Diabetic foot ulcers are a leading cause of morbidity, hospitalization, and nontraumatic lower-extremity amputation in patients with diabetes mellitus. Effective management of these wounds requires a multidisciplinary approach and combined therapies addressing infection control, perfusion optimization, and stimulation of tissue regeneration. This case report describes a patient with a severe infected neuroischemic foot ulcer treated with a sequential integrated strategy: infrapatellar endovascular revascularization, targeted antibiotic therapy, serial debridement, negative pressure wound therapy, application of an ovine-derived extracellular matrix, and autologous grafting of adipose tissue-derived mesenchymal stem cells. The treatment resulted in complete wound healing and limb preservation, with no recurrence after 7 months of follow-up. This case highlights the potential role of advanced regenerative therapies in the management of complex, refractory diabetic foot wounds, expanding therapeutic perspectives in the care of patients with diabetic foot.

ObjectivesThis study aimed to examine the clinical progression of Stage 2, 3, and 4 pressure ulcers (PUs) in patients receiving palliative care, and to assess the psychosocial burden and burnout levels among their primary caregivers. Additionally, it sought to identify patient- and caregiver-related factors that may influence short-term mortality.MethodsA total of 96 patients with advanced-stage PUs and their 96 primary caregivers were included in a study. The Pressure Ulcer Scale for Healing (PUSH) was used to evaluate wound severity at baseline and at a 3-month follow-up. Caregiver burden and burnout were assessed using the Zarit Burden Interview and Maslach Burnout Inventory. Sociodemographic data were also collected. Logistic regression analysis was performed to determine predictors of mortality.ResultsAt the end of the 3-month follow-up, 35 patients (36.5%) survived, showing statistically significant improvement in PUSH scores (p < .05). Patient age was positively correlated with mortality. Additionally, a significant inverse relationship was found between caregiver "personal accomplishment" scores and patient mortality (p < .05), suggesting that caregivers with lower perceived competence were associated with higher patient death rates.ConclusionPUs in palliative care are associated with high mortality and complex care demands. The results emphasize the importance of caregiver psychological well-being in influencing patient outcomes. Multidisciplinary strategies that include both clinical wound management and structured psychosocial support for caregivers are essential to improve the quality of care and survival among this vulnerable population.

Family caregivers play a critical role in preventing pressure injuries among patients receiving home care. This quasi-experimental pre- and post-test study evaluated the effect of teach-back training on caregivers' knowledge of pressure injury prevention in 2024 within the neurology department of a teaching hospital in Iran. A total of 110 family caregivers of patients requiring home care participated. A specialized wound care research nurse delivered structured education using the teach-back method. Caregivers' knowledge was measured before the intervention and 1 month after hospital discharge using a 23-item Family Caregivers' Knowledge Regarding Pressure Injuries Questionnaire. There was a statistically significant improvement in the mean knowledge score after the intervention. Findings indicate that teach-back is a practical, low-cost, and effective educational strategy for improving caregiver knowledge related to pressure injury prevention in home care settings. The results support integrating teach-back into caregiver education programs and highlight the need for additional studies to further evaluate its impact on caregiver competence and patient outcomes.

Pressure ulcers are well recognized, yet severe cases often require surgical closure. However, contaminated wounds and external forces from postoperative positioning can lead to high complication rates, prolonging treatment and increasing burdens on patients, providers, and healthcare costs. Negative pressure wound therapy has traditionally been used for chronic ulcers and traumatic wounds, and recent studies underscore the efficacy of incisional negative pressure wound therapy (INPWT) in reducing postoperative complications. Conventional closed suction drains, however, often lose suction pressure with increased drainage volume, risking clot obstruction. We report a case using a combination of INPWT and Penrose drainage on a flap surgical wound to achieve efficient drainage and favorable outcomes. Between April 2020 and September 2021, 4 cases using INPWT postoperatively following pressure ulcer surgery were evaluated. All 4 patients were women with sacral ulcers, with an average age of 70.3 years (range 43-89 y). Comorbidities included diabetes in 1 patient and a smoking history in another. The average healing time was 14 days (range 12-16 d). Postoperative complications-including hematoma, surgical site infection, wound dehiscence, and flap necrosis-pose risks for ulcer recurrence. Effective management is therefore crucial. Combining INPWT with Penrose drainage enhanced drainage efficiency and promoted wound healing, thereby reducing complications and expediting recovery.

Rapidly progressive infectious keratitis may involve the anterior uveal tract and lead to anterior segment inflammation, resulting in severe structural damage of the cornea and potentially causing corneal perforation or endophthalmitis if not promptly treated. We report the case of a 63-year-old male admitted to the Emergency Ophthalmology Department of the University Clinical Center in Katowice, Poland, with a rapidly progressive corneal ulcer of the left eye that had not responded to two weeks of outpatient topical antibiotic therapy. The condition developed after ocular trauma sustained while chopping wood. At presentation, visual acuity was limited to light perception with preserved projection. Multimodal imaging, including slit-lamp examination, anterior segment optical coherence tomography (AS-OCT), and in vivo confocal microscopy, revealed extensive corneal ulceration with severe stromal destruction, progressive corneal melting, and marked anterior segment inflammation, with an imminent risk of perforation. Microbiological cultures identified Pseudomonas aeruginosa. Despite intensive empiric topical antimicrobial therapy targeting both bacterial infection and a possible fungal component related to trauma with organic material, rapid clinical deterioration necessitated emergency therapeutic penetrating keratoplasty (PK). The procedure resulted in rapid resolution of inflammation and improvement in visual acuity, with best-corrected visual acuity (BCVA) reaching 0.3 logMAR during follow-up. At the three-month follow-up, the corneal graft remained clear with stable visual acuity and no recurrence of infection. The patient remains under regular long-term follow-up, with ongoing monitoring of graft clarity, intraocular pressure (IOP), and visual function. This case differs from routine presentations of infectious keratitis by demonstrating exceptionally rapid stromal melting despite promptly initiated empiric topical therapy. Multimodal imaging, particularly AS-OCT provided clinically meaningful information by revealing structural instability and an imminent risk of perforation not fully appreciable on slit-lamp examination, thereby supporting timely urgent keratoplasty. These findings highlight the practical diagnostic value of imaging-based assessment in advanced infectious keratitis and underscore its role in guiding surgical decision-making in eyes at high risk of corneal perforation.