【家庭护理】严防足部皮肤破损！糖尿病患者护脚指南

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Nutritional Interventions for Pressure Ulcer Prevention in Hip Fracture Patients: A Systematic Review and Meta-Analysis of Controlled Trials 2025-08-01 00:00

Jose M. Moran 1,* , Laura Trigo-Navarro 2 , Esther Diestre-Morcillo 3 , Elena Pastor-Ramon 4 and Luis M. Puerto-Parejo 5

1 Nursing and Occupational Therapy College, University of Extremadura, 10001 Caceres, Spain

2 Área de Salud de Badajoz, Supervisora del Bloque Quirúrgico, Hospital Materno Infantil de Badajoz, Calle Violeta 3, 06010 Badajoz, Spain; 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

3 Área de Salud de Badajoz, Banco de Sangre, Hospital Universitario de Badajoz, Av. de Elvas, s/n, 06080 Badajoz, Spain

4 Biblioteca Virtual de ciencias de la Salud de las Illes Balears (Bibliosalut), Ctra. De Valldemossa, 79, mòdul L+1, 07120 Palma, Spain; 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

5 Gerencia del Área de Salud de Badajoz, Supervisor del Área de Investigación, Proyectos y Gestión, Av. de Huelva, 8, 06005 Badajoz, Spain; 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

* Correspondence: 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

Academic Editor: Yi-Chia Huang

Received: 22 January 2025

Revised: 6 February 2025

Accepted: 8 February 2025

Published: 11 February 2025

Citation: Moran, J.M.; Trigo-Navarro, L.; Diestre-Morcillo, E.; Pastor-Ramon, E.; Puerto-Parejo, L.M. Nutritional Interventions for Pressure Ulcer Prevention in Hip Fracture Patients: A Systematic Review and Meta-Analysis of Controlled Trials. Nutrients 2025, 17, 644. https://doi.org/10.3390/ nu17040644

Copyright: © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/ licenses/by/4.0/

Abstract: Background/Objective: Pressure ulcers represent a significant complication in patients with reduced mobility, such as those recovering from hip fractures. In the present study, we aimed to comprehensively assess the impact of oral nutritional interventions on the development of pressure ulcers in hip fracture patients via a systematic review and meta analysis of controlled studies evaluating the effectiveness of oral nutritional supplements compared with standard care. Methods: In accordance with PRISMA standards, this systematic review and meta-analysis of controlled studies evaluated the effectiveness of any type of oral nutritional supplements compared with standard care in hip fracture patients. The risk of bias was evaluated using the Cochrane ROB2 tool for randomized controlled trials and the ROBINS-1 tool for nonrandomized trials. Results: Fourteen studies (10 randomized controlled trials and 4 controlled trials) published since 1990 (n = 1648) were included. Oral nutritional supplementation was associated with a statistically significant decrease in the odds ratio of developing pressure ulcers in hip fracture patients (OR 0.54, 95% CI: 0.40–0.73, p < 0.001). Conclusions: The incidence and evolution of pressure ulcers can be improved by oral dietary supplementation in patients who have undergone hip fracture surgery. Accordingly, we propose that oral nutritional supplementation should be considered an essential component of comprehensive post-hip-fracture care.

Keywords: hip fracture; pressure ulcers; oral nutritional supplement; pressure sores; meta-analysis; wound healing; nutritional intervention

CB-MNCs@ CS/HEC/GP promote wound healing in aged murine pressure ulcer model 2025-07-31 00:00

Zhi‑cheng Yang1,3, He Lin1 , Guo‑jun Liu2 , Hui Pan1 , Jun‑lu Zhu3 , Xiao‑hong Zhang3 , Feng Gao2 , Zhong Wang2 and Zhi‑hao Wang1* *Correspondence: Zhi‑hao Wang 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。 1 Department of Geriatric Medicine & Laboratory of Gerontology and Anti‑Aging Research, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China 2 Shandong Qilu Stem Cell Engineering Co., Ltd, Jinan 250012, Shandong, China 3 School of Nursing and Rehabilitation, Shandong University, Jinan 250012, Shandong, China

© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.

Abstract

Background Non-healing pressure ulcers impose heavy burdens on patients and clinicians. Cord blood mononu‑ clear cells (CB-MNCs) are a novel type of tissue repair seed cells. However, their clinical application is restricted by low retention and survival rates post-transplantation. This study aims to investigate the role of thermo-sensitive chitosan/ hydroxyethyl cellulose/glycerophosphate (CS/HEC/GP) hydrogel encapsulated CB-MNCs in pressure ulcer wound

Methods Pressure ulcers were induced on the backs of aged mice. After construction and validation of the charac‑ terization of thermo-sensitive CS/HEC/GP hydrogel, CB-MNCs are encapsulated in the hydrogel, called CB-MNCs@ CS/HEC/GP which was locally applied to the mouse wounds. Mouse skin tissues were harvested for histological and molecular biology analyses.

Results CB-MNCs@CS/HEC/GP therapy accelerated pressure ulcer wound healing, attenuated inflammatory responses, promoted cell proliferation, angiogenesis, and collagen synthesis. Further investigation revealed that CB MNCs@CS/HEC/GP exerted therapeutic effects by promoting changes in cell types, including fibroblasts, endothelial cells, keratinocytes, and smooth muscle cells.

Conclusion CB-MNCs@CS/HEC/GP enhanced the delivery efficiency of CB-MNCs, preserved the cell viability, and contributed to pressure ulcer wound healing. Thus, CB-MNCs@CS/HEC/GP represents a novel therapeutic approach for skin regeneration of chronic wounds.

Keywords Wound healing, Aged, Pressure ulcers, Cord blood mononuclear cells, Thermo-sensitive hydrogel
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【家庭护理】严防足部皮肤破损！糖尿病患者护脚指南

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06 9月 2019

Author : 伤口世界

中诺医疗文章转载公众号上海第九人民医院作者谢挺

糖尿病患者大约有1.5%会发生足部溃疡，足部溃疡经久不愈，继发感染，发生坏疽。糖尿病足的截肢率很高，有报道称截肢率可高达85%，给患者造成极大痛苦，而通过积极的预防措施，可以降低40%~80%的截肢发生率。

　　在糖尿病足的预防和综合治疗中，足部护理占有特别突出的地位，通过家庭中实施的足部护理，可有效地防止或延缓糖尿病足的发生发展。足部护理的主要内容包括以下方面：

　　注意局部皮肤变化，观察皮肤的色、温度及感觉。如皮肤干燥无汗、弹性差、毛发脱落、皮温下降、皮色变暗、足背动脉搏动减弱或消失，提示动脉供血不足；如皮肤感觉缺失提示有神经营养障碍。

　　注意足部的保护，鞋袜要合适，最好选用软底布鞋及棉线袜，穿着以舒适不挤脚为宜，以保证足部血液循环的供应。由于糖尿病患者末梢神经感觉障碍，对冷热等物理刺激反应迟钝，因此冬天注意足部保暖，避免冻伤，用热水袋取暖时，热水袋内水温不超过60℃，热水袋外面用毛巾套包裹，不可直接触及皮肤，以防烫伤。

　　注意足部卫生，每晚用40~42℃的温水浸泡双脚15~30分钟，洗后用柔软吸水性强的毛巾擦干。消除过厚角质层防止干裂，可涂上植物油按摩，以保持皮肤柔软。

　　按摩足部以改善微循环。足部按摩每日早、中、晚各一次，每次10分钟，动作轻柔，应从趾尖开始向上按摩，有利于循环流畅。

　　修剪趾甲不应太靠近皮肤以免损伤甲沟皮肤导致感染，应沿着足趾甲平行修剪，不要剪向趾甲边角的深部。有胼胝的患者不要自行处理，应请专业人员帮助处理，避免不适当地应用鸡眼膏或脚癣浸泡液，以免造成足部感染。

　　减轻病变部位的负重。为了减轻病变局部的压迫，患者应注意卧床休息，不可长时间站立，行走时使用拐杖。患肢水肿者，把患肢抬高18~30°以利于静脉回流，减轻水肿。

　　日常多进行腿部运动，每日适当步行，做到定时、定量、量力而行、持之以恒。对较轻的患者可在护士的指导下，手扶椅子做单腿站立或甩腿运动，不能行走的患者在床上取坐姿位做提足运动，每日1~2次，每次至少20下。

　　糖尿病患者足部皮肤常易发生水疱，皮肤水疱易诱发感染和坏疽，一旦出现要积极处理。保持水疱清洁，避免受压，微循环改善后可自行吸收；对严重的水疱，可在无菌操作下抽出渗液。医生建议，出现了类似水疱等糖尿病皮肤早期皮肤损害，应当前往医院，在专业医护人员的指导下进行处理。

文章作者创面修复科谢挺副主任医师

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Nutritional Interventions for Pressure Ulcer Prevention in Hip Fracture Patients: A Systematic Review and Meta-Analysis of Controlled Trials 2025-08-01 00:00

Jose M. Moran 1,* , Laura Trigo-Navarro 2 , Esther Diestre-Morcillo 3 , Elena Pastor-Ramon 4 and Luis M. Puerto-Parejo 5

1 Nursing and Occupational Therapy College, University of Extremadura, 10001 Caceres, Spain

2 Área de Salud de Badajoz, Supervisora del Bloque Quirúrgico, Hospital Materno Infantil de Badajoz, Calle Violeta 3, 06010 Badajoz, Spain; 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

3 Área de Salud de Badajoz, Banco de Sangre, Hospital Universitario de Badajoz, Av. de Elvas, s/n, 06080 Badajoz, Spain

4 Biblioteca Virtual de ciencias de la Salud de las Illes Balears (Bibliosalut), Ctra. De Valldemossa, 79, mòdul L+1, 07120 Palma, Spain; 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

5 Gerencia del Área de Salud de Badajoz, Supervisor del Área de Investigación, Proyectos y Gestión, Av. de Huelva, 8, 06005 Badajoz, Spain; 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

* Correspondence: 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

Academic Editor: Yi-Chia Huang

Received: 22 January 2025

Revised: 6 February 2025

Accepted: 8 February 2025

Published: 11 February 2025

Citation: Moran, J.M.; Trigo-Navarro, L.; Diestre-Morcillo, E.; Pastor-Ramon, E.; Puerto-Parejo, L.M. Nutritional Interventions for Pressure Ulcer Prevention in Hip Fracture Patients: A Systematic Review and Meta-Analysis of Controlled Trials. Nutrients 2025, 17, 644. https://doi.org/10.3390/ nu17040644

Copyright: © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/ licenses/by/4.0/

Abstract: Background/Objective: Pressure ulcers represent a significant complication in patients with reduced mobility, such as those recovering from hip fractures. In the present study, we aimed to comprehensively assess the impact of oral nutritional interventions on the development of pressure ulcers in hip fracture patients via a systematic review and meta analysis of controlled studies evaluating the effectiveness of oral nutritional supplements compared with standard care. Methods: In accordance with PRISMA standards, this systematic review and meta-analysis of controlled studies evaluated the effectiveness of any type of oral nutritional supplements compared with standard care in hip fracture patients. The risk of bias was evaluated using the Cochrane ROB2 tool for randomized controlled trials and the ROBINS-1 tool for nonrandomized trials. Results: Fourteen studies (10 randomized controlled trials and 4 controlled trials) published since 1990 (n = 1648) were included. Oral nutritional supplementation was associated with a statistically significant decrease in the odds ratio of developing pressure ulcers in hip fracture patients (OR 0.54, 95% CI: 0.40–0.73, p < 0.001). Conclusions: The incidence and evolution of pressure ulcers can be improved by oral dietary supplementation in patients who have undergone hip fracture surgery. Accordingly, we propose that oral nutritional supplementation should be considered an essential component of comprehensive post-hip-fracture care.

Keywords: hip fracture; pressure ulcers; oral nutritional supplement; pressure sores; meta-analysis; wound healing; nutritional intervention
CB-MNCs@ CS/HEC/GP promote wound healing in aged murine pressure ulcer model 2025-07-31 00:00

Zhi‑cheng Yang1,3, He Lin1 , Guo‑jun Liu2 , Hui Pan1 , Jun‑lu Zhu3 , Xiao‑hong Zhang3 , Feng Gao2 , Zhong Wang2 and Zhi‑hao Wang1* *Correspondence: Zhi‑hao Wang 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。 1 Department of Geriatric Medicine & Laboratory of Gerontology and Anti‑Aging Research, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China 2 Shandong Qilu Stem Cell Engineering Co., Ltd, Jinan 250012, Shandong, China 3 School of Nursing and Rehabilitation, Shandong University, Jinan 250012, Shandong, China

© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.

Abstract

Background Non-healing pressure ulcers impose heavy burdens on patients and clinicians. Cord blood mononu‑ clear cells (CB-MNCs) are a novel type of tissue repair seed cells. However, their clinical application is restricted by low retention and survival rates post-transplantation. This study aims to investigate the role of thermo-sensitive chitosan/ hydroxyethyl cellulose/glycerophosphate (CS/HEC/GP) hydrogel encapsulated CB-MNCs in pressure ulcer wound

Methods Pressure ulcers were induced on the backs of aged mice. After construction and validation of the charac‑ terization of thermo-sensitive CS/HEC/GP hydrogel, CB-MNCs are encapsulated in the hydrogel, called CB-MNCs@ CS/HEC/GP which was locally applied to the mouse wounds. Mouse skin tissues were harvested for histological and molecular biology analyses.

Results CB-MNCs@CS/HEC/GP therapy accelerated pressure ulcer wound healing, attenuated inflammatory responses, promoted cell proliferation, angiogenesis, and collagen synthesis. Further investigation revealed that CB MNCs@CS/HEC/GP exerted therapeutic effects by promoting changes in cell types, including fibroblasts, endothelial cells, keratinocytes, and smooth muscle cells.

Conclusion CB-MNCs@CS/HEC/GP enhanced the delivery efficiency of CB-MNCs, preserved the cell viability, and contributed to pressure ulcer wound healing. Thus, CB-MNCs@CS/HEC/GP represents a novel therapeutic approach for skin regeneration of chronic wounds.

Keywords Wound healing, Aged, Pressure ulcers, Cord blood mononuclear cells, Thermo-sensitive hydrogel
The association between obesity indicators and mortality among individuals with hyperlipidemia: evidence from the NHANES 2003–2018 2025-07-30 00:00

Yiheng Zhang1 and Yajun Yao2,3* *Correspondence: Yajun Yao 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。 Full list of author information is available at the end of the article

The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creati vecommons.org/licenses/by-nc-nd/4.0/

Abstract

Background Obesity is linked to a variety of metabolic issues, with hyperlipidemia being a crucial adjustable risk element for cardiovascular diseases (CVD). However, the connection between indicators of obesity with overall and CVD mortality in American adults with hyperlipidemia remains unknown.

Methods This research employed an extensive cohort drawn from the National Health and Nutrition Examination Survey (NHANES) (2003–2018). Hyperlipidemia was identified through either elevated lipid profiles or self-reported utilization of lipid-reducing medications. Obesity indicators (weight-adjusted waist index (WWI), waist-to-height ratio (WHtR), body mass index (BMI)) were evaluated by physical measurement data. Weighted Cox regression models and restricted cubic splines (RCS) were employed to assess the potential links between obesity indicators and mortality outcomes. Results were further validated through subgroup analyses to ensure robustness and reliability. The receiver operating characteristic (ROC) curve was utilized to evaluate the prognostic capability of obesity indicators for

Results This cohort study included data from 12,785 participants with hyperlipidemia. Over an average follow-up period of 8.4 years, a total of 1,454 deaths were documented, 380 of which were related to heart diseases. Cox analysis manifested that, after adjusting covariates, increased WWI was linked to a higher likelihood of overall and CVD mortality (both P<0.05). RCS analysis illustrated that BMI and WHtR had U-shaped relationships with the overall and CVD mortality. Conversely, a linear positive association was uncovered between WWI and mortality (both P>0.05 for nonlinearity). Age, alcohol consumption and chronic kidney disease had modifying effects on the relationship between WWI and total mortality among those with hyperlipidemia. The area under ROC indicated that WWI was more effective than for BMI and WHtR in predicting overall and CVD deaths.

Conclusions In US adults with hyperlipidemia, the connection between BMI, WHtR, with overall and CVD mortality followed a U-shaped pattern, whereas a positive linear correlation was identified between WWI and mortality. WWI has superior predictive capability for the prognosis of individuals with hyperlipidemia compared to BMI and WHtR. These findings provide new insights and targets for the health management of individuals affected by hyperlipidemia.

Keywords Obesity, Hyperlipidemia, Weight-adjusted waist index, Mortality, NHANES

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Custom Mod Mega1

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