{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:13:42Z","timestamp":1786122822120,"version":"build-2736575974"},"reference-count":48,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T00:00:00Z","timestamp":1747958400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The International Journal of Lower Extremity Wounds"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Topical timolol appears to provide a curative effect in managing chronic ulcers. However, the pooled evidence of its effect hasn\u2019t been established yet. This is the first Meta-analysis to evaluate and assess the efficacy of topical timolol in accelerating wound healing in patients with chronic refractory ulcers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We comprehensively searched different electronic databases; PubMed, Scopus, Web of Science, Cochrane library and ClinicalTrials.gov from their inception to November 2024. The search was conducted without imposing any restrictions on publication date or study design. The ROB-II tool was used to assess the quality of included RCTs. NIH tools were used to evaluate the quality of included cohort and single arm studies. Risk ratios (RR) and mean differences (MD), with 95% confidence intervals (CIs), were used as effect estimates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Six studies were included in this systematic review, comprising two single-arm studies and four double-arm studies (3 RCTs and 1 cohort study). Data from the four double-arm studies on venous ulcers were pooled for meta-analysis. The results showed that topical timolol significantly reduced ulcer area compared to control at 2 weeks (\u221223.63%; 95% CI: \u221229.26 to \u221218.00; p\u2009&lt;\u20090.00001), 4 weeks (\u221241.40%; 95% CI: \u221249.57 to \u221233.23; p\u2009&lt;\u20090.00001), and 12 weeks (\u221223.38%; 95% CI: \u221239.43 to \u22127.33; p\u2009=\u20090.004). Complete ulcer healing was observed at 4 weeks (RR: 12.00; 95% CI: 1.68 to 85.84; p\u2009=\u20090.01) and 12 weeks (RR: 3.79; 95% CI: 0.44 to 32.54; p\u2009=\u20090.22).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Topical timolol has the potential to promote healing in chronic unhealed ulcers. This meta-analysis, focusing on chronic venous ulcers, consistently showed favorable results across different time points. However, the small sample sizes, lack of blinding, and inclusion of only four studies limit the generalizability of the findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15347346251345249","type":"journal-article","created":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T03:49:28Z","timestamp":1747972168000},"page":"675-686","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Efficacy of Topical Timolol in Chronic Unhealed Ulcers: A Systematic Review and Meta-Analysis"],"prefix":"10.1177","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-3804-315X","authenticated-orcid":false,"given":"Muhammad M.","family":"Elsharkawy","sequence":"first","affiliation":[{"name":"Alexandria Main University Hospitals, Alexandria, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8464-3959","authenticated-orcid":false,"given":"Eslam Mohammed","family":"Rabea","sequence":"additional","affiliation":[{"name":"Alexandria Main University Hospitals, Alexandria, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0317-8713","authenticated-orcid":false,"given":"Anas Ashraf","family":"Elassal","sequence":"additional","affiliation":[{"name":"Alexandria Main University Hospitals, Alexandria, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5955-8422","authenticated-orcid":false,"given":"Anan Maher","family":"Salaimeh","sequence":"additional","affiliation":[{"name":"Alexandria Main University Hospitals, Alexandria, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7816-2218","authenticated-orcid":false,"given":"Adam Naji","family":"Zaro","sequence":"additional","affiliation":[{"name":"Alexandria Main University Hospitals, Alexandria, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0341-077X","authenticated-orcid":false,"given":"Saad Mohamed","family":"Saad","sequence":"additional","affiliation":[{"name":"Alexandria Main University Hospitals, Alexandria, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Eldesouki","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, New York Medical College at St Saint's Michael Center, Newark, New Jersey, USA"},{"name":"Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,5,23]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1101\/cshperspect.a041243"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.3009337"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)67700-8"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.00067.2017"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/dth.12051"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1155\/2013\/413604"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13047-020-0369-3"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1615439"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/wrr.12590"},{"issue":"5","key":"e_1_3_4_11_2","first-page":"347","article-title":"Classifications for wound bed preparation and stimulation of chronic wounds","volume":"8","author":"Falanga V","year":"2000","unstructured":"Falanga V. 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