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The level of personal health literacy of patients with venous leg ulcers is likely to affect their ability to self-manage their condition impacting on their adherence to treatment and influences healing and recovery outcomes. To scope existing research that examined the level of health literacy in venous leg ulcer patients, to identify how this may link to self-management behaviours (particularly physical activity and compression adherence), and venous leg ulcer healing outcomes. This scoping review was based on the PRISMA-ScR six-stage framework. We searched MEDLINE, EMBASE, the Cochrane Library, PsycInfo and Health, Open Grey, and Google Scholar for publications examining general and specific health literacy in those with venous leg ulcers and for those examining any potential links of health literacy with self-management/healing generally, published between 2000-2020. This search was guided by a published protocol; studies that described other types of ulcers or did not examine health literacy were excluded. After applying inclusion and exclusion criteria the initial search identified 660 articles. We included five articles. Four studies used randomised controlled trials or experimental designs to test the effect of specific health literacy interventions on venous leg ulcer knowledge, compression therapy use, or healing outcomes. One study was a cross- sectional survey with qualitative elements, assessing health literacy in venous leg ulcer patients. Broadly, the research suggested that health literacy was suboptimal amongst those with venous leg ulcers, and health literacy interventions had limited effects on improving key venous leg ulcer specific outcomes. This review provides a synthesis of extant literature examining health literacy in patients with venous leg ulcers. We identified a dearth of literature investigating the value of general and specific health literacy interventions in this space. Most importantly, no recent research on general health literacy and venous leg ulcers was identified, despite strong theoretical utility to do so. The few studies identified largely indicated that targeting health literacy of patients with venous leg ulcers is a viable area of research and intervention, encouraging future researchers and clinicians to consider patient health literacy in venous leg ulcer management.

Background Wound care represents a considerable challenge, especially for newly graduated nurses. The development of a mobile application is envisioned to improve knowledge transfer and facilitate evidence-based practice. The aim of this study was to establish expert consensus on the initial content of the algorithm for a wound care mobile application for newly graduated nurses. Methods Experts participated in online surveys conducted in three rounds. Twenty-nine expert wound care nurses participated in the first round, and 25 participated in the two subsequent rounds. The first round, which was qualitative, included a mandatory open-ended question solicitating suggestions for items to be included in the mobile application. The responses underwent content analysis. The subsequent two rounds were quantitative, with experts being asked to rate their level of agreement on a 5-point Likert scale. These rounds were carried out iteratively, allowing experts to review their responses and see anonymized results from the previous round. We calculated the weighted kappa to determine the individual stability of responses within-subjects between the quantitative rounds. A consensus threshold of 80% was predetermined. Results In total, 80 items were divided into 6 categories based on the results of the first round. Of these, 75 (93.75%) achieved consensus during the two subsequent rounds. Notably, 5 items (6.25%) did not reach consensus. The items with the highest consensus related to the signs and symptoms of infection, pressure ulcers, and the essential elements for healing. Conversely, items such as toe pressure measurement, wounds around drains, and frostbite failed to achieve consensus. Conclusions The results of this study will inform the development of the initial content of the algorithm for a wound care mobile application. Expert participation and their insights on infection-related matters have the potential to support evidence-based wound care practice. Ongoing debates surround items without consensus. Finally, this study establishes expert wound care nurses’ perspectives on the competencies anticipated from newly graduated nurses.

Background Chronic wounds (CWs) represent a significant and growing challenge in healthcare due to their prolonged healing times, complex management, and associated costs. Inadequate wound assessment by healthcare professionals (HCPs), often due to limited training and high clinical workload, contributes to suboptimal treatment and increased risk of complications. This study aimed to develop an artificial intelligence (AI)-powered wound assessment tool, integrated into a mobile application, to support HCPs in diagnosis, monitoring, and clinical decision-making. Methods A multicenter observational study was conducted across three healthcare institutions in Western Switzerland. Researchers compiled a hybrid dataset of approximately 4,000 wound images through both retrospective extraction from clinical records and prospective collection using a standardized mobile application. The prospective data included high-resolution images, short videos, and 3D scans, along with structured clinical metadata. Retrospective data were anonymized and manually annotated by wound care experts. All images were labeled for wound segmentation and tissue classification to train and validate deep learning models. Results The resulting dataset represented a broad spectrum of wound types (acute and chronic), anatomical locations, skin tones, and healing stages. The AI-based wound segmentation model, developed using the Deeplabv3 + architecture with a ResNet50 backbone, achieved a DICE score of 92% and an Intersection-over-Union (IOU) score of 85%. Tissue classification yielded a preliminary mean DICE score of 78%, although accuracy varied across tissue types, especially fibrin and necrosis. The models were optimized for mobile implementation through quantization, achieving real-time inference with an average processing time of 0.3 seconds and only a 0.3% performance reduction. The dual approach to data collection, prospective and retrospective—ensured both image standardization and real-world variability, enhancing the model’s generalizability. Conclusions This study laid the foundation for an AI-driven digital tool to assist clinical wound assessment and education. The integration of robust datasets and AI models demonstrated the potential to improve diagnostic precision, support personalized care, and reduce wound-related healthcare costs. Although challenges remained, particularly in tissue classification, this work highlighted the promise of AI in transforming wound care and advancing clinical training. Trial registration Not applicable. Key Points This study aims to develop an AI-powered wound assessment tool that supports clinical decision-making and enhances wound care quality through accurate tissue segmentation, wound monitoring, and healing prediction. A large and diverse wound image database, including over 4000 wound assessments—will be created to train and validate AI models, ensuring clinical relevance across various wound types and patient profiles. This innovation addresses a critical gap in wound care expertise, aiming to reduce diagnostic variability, support guideline adherence, and ultimately improve patient outcomes while lowering healthcare costs.

This manuscript provides critical reflections on using reporting guidelines in qualitative research and examines the tensions that arise when universal checklists are applied across diverse methodological traditions. While transparency and rigor are essential, our manuscript supports that widely adopted tools such as COREQ-32 insufficiently capture the epistemological and procedural features of certain methodologies, particularly Constructivist Grounded Theory. Drawing on existing critiques and emerging methodology-specific frameworks, we argue that rigid, sometimes unvalidated criteria could impede methodological congruence and provide limitations to report Constructivist Grounded Theory research. This reflection contributes to methodological scholarship by advocating for reporting guidance that aligns with the philosophical and methodological stance of each qualitative approach. Therefore, we call for nuanced, method-congruent standards that enhance transparency while preserving the richness, reflexivity, and flexibility that underpin excellence in qualitative inquiry.

An increasing number of health care professionals are using mobile apps. The mHealth App Usability Questionnaire (MAUQ) was designed to evaluate the usability of mobile health apps by patients and providers. However, this questionnaire is not available in French. This study aims to translate (from English to Canadian French), cross-culturally adapt, and initiate the validation of the original version of MAUQ for stand-alone mobile health apps used by French-speaking health care providers. A cross-cultural research study using a well-established method was conducted to translate MAUQ to Canadian French by certified translators and subsequently review it with a translation committee. It was then back translated to English. The back translations were compared with the original by the members of the committee to reach consensus regarding the prefinal version. A pilot test of the prefinal version was conducted with a sample of 49 potential users and 10 experts for content validation. The statements are considered clear, with interrater agreement of 99.14% among potential users and 90% among experts. Of 21 statements, 5 (24%) did not exceed the 80% interrater agreement of the experts regarding clarity. Following the revisions, interrater agreement exceeded 80%. The content validity index of the items varied from 0.90 to 1, and the overall content validity index was 0.981. Individual Fleiss multirater κ of each item was between 0.89 and 1, showing excellent agreement and increasing confidence in the questionnaire's content validity. This process of translation and cultural adaptation produced a new version of MAUQ that was validated for later use among the Canadian French-speaking population. An upcoming separate study will investigate the psychometric properties of the adapted questionnaire.

Wound care and soft tissue repair have been a major human concern for millennia. Despite considerable advancements in standards of living and medical abilities, difficult-to-heal wounds remain a major burden for patients, clinicians and the healthcare system alike. Due to an aging population, the rise in chronic diseases such as vascular disease and diabetes, and the increased incidence of antibiotic resistance, the problem is set to worsen. The global wound care market is constantly evolving and expanding, and has yielded a plethora of potential solutions to treat poorly healing wounds. In ancient times, before such a market existed, metals and their ions were frequently used in wound care. In combination with plant extracts, they were used to accelerate the healing of burns, cuts and combat wounds. With the rise of organic chemistry and small molecule drugs and ointments, researchers lost their interest in inorganic materials. Only recently, the advent of nano-engineering has given us a toolbox to develop inorganic materials on a length-scale that is relevant to wound healing processes. The robustness of synthesis, as well as the stability and versatility of inorganic nanotherapeutics gives them potential advantages over small molecule drugs. Both bottom-up and top-down approaches have yielded functional inorganic nanomaterials, some of which unite the wound healing properties of two or more materials. Furthermore, these nanomaterials do not only serve as the active agent, but also as the delivery vehicle, and sometimes as a scaffold. This review article provides an overview of inorganic hybrid nanotherapeutics with promising properties for the wound care field. These therapeutics include combinations of different metals, metal oxides and metal ions. Their production, mechanism of action and applicability will be discussed in comparison to conventional wound healing products.

IntroductionVenous leg ulcers are slow-healing wounds with a high risk of recurrences. To prevent recurrences and promote healing, different nurse-led educational interventions have been developed. The impact of these interventions on self-management is ambiguous. Also, how persons with a venous leg ulcer experiences these educational sessions are poorly described.AimThis study protocol presents the methodology to provide a comprehensive explanation of participants’ journeys—of how they experience their individualised education sessions concerning self-management.Methods and analysisA constructivist grounded theory approach according to Charmaz involving 30 participants will be used. Data will be collected through semistructured face-to-face interviews. Interviews will be transcribed verbatim and analysed with initial and focus coding using MAXQDA. Data collection and data analysis will occur iteratively, focusing on constant comparison to obtain well-developed categories. Categories will be reinforced using existent literature.Ethics and disseminationThis pre-results study is embedded in a clinical trial (NCT04019340) and approved by ethical committee of the canton of Geneva (CCER: 2019-01964). A theory will emerge from participants’ journeys informing future education sessions for patients with venous leg ulcers. The findings will be disseminated through peer-reviewed publications and communications.

Background Venous leg ulcers are slow-healing wounds with a high recurrence rate of 70% and a 60% risk of becoming chronic. Signs and symptoms such as pain or exudate are not only a burden on those affected but also on the healthcare system and society in general. The estimated leg ulcer prevalence in the general population is 1%. Treatment costs for leg ulcers are estimated to be 3% of overall health expenditure. Current therapeutic approaches are multifaceted and include compression therapy, leg elevation, specific ankle-exercises and a protein diet. They require an interdisciplinary team of health care professionals. Approximately 70% of patients have a knowledge deficit with regards to therapeutic measures and have difficulties with adherence to treatment protocols. Therefore, it is of utmost importance that the treatment team provides effective patient education and support during the learning phase. However, there is little evidence and no published studies that describe and evaluate effective interdisciplinary educational interventions that target compliance/adherence to the treatment plan in patients with leg ulcers. We therefore propose to develop an evidence-based interprofessional educational intervention and evaluate its feasibility first in a pilot study and subsequently in a randomized controlled trial. Method/Design First, the development of an evidence-based educational intervention in collaboration with an expert panel is proposed and second, a randomized controlled feasibility study in a wound-care outpatient clinic. Eligible patients ( n = 20) with leg ulcers will be randomized to receive either interdisciplinary education and usual care or only usual care, for 12 weeks. Data will be analyzed using SPSS version 25. Univariate and bivariate analysis will be conducted according to the data level and distribution of the data. Discussion We will first develop an evidenced-based educational intervention and second, we will examine the feasibility of implementing this educational intervention in a realistic care context in patients with leg ulcers. The results will inform the final design of a subsequent randomized controlled trial, which will examine the effectiveness of the educational intervention. An intervention that enhances patient adherence to therapy would be beneficial to individual patients and to society as a whole. Trial registration ClinicalTrials.gov, NCT03454698 . Registered on 6 March 2018.

ObjectiveThis study was conducted to assess the psychometric properties of the translated and adapted Venous Leg Ulcer Self Efficacy Tool (VeLUSET) in the new cultural context.DesignValidation studySettingThree outpatient clinics in Western Switzerland.Participants32 consecutive persons with venous leg ulcers (VLU).Main outcome measuresTo determine the internal consistency and reliability of the VeLUSET for use in a Swiss-French speaking venous leg ulcer population.ResultsOverall, the Cronbach alpha for the VeLUSET-FR was 0.96 (95% CI 0.93 to 0.98) on test and retest. Lin’s concordance correlation coefficient of test and retest scores was 0.93 (95% CI 0.86 to 0.96).ConclusionThe results indicate that the VeLUSET-FR is a valid and reliable instrument for measuring self-efficacy among Swiss-French persons affected by a venous leg ulcer. Our findings show that the psychometric properties are similar to those of the original tool. Therefore, we suggest that the VeLUSET-FR can be effectively used for measuring self-efficacy in Swiss-French persons with VLU.