{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T12:31:38Z","timestamp":1788093098346,"version":"build-2803163510"},"reference-count":44,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2018,10,17]],"date-time":"2018-10-17T00:00:00Z","timestamp":1539734400000},"content-version":"vor","delay-in-days":169,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Japanese Society of Pressure Ulcer"},{"name":"Japanese Ministry of Education, Culture, Sports, Science and Technology JSPS KAKENHI","award":["JP17K11547"],"award-info":[{"award-number":["JP17K11547"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Wound Repair Regeneration"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>The authors aimed to assess the factors that impair cell proliferation in the granulation tissue of pressure ulcers using immunohistochemistry for the cell proliferation marker Ki\u201067. This was a single center, cross\u2010sectional study. The study included 86 patients with stage III or IV pressure ulcers. Two granulation tissue biopsy specimens were obtained from 86 patients. The specimens were used for histological examination, Ki\u201067 immunohistochemistry, and bacterial count assessment. The % of Ki\u201067\u2010stained cells was considered as the Ki\u201067 index. Pearson's product\u2013moment correlation coefficient (r) was used to assess the relationship between the Ki\u201067 index and other quantitative variables, including age, body mass index, bacterial count (Log10 CFU\/g), serum albumin level, hemoglobin level, white blood cell count, and C\u2010reactive protein level. The Mann\u2013Whitney <jats:italic>U<\/jats:italic> test was used to compare the mean Ki\u201067 index according to gender, diabetes, smoking status, and wound culture. Univariate and multivariate linear regression analyses were used to assess the association between the Ki\u201067 index and other parameters. The Mann\u2013Whitney <jats:italic>U<\/jats:italic> test revealed that the bacteria\u2010positive group had a lower Ki\u201067 index (<jats:italic>p<\/jats:italic> = 0.045). Bacterial count demonstrated a significant negative correlation with the Ki\u201067 index (<jats:italic>r<\/jats:italic> = \u22120.325, <jats:italic>p<\/jats:italic> = 0.002). Multivariate linear regression analysis showed that bacterial count was a significant predictor of the Ki\u201067 index. The adjusted \u03b2\u2010coefficient was \u22121.34 (95% confidence interval, \u22122.01 to \u22120.66, <jats:italic>p<\/jats:italic> &lt; 0.001). Among the isolated bacteria, <jats:italic>Corynebacterium spp.<\/jats:italic> and <jats:italic>Staphylococcus aureus<\/jats:italic> were significantly associated with a low Ki\u201067 index, but <jats:italic>Pseudomonas aeruginosa<\/jats:italic> was not. These results suggest a negative relationship between bacterial count and cell proliferation in pressure ulcer granulation tissue, as indicated by the Ki\u201067 index. Granulation tissue formation in pressure ulcers may be accelerated if high bacterial load is treated appropriately.<\/jats:p>","DOI":"10.1111\/wrr.12675","type":"journal-article","created":{"date-parts":[[2018,9,28]],"date-time":"2018-09-28T23:00:50Z","timestamp":1538175650000},"page":"284-292","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Factors impairing cell proliferation in the granulation tissue of pressure ulcers: Impact of bacterial burden"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8253-5540","authenticated-orcid":false,"given":"Tomoya","family":"Sato","sequence":"first","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Saitama Medical University  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Abe","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery The University of Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigeru","family":"Ichioka","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Saitama Medical University  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,10,17]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/nature07039"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1159\/000339613"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jccw.2014.03.001"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1089\/wound.2012.0377"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e31824f632d"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00109-011-0754-2"},{"key":"e_1_2_7_8_1","first-page":"1479","article-title":"Impaired wound repair 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