study enrolled 40 patients with diabetes mellitus and post-surgical foot wounds (narrow and deep lesions, including tunneling ulcers) treated at the Diabetic Foot Unit of San Donato Hospital, Arezzo (March 2024–April 2025). Patients were allocated into two groups: those treated by the standard wound care (n = 20) and those treated by OEOd (n = 20). The primary outcome was complete wound healing at 16 weeks; other exploratory endpoints were wound area reduction at 4 and 16 weeks, onset of infection, need for re-intervention, and adverse events. Results: Complete wound healing was achieved in 85.0% of OEOd patients versus 45.0% in the control group (p = 0.020). At 16 weeks, wound area reduction was significantly greater in the OEOd group compared with standard therapy (89.8% vs. 64.0%, p = 0.013). Although infection rates (10.0% vs. 35.0%, p = 0.130) and need for re-intervention (0% vs. 25.0%, p = 0.056) did not reach statistical significance, both favored the OEOd group. No adverse events were reported. Conclusions: OEOd significantly improved the chance of healing post-surgery and showed favorable trends in reducing complications, with an excellent safety profile. Larger randomized controlled trials are warranted to confirm these findings and assess long-term outcomes. Full article

Background: Breast surgery, both aesthetic and reconstructive, has evolved significantly over the years. Postoperative care is vital for patient recovery, with surgical dressings playing a crucial role in minimizing complications, including infections and bleeding. This review aims to evaluate the safety, comfort, and effectiveness of different durations for wearing surgical dressings after breast surgery. It also explores the use of negative pressure wound dressings and postoperative bras to enhance surgical outcomes. Methods: A comprehensive review of literature published from 2003 to 2024. Studies focusing on breast dressing techniques after mammary reconstruction and aesthetic surgery in plastic surgery were included. Results: Of 1503 initially identified articles, 12 were deemed relevant and included in this review. The findings suggest that prolonged dressing wear, up to 6 days postsurgery, may reduce cutaneous colonization without affecting infection rates in aesthetic breast surgery. Additionally, negative pressure wound therapy demonstrates promise in reducing overall wound complications and mastectomy flap necrosis. The utilization of specific postoperative bras is shown to improve patient comfort, mobility, and security, contributing to pain reduction and aesthetic outcomes. Conclusions: The lack of consensus on dressing selection and duration calls for further research in breast surgery postoperative care. Extended dressing wear, negative pressure therapy, and customized postoperative bras show potential in reducing complications, providing new avenues to enhance patient outcomes in the field of plastic surgery. Addressing these issues can lead to improved patient satisfaction and surgical results. Full article

Background/Objectives: Surgical site infection (SSI) after autologous rib cartilage microtia reconstruction is an uncommon but potentially devastating complication, as infection of the avascular cartilage framework can rapidly lead to partial or complete framework loss. Traditional management often favored aggressive debridement or framework removal, resulting in significant deformity. This study aimed to evaluate salvage-oriented management strategies and to propose a structured treatment algorithm for SSI following microtia reconstruction. Methods: A retrospective case series was conducted of patients who developed SSI after autologous rib cartilage microtia reconstruction between March 2021 and November 2025. SSI was defined by clinical and surveillance criteria requiring intervention beyond routine postoperative care. Nine patients were included. Management strategies were analyzed with respect to infection control, framework preservation, and wound healing outcomes. Results: SSI occurred at variable time points, ranging from early postoperative infection to delayed and late-onset presentations. Identified pathogens included Gram-positive cocci and multidrug-resistant Gram-negative organisms. Negative-pressure wound therapy (NPWT) was applied in all cases with wound dehiscence, persistent drainage, or cartilage exposure. Conservative staged debridement was performed only after clear demarcation of nonviable tissue. Overall auricular framework preservation was achieved in 100% of patients, with no cases requiring complete framework removal, although limited cartilage loss occurred in select cases. These outcomes demonstrate the clinical feasibility and effectiveness of salvage-oriented management across heterogeneous infection scenarios. Conclusions: SSI following autologous microtia reconstruction can be effectively salvaged without routine framework removal through a structured, timing-based algorithm emphasizing early culture-guided antimicrobial therapy, NPWT, and conservative staged intervention. This salvage-oriented approach provides a clinically relevant and reproducible framework for preserving auricular structure while minimizing morbidity, even in infections involving multidrug-resistant organisms. Full article

Background: Burns represent a public health problem because they generate both physical and psychological damage, especially in the child and adolescent population, and high costs, especially due to the management of scars. Advances in burn care have improved survival and quality of life for this population. New clinical trials have been conducted on the benefits of negative pressure wound therapy (NPWT), showing that it improves the healing of burns and the appearance of scars. Therefore, this study aims to analyze the efficacy of NPWT both alone and as an adjunct to conventional dressings in pediatric and adolescent patients compared with conventional treatments. Methodology: A systematic search was carried out between December 2023 and the last quarter of 2025 in databases such as PubMed, Scopus, CINAHL, and the Cochrane Library. This meta-analysis was performed following the PRISMA statement (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and was registered in PROSPERO with registration number CRD42024597293. The risk of bias 2 (RoB2) tool was used to assess the risk of bias in the studies. Quantitative meta-analyses using random-model effects were performed only for variables with sufficient comparable data among studies. For other outcomes, where meta-analysis was not feasible due to lack of comparable data or control groups, results were synthesized qualitatively. Results: A total of seven articles (three clinical trials and four retrospective studies), in which a total of 323 subjects participated, were included. The main results demonstrate the efficacy of NPWT, as it decreases the re-epithelialization time, improves the appearance of scars (MD = −1.25 (95% CI between −1.80 and −0.70)), reduces the probability of skin grafts (OR = 0.17 (95% CI between 0.06 and 0.46)), and therefore, as there is less need for surgery and fewer dressing changes, reduces costs. Conclusions: NPWT offers significant clinical benefits in the treatment of burns in children and adolescents. Although a meta-analysis could not be performed due to the lack of a control group in some studies, studies with larger samples and multicenter designs will be necessary to better assess the relevant clinical outcomes. However, the results of this study show that NPWT is effective in treating burns in children and adolescents and that its use in clinical practice may represent a promising adjunctive therapy. Full article

Hard-to-heal wounds remain a significant challenge for healthcare professionals, particularly in aging populations. Although most chronic wounds are associated with diabetes or chronic venous insufficiency, rare etiologies should also be considered. One such cause is envenomation by Phoneutria spp. (native to South America, rare in Europe). Their venom contains potent neurotoxins. While systemic manifestations are more commonly reported, localized necrotic skin lesions may also occur. This case report presents a rare chronic wound following a suspected Phoneutria spider bite and highlights the importance of an individualized, multimodal treatment approach. A 61-year-old male patient with a progressive thigh wound following a spider bite sustained during work. Despite initial self-treatment and pharmacotherapy the wound deteriorated. The patient was admitted to the authors’ facility, where surgical treatment included necrosectomy and a sandwich graft using an acellular dermal matrix combined with a split-thickness skin graft. Adjunctive therapies included negative pressure wound therapy and hyperbaric oxygen therapy. After discharge, outpatient wound care was continued. Treatment was monitored with photographic documentation and serial microperfusion measurements. Complete wound closure was achieved after 4 months of specialized therapy. Management of chronic wounds requires a multidisciplinary and individualized approach with surgical intervention, advanced wound care and specialized outpatient follow-up. Full article

Background and Objectives: To evaluate and synthesize evidence on the independent clinical effectiveness, safety, and applicability of Negative Pressure Wound Therapy (NPWT) and Hyperbaric Oxygen Therapy (HBOT) in diabetic foot ulcers (DFUs), and to determine whether current evidence allows for a direct comparison between both interventions: NPWT and HBOT are widely advanced therapies for DFUs. Although both show benefits, the relative superiority of one over the other remains unclear. Systematic review of the literature conducted in accordance with PRISMA guidelines. Materials and Methods: A comprehensive literature search was performed using two electronic databases. The review included randomized controlled trials, systematic reviews, meta-analyses, and non-randomized studies. Methodological quality and risk of bias were assessed using validated tools: RoB 2.0 for randomized trials, AMSTAR-2 for systematic reviews, and ROBINS-I for non-randomized studies. Results: A total of 22 studies were included. NPT was shown to be effective in accelerating wound healing, though results varied depending on the type of intervention and clinical context. HBOT demonstrated beneficial effects on angiogenesis and significantly reduced the rate of major amputations. Both therapies presented significant advantages in the management of diabetic foot ulcers. Conclusions: Negative pressure therapy and hyperbaric oxygen therapy are both effective treatments for diabetic foot ulcer healing. However, treatment selection should be individualized based on patient-specific clinical factors, ulcer severity, and available healthcare resources. Integrating these advanced therapies within a multidisciplinary care approach may optimize outcomes and reduce the risk of complications. Future research should include standardized, head-to-head RCTs. Full article

Objective: Sternum osteomyelitis and deep sternal wound infection (DSWI) are often used to describe the same clinical condition interchangeably. The aim of our current study is to investigate the prevalence of osteomyelitis in cardiac surgery patients with DSWI and its consequences in therapy and osteosynthetic reconstruction. Patients and Methods: This is a retrospective single-center observational study. All consecutive patients with DSWI after cardiac surgery between 01/2014 and 12/2019 were included. In all patients, the sternal wound was reopened, sternal closure material was removed, and negative pressure therapy was initiated. Wound swabs were taken for microbiological examination, and a bone biopsy was examined for the presence of osteomyelitis. In the presence of osteomyelitis, long-term antibiotics were administered. Results: A total of 130 patients were identified in whom DSWI occurred after sternotomy. In 102 patients (77%), osteomyelitis could be detected histopathologically. The frequency of transverse sternal fractures was lower (p < 0.05) in the osteomyelitis subgroup (63%) as compared to the non-osteomyelitis subgroup (93%). Pathogens were detected in all patients with osteomyelitis, but less frequently (p < 0.05) in the group with no osteomyelitis (64%). If osteomyelitis was treated with long-term antibiotics, there was no difference in the complication rate (reinfection) after sternal restabilization between the two groups. Conclusions: DSWI and osteomyelitis should not be used interchangeably. If osteomyelitis can be detected histopathologically, long-term antibiotic treatment should be consistently conducted. As DSWI, with or without osteomyelitis, has been suggested to be associated with inadequate or failed sternal osteosynthesis, a key strategy to reduce its risk is to ensure safe and reliable primary sternal fixation. Full article

Background: The management of hard-to-heal wounds poses a major clinical challenge due to heterogeneous etiology and significant global healthcare costs (estimated at USD 148.64 billion in 2022). Large Language Models (LLMs), such as ChatGPT and Gemini, are emerging as potential decision-support tools. This study aimed to rigorously assess the accuracy and reliability of ChatGPT and Gemini in the visual description and initial therapeutic management of complex wounds based solely on clinical images. Methods: Twenty clinical images of complex wounds from diverse etiologies were independently analyzed by ChatGPT (version dated 15 October 2025) and Gemini (version dated 15 October 2025). The models were queried using two standardized, concise prompts. The AI responses were compared against a clinical gold standard established by the unanimous consensus of an expert panel of three plastic surgeons. Results: Statistical analysis showed no significant difference in overall performance between the two models and the expert consensus. Gemini achieved a slightly higher percentage of perfect agreement in management recommendations (75.0% vs. 60.0% for ChatGPT). Both LLMs demonstrated high proficiency in identifying the etiology of vascular lesions and recognizing critical “red flags,” such as signs of ischemia requiring urgent vascular assessment. Noted divergences included Gemini’s greater suspicion of potential neoplastic etiology and the models’ shared error in suggesting Negative Pressure Wound Therapy (NPWT) in a case potentially contraindicated by severe infection. Conclusions: LLMs, particularly ChatGPT and Gemini, demonstrate significant potential as decision-support systems and educational tools in wound care, offering rapid diagnosis and standardized initial management, especially in non-specialist settings. Instances of divergence in systemic treatments or in atypical presentations highlight the limitations of relying on image-based reasoning alone. Ultimately, LLMs serve as powerful, scalable assets that, under professional supervision, can enhance diagnostic speed and improve care pathways. Full article

The purpose of this analysis is to report on the clinical efficacy of Continuous Diffusion of Oxygen (CDO) therapy in real-world clinical practice and compare those results to data published in controlled clinical studies. For the real-world clinical results, a Prospective Patients Database (PPD) of 764 patients treated using CDO therapy in a broad range of clinical practices across a wide range of wound types and wound locations was analyzed. The objectives included analyzing the clinical efficacy of CDO therapy across multiple wound types and anatomical locations, testing the data for robustness, and comparing the efficacy to results from controlled clinical studies for CDO and NPWT. The PPD data is also analyzed for efficacy among the sexes and by age for older patients in the Medicare population. The robustness of the PPD data is tested using various non- and semi-parametric statistical tools, including the Kaplan–Meier and Cox proportional hazard (PH) models, among others. The results show that CDO therapy is highly efficacious with an average healing success rate of 76.3% in real-world application, ranging from 71.2% to 84.1% for different wound types. The Medicare age population had an average age of 78 years old and similar healing rates to the overall population, with slightly better results for pressure ulcers in the older patient population. The PPD data proved to be extremely robust in every test method, demonstrating substantially equivalent efficacy in various wound types and locations, as well as between men and women. The PPD results for CDO compared favorably to clinical trial results for CDO and NPWT. Both clinical trial and PPD data for CDO exhibited better healing rates when compared to NPWT. Kaplan–Meier analysis shows that CDO use in clinical practice has 79.2% full closure in 112 days, as compared to NPWT, which has 43.2% full closure in the same timeframe for similar wound sizes and severity. These results demonstrate not only that CDO is highly efficacious in clinical practice, but that the efficacy is also similar across all wound types and locations in the body. CDO also compares very favorably to NPWT. Full article