36-3: Wound Bed Preparation Paradigm and Keys to Assessment

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EDITORIAL

» Wound bed preparation remains central to the management of chronic, recalcitrant wounds, and continues to...

offer clinicians a practical yet scientifically grounded framework for optimizing healing outcomes. This paradigm emphasizes the importance of identifying and systematically addressing modifiable barriers through evidence-based interventions such as debridement, infection and inflammation control, moisture balance and edge advancement. Its enduring relevance lies in its ability to transform complex wound-healing science into actionable clinical practice, enabling a consistent yet individualized approach to care across diverse patient populations.

A central challenge within this framework is the persistent presence of biofilm, a key element that contributes to chronicity and resistance to conventional therapies. Biofilm management, therefore, represents a pivotal component of effective wound care. In this issue, we feature expert perspectives and scientific reviews that highlight the burden of biofilm on delayed wound healing, explore state-of-the-art diagnostic modalities, and evaluate debridement and antimicrobial strategies designed to disrupt biofilm defense mechanisms. These insights bridge the gap between microbiological science and bedside application, reinforcing the importance of continuous biofilm control as part of comprehensive wound bed preparation.

This issue of FAQ addresses objective assessment tools such as the WIfI (wound, ischemia and foot infection) classification system, which has emerged as a cornerstone in evaluating ischemic and diabetic foot wounds. A thorough vascular assessment remains a critical step in the diagnostic process, guiding appropriate revascularization decisions and adjunctive treatment strategies. The issue also explores advanced evaluation techniques, including perfusion imaging, tissue oxygenation assessment and microcirculatory analysis, all of which contribute to a more nuanced understanding of wound pathophysiology. Contemporary literature continues to highlight the synergistic importance of optimizing systemic factors, utilizing precision diagnostics and implementing cutting-edge treatments – from biologics and cellular therapies to innovative debridement modalities – to restore healing potential.

I hope that you enjoy this monograph and find it both intellectually stimulating and clinically relevant. The collective contributions in this issue underscore our shared commitment to advancing evidence-based best practices in wound assessment, diagnosis and management. As our understanding of wound healing evolves, so too must our willingness to adapt and refine clinical strategies in pursuit of improved patient outcomes.

Robert J. Snyder, DPM, MSc, MBA, CWSP, FFPM, RCPS (Glasgow)

 


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Article Authors and Lecturers

  • Windy Cole (n.)
  • Cyaandi Dove (n.)
  • J. Karim Ead (1. Data Trace Publishing Co.)
  • Howard Petusevsky (n.)
  • Robert J. Snyder (1. Data Trace Publishing Co.)

FAQ Journal Planning Committee

  • Chrissy Wesolowski (n.)
  • Lauren Molander (n.)
  • Stephanie Wu, DPM, MSc (n.)

Guest Editor

Robert J. Snyder, DPM, MSc, MBA, CWSP, FFPM, RCPS (Glasgow)
Professor, Cardiff University School of Medicine, Wales, UK; Former Dean, Professor and Director of Clinical Research, Barry University School of Podiatric Medicine, Miami, FL; Past-President, Association for the Advancement of Wound Care, Past-President, American Board of Wound Management; Certified in Foot and Ankle Surgery, American Board of Podiatric Surgery; Board-Certified Wound Specialist-Physician

Contributors

Windy Cole, DPM, CWSP
Director of Wound Care Research, Kent State University College of Podiatric Medicine, Independence, OH; Board-Certified, American Board of Foot and Ankle Surgery and American Board of Wound Management

Cyaandi Dove, DPz
Director, Diabetes Foot Program in the Division of Endocrinology, Diabetes and Clinical Nutrition, Harold Schnitzer Diabetes Health Center, Oregon Health and Science University, Portland, OR

Karim Ead, DPM, MS, AACFAS
Fellowship-Trained Podiatric Surgeon, Hearth and Vascular Institute, Division of Limb Preservation, CHRISTUS Health / CHRISTUS Trinity Clinic, Alexandria, LA; Assistant Professor of Surgery, Edward Via College of Osteopathic Medicine – Louisiana (Monroe Campus), Alexandria, LA

Howard Petusevsky, DPM, DABPM
Assistant Professor of Podiatric Medicine, College of Health Professions and Medical Sciences, Barry University, Tamarac, FL; Board-Certified, American Board of Podiatric Medicine


36-3 In This Issue

  • FEATURE ARTICLE: Wound Bed Preparation: A Comprehensive Review
    Robert J. Snyder, DPM, MSc, MBA, CWSP, FFPM, RCPS(Glasgow)
  • CONDENSATIONS and COMMENTARIES
    • Enhancing Limb Salvage in Critical Limb-Threatening Ischemia: Pedal Arch Assessment and Intervention are a Promising Step Forward
      Commentary by Windy Cole, DPM, CWSP
    • Effectiveness of Revascularization for the Ulcerated Foot in Patients with Diabetes and Peripheral Artery Disease: A Systematic Review
      Commentary by J. Karim Ead, DPM, MS, AACFAS
    • The Correlation between Transcutaneous Oxygen Pressure (TcPO2) and Forward-Looking Infrared (FLIR) Thermography in the Evaluation of Lower Extremity Perfusion According to Angiosome
      Commentary by Cyaandi Dove, DPM
    • Innovative Biochemisurgical Treatment for Stabilization of an End-Stage Chronic Wound in a Complex Vascular Compromised Patient
      Commentary by J. Karim Ead, DPM, MS, AACFAS
    • Is the Pre-Operative Wound Culture Necessary before Skin Grafting Minor Burns? A Pilot Study in a Low Resource Setting Burn Service
      Commentary by Cyaandi Dove, DPM
    • New Insights into the Role of Cellular Senescence and Chronic Wounds
      Commentary by Windy Cole, DPM, CWSP
    • Innovative Treatment of Diabetic Ulcers: Combining Chemical Debridement and Xenograft Applications: A Case Study
      Commentary by Howard Petusevsky, DPM, DABPM
    • The Landscape of Biofilm Models for Phage Therapy: Mimicking Biofilms in Diabetic Foot Ulcers Using 3D Models
      Commentary by Cyaandi Dove, DPM
    • What’s New in Wound Healing: Treatment Advances and Microbial Insights
      Commentary by J. Karim Ead, DPM, MS, AACFAS
  • AUDIO LECTURE 1: Demystifying Wound Infection: A Clinical Perspective on Biofilm and New Innovations
    Robert J. Snyder, DPM, MSc, MBA, CWSP, FFPM, RCPS(Glasgow)
  • AUDIO LECTURE 2: Making WIfI Real: Using the Wound-Ischemia-Foot Infection (WIfI) Classification to Guide Limb-Threatening Diabetic Foot Care
    Karim Ead, DPM, MS, AACFAS
  • CME Questionnaire