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Article ; Online: Prevalence and characteristics of pain in patients with lower-extremity ulcers-A cross-sectional study.

Sabah, Lubna / Burian, Ewa Anna / Kirketerp-Møller, Klaus / Thomsen, Simon Francis / Moltke, Finn Borgbjerg

Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society

2024 Volume 32, Issue 2, Page(s) 155–163

Abstract: The study aimed to investigate the prevalence and characteristics of pain in different ulcer types and to identify factors associated with pain experience in patients with lower-extremity ulcers. A cross-sectional single-centre study was performed, ... ...

Abstract	The study aimed to investigate the prevalence and characteristics of pain in different ulcer types and to identify factors associated with pain experience in patients with lower-extremity ulcers. A cross-sectional single-centre study was performed, including 130 newly referred outpatients with lower-extremity ulcers. Pain intensity was measured with a visual analog scale (VAS) and pain characteristics with the short form mcgill pain questionnaire-2 (SF-MPQ-2). The mean pain intensity was 29.5 (SD 31.8) at rest and 35.5 (SD 34.1) during movement (0-100 VAS). 61.5% of the patients experienced pain (VAS > 0) at rest and 70.8% during movement. Moderate to severe pain at rest was seen in 39.2% and in 43.8% of patients during movement. The mean total score on SF-MPQ-2 (range 0-220) was 35.9 (SD 32.6). Most of the patients described pain as intermittent (mean 11.8 SD 13.9). Analgesics were prescribed for 78% of the patients. Ulcer type (i.e., arterial, immunological, pressure and venous) and age were associated with pain severity, and women had a significantly lower well-being score than men. Prevalence of pain in patients with lower-extremity ulcers was high across different ulcer aetiologies. Pain intensity and quality must be assessed to obtain adequate pain management.
MeSH term(s)	Male ; Humans ; Female ; Cross-Sectional Studies ; Ulcer ; Prevalence ; Wound Healing ; Pain/epidemiology ; Pain/etiology ; Leg Ulcer/epidemiology ; Leg Ulcer/complications ; Extremities
Language	English
Publishing date	2024-01-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	1174873-4
ISSN	1524-475X ; 1067-1927
ISSN (online)	1524-475X
ISSN	1067-1927
DOI	10.1111/wrr.13153
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Article ; Online: [No title information]

Svendsen, Ole Lander / Kirketerp-Møller, Klaus / Olsen, Johnny Baumann / Palm, Henrik

Ugeskrift for laeger

2023 Volume 185, Issue 35

Abstract: In Denmark, the incidence rate of lower extremity amputations (LEA) in patients with diabetes has decreased remarkably from 1980 to 2017, in contrast to USA, where it has increased in the last decade. In this review the development in Denmark is ... ...

Title translation	Amputations in Denmark in patients with diabetes.
Abstract	In Denmark, the incidence rate of lower extremity amputations (LEA) in patients with diabetes has decreased remarkably from 1980 to 2017, in contrast to USA, where it has increased in the last decade. In this review the development in Denmark is summarised. In fact, in 2017, the incidence rate of LEA in patient with diabetes was "only" two-4 four-fold larger than in persons without diabetes. Evidence-based guidelines, like the national treatment guideline from the Danish Endocrine Society, must be followed by health-care providers and patients to further decrease the incidence rate of LEA.
MeSH term(s)	Humans ; Diabetes Mellitus ; Amputation, Surgical ; Health Personnel ; Denmark/epidemiology
Language	Danish
Publishing date	2023-09-26
Publishing country	Denmark
Document type	Review ; English Abstract ; Journal Article
ZDB-ID	124102-3
ISSN	1603-6824 ; 0041-5782
ISSN (online)	1603-6824
ISSN	0041-5782
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Article ; Online: Novel sampling technique maintaining the two-dimensional organization of microbes during cultivation from chronic wounds: The Imprint method.

Iversen, Anne Kristine Servais / Fritz, Blaine Gabriel / Hansen, Mads Joachim / Kirketerp-Møller, Klaus / Jakobsen, Tim Holm / Bjarnsholt, Thomas / Lichtenberg, Mads

APMIS : acta pathologica, microbiologica, et immunologica Scandinavica

2024 Volume 132, Issue 3, Page(s) 210–220

Abstract: This study aimed to develop and validate "the Imprint method,", a technique for sampling microbes from chronic wounds while preserving their two-dimensional spatial organization. We used nylon filters to sample bacteria and compared with sampling using ... ...

Abstract	This study aimed to develop and validate "the Imprint method,", a technique for sampling microbes from chronic wounds while preserving their two-dimensional spatial organization. We used nylon filters to sample bacteria and compared with sampling using Eswabs in 12 patients. The Imprint method identified a mean of 0.93 unique species more than Eswab (4.3 ± 2.2 and 3.4 ± 1.4 unique species, respectively; mean ± SD; n = 30). Accuracy between the Eswab and the Imprint method was 93.2% and in cases of disagreement between methods, Imprint had a higher sensitivity in 6/8 of the most prevalent species. In vitro validation confirmed that the Imprint method could transfer bacterial colonies while replicating their two-dimensional organization and the area covered by bacteria on the plate sampled. Clinical testing demonstrated that the imprint method is a rapid and feasible technique that identified more unique bacterial species than Eswab with a good agreement between methods but that Imprint was better at detecting important pathogens such as Staphylococcus aureus and Pseudomonas aeruginosa. The Imprint method is a novel technique that cultures and records the two-dimensional organization of microbes, providing an alternative or supplement to conventional surface culture using Eswab.
MeSH term(s)	Humans ; Bacteria ; Staphylococcus aureus ; Specimen Handling/methods ; Staphylococcal Infections/microbiology ; Pseudomonas aeruginosa
Language	English
Publishing date	2024-01-25
Publishing country	Denmark
Document type	Journal Article
ZDB-ID	93340-5
ISSN	1600-0463 ; 0903-4641
ISSN (online)	1600-0463
ISSN	0903-4641
DOI	10.1111/apm.13372
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Article ; Online: Bacterial invasion of the submicron osteocyte lacuna-canaliculi network (OLCN): a part of osteomyelitis disease biology.

Jensen, Louise Kruse / Birch, Julie Melsted / Jensen, Henrik Elvang / Kirketerp-Møller, Klaus / Gottlieb, Hans

APMIS : acta pathologica, microbiologica, et immunologica Scandinavica

2023 Volume 131, Issue 7, Page(s) 325–332

Abstract: Two chronic osteomyelitis patients, a diabetic foot osteomyelitis patient and a fracture-related infection patient, all with staphylococci-positive microbiology, were examined to confirm the clinical relevance of bacterial invasion of the submicron ... ...

Abstract	Two chronic osteomyelitis patients, a diabetic foot osteomyelitis patient and a fracture-related infection patient, all with staphylococci-positive microbiology, were examined to confirm the clinical relevance of bacterial invasion of the submicron osteocyte lacuna-canaliculi network (OLCN) in bone tissue. Based on immunohistochemistry and light microscopy both Staphylococcus aureus and Staphylococcus epidermidis were identified within the OLCN of all four patients. The findings consolidate that bacterial OLCN invasion is a clinically relevant part of osteomyelitis disease biology, which from experimental porcine infections, seems to be time depending. The microscopy pictures of the four patients significantly add to visualize the phenomenon of bacterial OLCN invasion.
MeSH term(s)	Animals ; Swine ; Osteocytes/microbiology ; Osteomyelitis/microbiology ; Staphylococcus aureus ; Staphylococcus ; Staphylococcal Infections/microbiology ; Biology
Language	English
Publishing date	2023-05-11
Publishing country	Denmark
Document type	Journal Article
ZDB-ID	93340-5
ISSN	1600-0463 ; 0903-4641
ISSN (online)	1600-0463
ISSN	0903-4641
DOI	10.1111/apm.13312
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Article ; Online: Glucagon-like peptide-1 treatment reduces the risk of diabetes-type 2 related amputations: A cohort study in Denmark.

Schäfer, Zeinab / Mathisen, Andreas / Thomsen, Trine Rolighed / Rossing, Peter / Kirketerp-Møller, Klaus

Diabetes research and clinical practice

2023 Volume 202, Page(s) 110799

Abstract: Aims: To assess the impact of Glucagon-like peptide-1 (GLP-1) agonists on the risk of lower extremity amputations in patients with type 2 diabetes mellitus (DM2).: Methods: We conducted a cohort study on 309,116 patients with DM2 using Danish ... ...

Abstract	Aims: To assess the impact of Glucagon-like peptide-1 (GLP-1) agonists on the risk of lower extremity amputations in patients with type 2 diabetes mellitus (DM2). Methods: We conducted a cohort study on 309,116 patients with DM2 using Danish National Register and Diabetes Database. We tracked the GLP-1 agonists over time along with the medication dose. Time-varying models are used to assess the risk of amputation for patients with/without GLP-1 treatment. Results: Patients on GLP-1 treatment experience a notable reduction in the risk of amputation compared to those without the treatment with a hazard ratio (HR) of 0.5, 95% CI [0.54-0.74], indicating a statistically significant difference (p <.005). This risk reduction was consistent across different age groups, but notably most pronounced among middle income patients. The findings were further validated by using time-varying Cox models, which considered the patient's comorbidity history. Conclusions: Our analysis reveals compelling evidence of a reduced risk of amputation among patients receiving GLP-1 therapy, an effect dominated by liraglutide, compared to those without the treatment, even after adjusting for various socio-economic factors. However, further investigation is required to identify and account for any other potential confounding variables that may impact the outcome.
MeSH term(s)	Humans ; Diabetes Mellitus, Type 2/drug therapy ; Diabetes Mellitus, Type 2/chemically induced ; Glucagon-Like Peptide 1 ; Hypoglycemic Agents ; Cohort Studies ; Amputation, Surgical ; Denmark/epidemiology ; Glucagon-Like Peptide-1 Receptor/therapeutic use
Chemical Substances	Glucagon-Like Peptide 1 (89750-14-1) ; Hypoglycemic Agents ; Glucagon-Like Peptide-1 Receptor
Language	English
Publishing date	2023-06-28
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	632523-3
ISSN	1872-8227 ; 0168-8227
ISSN (online)	1872-8227
ISSN	0168-8227
DOI	10.1016/j.diabres.2023.110799
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Article: Non-antibiotic antimicrobial interventions and antimicrobial stewardship in wound care.

Cooper, Rose / Kirketerp-Møller, Klaus

Journal of wound care

2018 Volume 27, Issue 6, Page(s) 355–377

Abstract: Control of wound infection today relies largely on antibiotics, but the continual emergence of antibiotic-resistant microorganisms threatens a return to the pre-antibiotic era when physicians used antiseptics to prevent and manage infection. Some of ... ...

Abstract	Control of wound infection today relies largely on antibiotics, but the continual emergence of antibiotic-resistant microorganisms threatens a return to the pre-antibiotic era when physicians used antiseptics to prevent and manage infection. Some of those antiseptics are still used today, and others have become available. A diverse variety of non-antibiotic antimicrobial interventions are found on modern formularies. Unlike the mode of action of antibiotics, which affect specific cellular target sites of pathogens, many non-antibiotic antimicrobials affect multiple cellular target sites in a non-specific way. Although this reduces the likelihood of selecting for resistant strains of microorganisms, some have emerged and cross-resistance between antibiotics and antiseptics has been detected. With the prospect of a post-antibiotic era looming, ways to maintain and extend our antimicrobial armamentarium must be found. In this narrative review, current and emerging non-antibiotic antimicrobial strategies will be considered and the need for antimicrobial stewardship in wound care will be explained.
MeSH term(s)	Anti-Bacterial Agents/therapeutic use ; Anti-Infective Agents/therapeutic use ; Antimicrobial Stewardship/methods ; Drug Resistance, Microbial/drug effects ; Humans ; Wound Infection/drug therapy
Chemical Substances	Anti-Bacterial Agents ; Anti-Infective Agents
Language	English
Publishing date	2018-06-08
Publishing country	England
Document type	Journal Article
ZDB-ID	1353951-6
ISSN	0969-0700
ISSN	0969-0700
DOI	10.12968/jowc.2018.27.6.355
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Article ; Online: The zone model: A conceptual model for understanding the microenvironment of chronic wound infection.

Kirketerp-Møller, Klaus / Stewart, Philip S / Bjarnsholt, Thomas

Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society

2020 Volume 28, Issue 5, Page(s) 593–599

Abstract: In 2008, two articles in Wound Repair and Regeneration changed the clinical perspective on chronic wounds. They stated that chronic wounds that do not heal contain bacterial biofilms and that these biofilms may be one of the reasons for the nonhealing ... ...

Abstract	In 2008, two articles in Wound Repair and Regeneration changed the clinical perspective on chronic wounds. They stated that chronic wounds that do not heal contain bacterial biofilms and that these biofilms may be one of the reasons for the nonhealing properties of the wounds. However, we still do not understand the exact role biofilms play in the halted healing process, and we are not able to successfully treat them. The reason for this could be that in vivo biofilms differ substantially from in vitro biofilms, and that most of the knowledge about biofilms originates from in vitro research. In this article, we introduce the zone model as a concept for understanding bacterial behavior and the impact of the microenvironment on both the host and the bacteria. Until now, identification of bacteria, gene expression, and postscript regulation have been looking at a bulk of bacteria and averaging the behavior of all the bacteria. As the zone model dictates that every single bacterium reacts to its own microenvironment, the model may facilitate the planning of future research with improved clinical relevance. The zone model integrates physiology and biology from single cells, microbial aggregates, local host response, surrounding tissue, and the systemic context of the whole host. Understanding the mechanisms behind the actions and reactions by a single bacterium when interacting with other neighboring bacteria cells, other microorganisms, and the host will help us overcome the detrimental effects of bacteria in chronic wounds. Furthermore, we propose use of the terminology "bacterial phenotype" when describing the actions and reactions of bacteria, and the term "biofilms" to describe the morphology of the bacterial community.
MeSH term(s)	Bacterial Infections/microbiology ; Biofilms ; Humans ; Skin Diseases, Bacterial/microbiology ; Wound Healing ; Wound Infection/microbiology
Language	English
Publishing date	2020-06-30
Publishing country	United States
Document type	Journal Article
ZDB-ID	1174873-4
ISSN	1524-475X ; 1067-1927
ISSN (online)	1524-475X
ISSN	1067-1927
DOI	10.1111/wrr.12841
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Article ; Online: The clinical course and mortality of persons with diabetic Charcot foot.

Engberg, Susanne / Andersen, Henrik Ullits / Rasmussen, Anne / Kirketerp-Møller, Klaus

Danish medical journal

2021 Volume 69, Issue 1

Abstract: Introduction: The aim was to study the mortality and the clinical course of diabetic Charcot foot.: Methods: This was a retrospective cohort study including all persons with diabetes and a Charcot diagnosis from 2000 to 2016.: Results: In the ... ...

Abstract	Introduction: The aim was to study the mortality and the clinical course of diabetic Charcot foot. Methods: This was a retrospective cohort study including all persons with diabetes and a Charcot diagnosis from 2000 to 2016. Results: In the mortality sub-study, 164 persons had the Charcot diagnosis, 52 (31.1%) died in the follow-up period. The mortality rate was 4.6/100 person-years at risk. Rate ratios for death were insignificantly different among smokers and non-smokers, among persons with type 1 and type 2 diabetes, among persons with a diabetes duration below or above ten years and among persons with a glycated haemoglobin (HbA1c) level above or below 60 mmol/mol after adjustment for age and gender. In the clinical course sub-study, 114 persons with Charcot were identified whereof 97 (85%) had an active Charcot. The duration from start of symptoms to diagnosis was ten weeks, the treatment period was 7.5 months and 46 (40%) had bony prominences (rocker bottom) in the planta at follow-up. Conclusions: The mortality rate among persons with Charcot was 4.6/person-years at risk, which was unaffected by smoking, diabetes type, diabetes duration and HbA1c level. The persons with Charcot had a long delay from symptom onset to diagnosis, a long treatment period and often developed complications. Funding: This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors. Trial registration: not relevant.
MeSH term(s)	Arthropathy, Neurogenic/etiology ; Diabetes Mellitus, Type 2/complications ; Diabetic Foot ; Glycated Hemoglobin A ; Humans ; Retrospective Studies
Chemical Substances	Glycated Hemoglobin A
Language	English
Publishing date	2021-12-15
Publishing country	Denmark
Document type	Journal Article
ZDB-ID	2648771-8
ISSN	2245-1919 ; 2245-1919
ISSN (online)	2245-1919
ISSN	2245-1919
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Article ; Online: [Research trends in wound care].

Burian, Ewa Anna / Karlsmark, Tonny / Ågren, Magnus S / Jørgensen, Bo / Kirketerp-Møller, Klaus

Ugeskrift for laeger

2022 Volume 184, Issue 8

Abstract: Advanced wound care strategies are emerging, but more robust clinical data are needed such as identification of precise biomarkers for point-of-care diagnostics and 24/7 data. This will aid in the implementation of effective therapies in relevant ... ...

Abstract	Advanced wound care strategies are emerging, but more robust clinical data are needed such as identification of precise biomarkers for point-of-care diagnostics and 24/7 data. This will aid in the implementation of effective therapies in relevant patients. Increased knowledge among health care providers, health literacy improvement as well as patient involvement are also important in this process. In this review we focus on current research trends in compression therapy, modulation of inflammation and growth factors, the proteolytic microenvironment and microbiology.
MeSH term(s)	Health Literacy ; Humans
Language	Danish
Publishing date	2022-03-03
Publishing country	Denmark
Document type	Journal Article ; Review
ZDB-ID	124102-3
ISSN	1603-6824 ; 0041-5782
ISSN (online)	1603-6824
ISSN	0041-5782
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Article ; Online: Effect of Stabilized Hypochlorous Acid on Re-epithelialization and Bacterial Bioburden in Acute Wounds: A Randomized Controlled Trial in Healthy Volunteers.

Burian, Ewa A / Sabah, Lubna / Kirketerp-Møller, Klaus / Gundersen, Glenn / Ågren, Magnus S

Acta dermato-venereologica

2022 Volume 102, Page(s) adv00727

Abstract: The aim of this randomized controlled trial was to evaluate the wound-healing effect and antimicrobial properties of a novel stabilized hypochlorous acid solution on acute wounds, using a suction blister wound model. One suction blister was raised and de- ...

Abstract	The aim of this randomized controlled trial was to evaluate the wound-healing effect and antimicrobial properties of a novel stabilized hypochlorous acid solution on acute wounds, using a suction blister wound model. One suction blister was raised and de-roofed on each forearm in 20 healthy volunteers. Stabilized hypochlorous acid/control (sterile 0.9% NaCl) solutions were assigned to either wound by randomization. Wounds were irrigated and treated on days 0, 2 and 4. Re-epithelialization was assessed blindly by digital planimetry, and bacterial growth was assessed as the number of colony-forming units cultured from surface swabs. Hypochlorous acid solution increased the degree of re-epithelialization on day 4 by 14% compared with the control solution (95% confidence interval (CI) 6.8-20%, p = 0.00051) and was not inferior (p < 0.0001) to the control solution on day 10 (0.3%, 95% CI -1.3-1.9%). Median bacterial counts were lower with stabilized hypochlorous acid compared with control and were further reduced after irrigation and treatment of both groups on day 4, but remained lower in the stabilized hypochlorous acid group compared with the control group. This study demonstrates immediate and durable antimicrobial action and a beneficial effect on acute wound healing after irrigation and treatment with a stabilized hypochlorous acid formulation.
MeSH term(s)	Blister ; Healthy Volunteers ; Humans ; Hypochlorous Acid ; Re-Epithelialization ; Wound Healing
Chemical Substances	Hypochlorous Acid (712K4CDC10)
Language	English
Publishing date	2022-05-31
Publishing country	Sweden
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	80007-7
ISSN	1651-2057 ; 0001-5555
ISSN (online)	1651-2057
ISSN	0001-5555
DOI	10.2340/actadv.v102.1624
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