{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T03:14:18Z","timestamp":1777864458581,"version":"3.51.4"},"reference-count":50,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:00:00Z","timestamp":1777507200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The delayed healing of chronic wounds is a major challenge in clinical treatment, with complex pathogenesis involving multisystem dysfunction. In recent years, the role of intestinal flora imbalance in the impairment of chronic wound healing has received increasing attention. Given the physiological similarities and pathological correlations between the skin and the intestine, some scholars have proposed the concept of the \u201cskin-gut axis\u201d and believe that there is a close connection between the skin microbiota, skin condition, and intestinal flora. However, systematic analysis of research trends remains limited. This bibliometric study comprehensively evaluates the research status in the fields of chronic refractory wounds and intestinal microbiota from 2005 to 2025.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used CiteSpace, VOSviewer, and Bibliometrix software to analyze 553 English articles from the Web of Science Core Collection. Bibliometric assessments included publication trends, collaborative networks, geographical distribution, journal impact, and keyword clustering.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 553 papers were included. The number of publications in this field increased markedly from 2020 to 2025, with 2025 being the most productive year. The leading contributing countries were the United States and China; key institutions included the University of Pennsylvania and the University of Copenhagen. Elizabeth A. Grice was the most impactful author. Keyword analysis identified high-frequency terms: wound healing, biofilm, chronic wound, bacteria, and microbiota. Timeline visualization of keywords revealed emerging research hotspots, including diabetic foot ulcer and\n                      <jats:italic>in situ<\/jats:italic>\n                      detection.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>To the best of our knowledge, this study represents the first bibliometric analysis in the field of chronic wounds and intestinal microbiota. Core research foci include disease-associated microbiota characteristics, probiotic therapy, microecological intervention, and the distal gut\u2013target organ axis. Future research should prioritize microbe-targeted therapy, regulation of the immune\u2013barrier metabolic network, and integrative medicine combining traditional Chinese and Western medicine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic Review Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/ID=CRD420261362660<\/jats:ext-link>\n                      , identifier CRD420261362660.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcimb.2026.1800070","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T05:42:09Z","timestamp":1777527729000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The gut-skin axis in wound healing: a bibliometric analysis of intestinal flora and chronic wounds (2005-2025)"],"prefix":"10.3389","volume":"16","author":[{"given":"Jing","family":"Chen","sequence":"first","affiliation":[{"name":"Qinghai University","place":["Xining, Qinghai, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aode","family":"Tian","sequence":"additional","affiliation":[{"name":"Qinghai University","place":["Xining, Qinghai, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianliang","family":"Huang","sequence":"additional","affiliation":[{"name":"Qinghai University","place":["Xining, Qinghai, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhenghe","family":"Wang","sequence":"additional","affiliation":[{"name":"Qinghai University","place":["Xining, Qinghai, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongjin","family":"Wang","sequence":"additional","affiliation":[{"name":"Qinghai University","place":["Xining, Qinghai, China"]},{"name":"Department of Burns and Plastic Surgery, Qinghai University Affiliated Hospital","place":["Xining, Qinghai, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,30]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"350","DOI":"10.1016\/j.aninu.2021.11.005","article-title":"Gut microbiota-derived short chain fatty acids are potential mediators in gut inflammation","volume":"8","author":"Akhtar","year":"2022","journal-title":"Anim. Nutr."},{"key":"B2","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1111\/j.1600-0625.2009.01060.x","article-title":"Is there a 'gut-brain-skin axis'","volume":"19","author":"Arck","year":"2010","journal-title":"Exp. Dermatol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1001\/jama.2023.10578","article-title":"Diabetic Foot Ulcers: A Review","volume":"330","author":"Armstrong","year":"2023","journal-title":"Jama"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.3390\/medicina61081360","article-title":"Gut Feelings: Linking Dysbiosis to Depression-A Narrative Literature Review","volume":"61","author":"Bibolar","year":"2025","journal-title":"Medicina (Kaunas)"},{"key":"B5","doi-asserted-by":"crossref","first-page":"1615","DOI":"10.2337\/diabetes.54.6.1615","article-title":"The pathobiology of diabetic complications: a unifying mechanism","volume":"54","author":"Brownlee","year":"2005","journal-title":"Diabetes"},{"key":"B6","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1038\/nrmicro.2017.157","article-title":"The human skin microbiome","volume":"16","author":"Byrd","year":"2018","journal-title":"Nat. Rev. Microbiol."},{"key":"B7","doi-asserted-by":"crossref","first-page":"1761","DOI":"10.2337\/db06-1491","article-title":"Metabolic Endotoxemia Initiates Obesity and Insulin Resistance","volume":"56","author":"Cani","year":"2007","journal-title":"Diabetes"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1546","DOI":"10.2174\/138161209788168164","article-title":"The role of the gut microbiota in energy metabolism and metabolic disease","volume":"15","author":"Cani","year":"2009","journal-title":"Curr. Pharm. Des."},{"key":"B9","doi-asserted-by":"crossref","DOI":"10.3389\/fmicb.2024.1427770","article-title":"Editorial: The gut-skin axis: interaction of gut microbiome and skin diseases","volume":"15","author":"Chai","year":"2024","journal-title":"Front. Microbiol."},{"key":"B10","doi-asserted-by":"publisher","first-page":"5303","DOI":"10.1073\/pnas.0307513100","article-title":"Searching for intellectual turning points: progressive knowledge domain visualization","author":"Chen","year":"2004","journal-title":"Proc. Natl. Acad. Sci. U.S.A."},{"key":"B11","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1515\/jdis-2017-0006","article-title":"Science Mapping: A Systematic Review of the Literature","volume":"2","author":"Chen","year":"2017","journal-title":"J. Data Inf Sci."},{"key":"B12","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1016\/j.ebiom.2018.03.030","article-title":"Sodium Butyrate Inhibits Inflammation and Maintains Epithelium Barrier Integrity in a TNBS-induced Inflammatory Bowel Disease Mice Model","volume":"30","author":"Chen","year":"2018","journal-title":"EBioMedicine"},{"key":"B37","doi-asserted-by":"publisher","first-page":"1029","DOI":"10.3760\/cma.j.cn501225-20250801-00345","article-title":"Practical guideline on the prevention and management of diabetic foot in China (II)","volume":"41","year":"2025","journal-title":"Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi"},{"key":"B13","doi-asserted-by":"publisher","first-page":"360","DOI":"10.1136\/bmj.j5145","article-title":"The role of the gut microbiome in systemic inflammatory disease","author":"Clemente","year":"2018","journal-title":"BMJ"},{"key":"B15","doi-asserted-by":"publisher","first-page":"467","DOI":"10.3233\/ch-179228","article-title":"Hyperspectral imaging as a novel diagnostic tool in microcirculation of wounds","volume":"67","author":"Daeschlein","year":"2017","journal-title":"Clin. Hemorheol Microcirc"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2025.11.027","article-title":"Management of Peripheral Artery Disease in Adults With Diabetes: 2025 ACC Scientific Statement: A Report of the American College of Cardiology","author":"Das","year":"2025","journal-title":"J. Am. Coll. Cardiol"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms9020353","article-title":"Gut-Skin Axis: Current Knowledge of the Interrelationship between Microbial Dysbiosis and Skin Conditions","volume":"9","author":"De Pessemier","year":"2021","journal-title":"Microorganisms"},{"key":"B17","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1093\/ndt\/gfaf177","article-title":"IDF Diabetes Atlas 11th edition 2025: global prevalence and projections for 2050","volume":"41","author":"Duncan","year":"2025","journal-title":"Nephrol. Dial Transplant."},{"key":"B18","doi-asserted-by":"publisher","first-page":"514","DOI":"10.1038\/sj.jid.5700701","article-title":"Inflammation in wound repair: molecular and cellular mechanisms","volume":"127","author":"Eming","year":"2007","journal-title":"J. Invest. Dermatol."},{"key":"B19","doi-asserted-by":"publisher","first-page":"560","DOI":"10.1089\/wound.2015.0635","article-title":"Challenges in the Treatment of Chronic Wounds","volume":"4","author":"Frykberg","year":"2015","journal-title":"Adv. Wound Care (New Rochelle)"},{"key":"B20","doi-asserted-by":"publisher","first-page":"446","DOI":"10.1038\/nature12721","article-title":"Commensal microbe-derived butyrate induces the differentiation of colonic regulatory T cells","volume":"504","author":"Furusawa","year":"2013","journal-title":"Nature"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1210\/jendso\/bvz039","article-title":"Intestinal Barrier Dysfunction, LPS Translocation, and Disease Development","volume":"4","author":"Ghosh","year":"2020","journal-title":"J. Endocr. Soc."},{"key":"B22","doi-asserted-by":"publisher","first-page":"e70316","DOI":"10.1096\/fj.202401478RR","article-title":"Novel insights into the role of gut microbiota and its metabolites in diabetic chronic wounds","volume":"39","author":"Huang","year":"2025","journal-title":"FASEB J."},{"key":"B23","doi-asserted-by":"publisher","first-page":"649","DOI":"10.3934\/microbiol.2025027","article-title":"The emerging role of probiotics in the management and treatment of diabetic foot ulcer: a comprehensive review","volume":"11","author":"Hussain","year":"2025","journal-title":"AIMS Microbiol."},{"key":"B24","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1186\/s13643-016-0329-y","article-title":"Prevalence and incidence of chronic wounds and related complications: a protocol for a systematic review","volume":"5","author":"J\u00e4rbrink","year":"2016","journal-title":"Syst. Rev."},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2024.1439176","article-title":"Safety and efficacy of fecal microbiota transplantation (FMT) as a modern adjuvant therapy in various diseases and disorders: a comprehensive literature review","volume":"15","author":"Karimi","year":"2024","journal-title":"Front. Immunol."},{"key":"B27","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1053\/j.gastro.2020.09.038","article-title":"Fecal Microbiota Transplantation Is Highly Effective in Real-World Practice: Initial Results From the FMT National Registry","volume":"160","author":"Kelly","year":"2021","journal-title":"Gastroenterology"},{"key":"B26","doi-asserted-by":"publisher","first-page":"662","DOI":"10.1016\/j.chom.2015.03.005","article-title":"Crosstalk between Microbiota-Derived Short-Chain Fatty Acids and Intestinal Epithelial HIF Augments Tissue Barrier Function","volume":"17","author":"Kelly","year":"2015","journal-title":"Cell Host Microbe"},{"key":"B28","author":"Khadka","year":"2023"},{"key":"B29","doi-asserted-by":"publisher","first-page":"2369","DOI":"10.1056\/NEJMra1600266","article-title":"The Human Intestinal Microbiome in Health and Disease","volume":"375","author":"Lynch","year":"2016","journal-title":"N Engl. J. Med."},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.3390\/ijms25094629","article-title":"Host-Microbiome Crosstalk in Chronic Wound Healing","volume":"25","author":"Mihai","year":"2024","journal-title":"Int. J. Mol. Sci."},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.3390\/antiox13080985","article-title":"Gut Microbiota Dysbiosis, Oxidative Stress, Inflammation, and Epigenetic Alterations in Metabolic Diseases","volume":"13","author":"Mostafavi Abdolmaleky","year":"2024","journal-title":"Antioxidants (Basel)"},{"key":"B32","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1016\/j.immuni.2014.07.009","article-title":"Macrophage Activation and Polarization: Nomenclature and Experimental Guidelines","volume":"41","author":"Murray","year":"2014","journal-title":"Immunity"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1098\/rsob.230014","article-title":"Short chain fatty acids: key regulators of the local and systemic immune response in inflammatory diseases and infections","volume":"13","author":"Ney","year":"2023","journal-title":"Open Biol."},{"key":"B34","doi-asserted-by":"publisher","first-page":"1167","DOI":"10.1002\/bies.201600008","article-title":"The gut-skin axis in health and disease: A paradigm with therapeutic implications","volume":"38","author":"O'Neill","year":"2016","journal-title":"Bioessays"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n160","article-title":"PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"B36","doi-asserted-by":"crossref","first-page":"1576","DOI":"10.1111\/jam.14421","article-title":"Metabolic modelling of chronic wound microbiota predicts mutualistic interactions that drive community composition","volume":"127","author":"Phalak","year":"2019","journal-title":"J. Appl. Microbiol."},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2018.01459","article-title":"The Gut Microbiome as a Major Regulator of the Gut-Skin Axis","volume":"9","author":"Salem","year":"2018","journal-title":"Front. Microbiol."},{"key":"B39","volume-title":"What Lives On Our Skin: Ecology, Genomics and Therapeutic Opportunities Of the Skin Microbiome","author":"Scharschmidt","year":"2013"},{"key":"B41","doi-asserted-by":"publisher","first-page":"429","DOI":"10.1177\/21621918251359554","article-title":"Human Wound and Its Burden: Updated 2025 Compendium of Estimates","volume":"14","author":"Sen","year":"2025","journal-title":"Adv. Wound Care (New Rochelle)"},{"key":"B42","doi-asserted-by":"publisher","first-page":"495","DOI":"10.1038\/s41574-025-01107-x","article-title":"Neuro-immuno-endocrinology of the skin: how environment regulates body homeostasis","volume":"21","author":"Slominski","year":"2025","journal-title":"Nat. Rev. Endocrinol."},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics14070724","article-title":"Exploring the Microbiome of Diabetic Foot Ulcers: A Focus on Cases with a Clinical Worse Outcome","author":"Soldevila-Boixader","year":"2025","journal-title":"Antibiotics (Basel)"},{"key":"B44","doi-asserted-by":"publisher","first-page":"1376","DOI":"10.1126\/science.aar3318","article-title":"Hyperglycemia drives intestinal barrier dysfunction and risk for enteric infection","volume":"359","author":"Thaiss","year":"2018","journal-title":"Science"},{"key":"B46","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1038\/nm.3444","article-title":"Gut microbiota metabolism of dietary fiber influences allergic airway disease and hematopoiesis","volume":"20","author":"Trompette","year":"2014","journal-title":"Nat. Med."},{"key":"B47","doi-asserted-by":"publisher","first-page":"908","DOI":"10.1038\/s41385-022-00524-9","article-title":"Gut-derived short-chain fatty acids modulate skin barrier integrity by promoting keratinocyte metabolism and differentiation","volume":"15","author":"Trompette","year":"2022","journal-title":"Mucosal Immunol."},{"key":"B45","doi-asserted-by":"publisher","first-page":"799","DOI":"10.1038\/nri2653","article-title":"Intestinal mucosal barrier function in health and disease","volume":"9","author":"Turner","year":"2009","journal-title":"Nat. Rev. Immunol."},{"key":"B48","doi-asserted-by":"publisher","first-page":"977","DOI":"10.1007\/s00592-025-02508-0","article-title":"The role of fecal microbiota transplantation in diabetes","volume":"62","author":"Vassallo","year":"2025","journal-title":"Acta Diabetol."},{"key":"B49","doi-asserted-by":"publisher","first-page":"212","DOI":"10.1186\/s12964-023-01219-9","article-title":"Short-chain fatty acids in diseases","volume":"21","author":"Zhang","year":"2023","journal-title":"Cell Commun. Signal"},{"key":"B50","doi-asserted-by":"publisher","first-page":"583","DOI":"10.1007\/s11684-019-0729-1","article-title":"Oxidative stress and diabetes: antioxidative strategies","volume":"14","author":"Zhang","year":"2020","journal-title":"Front. Med."},{"key":"B51","doi-asserted-by":"publisher","DOI":"10.1101\/gr.280858.125","article-title":"Strain-level metagenomic profiling using pangenome graphs with PanTax","author":"Zhang","year":"2026","journal-title":"Genome Res"}],"container-title":["Frontiers in Cellular and Infection Microbiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2026.1800070\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T05:42:13Z","timestamp":1777527733000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2026.1800070\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,30]]},"references-count":50,"alternative-id":["10.3389\/fcimb.2026.1800070"],"URL":"https:\/\/doi.org\/10.3389\/fcimb.2026.1800070","relation":{},"ISSN":["2235-2988"],"issn-type":[{"value":"2235-2988","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,30]]},"article-number":"1800070"}}