References
Use of a bacterial fluorescence imaging system to target wound debridement and accelerate healing: a pilot study
Abstract
Objective:
Optimal wound-bed preparation consists of regular debridement to remove devitalised tissues, reduce bacterial load, and to establish an environment that promotes healing. However, lack of diagnostic information at point-of-care limits effectiveness of debridement.
Method:
This observational case series investigated use of point-of-care fluorescence imaging to detect bacteria (loads >104 CFU/g) and guide wound bed preparation. Lower extremity hard-to-heal wounds were imaged over a 12-week period for bacterial fluorescence and wound area.
Results:
A total of 11 wounds were included in the study. Bacterial fluorescence was present in 10 wounds and persisted, on average, for 3.7 weeks over the course of the study. The presence of red or cyan fluorescent signatures from bacteria correlated with an average increase in wound area of 6.5% per week, indicating stalled or delayed wound healing. Fluorescence imaging information assisted in determining the location and extent of wound debridement, and the selection of dressings and/or antimicrobials. Elimination of bacterial fluorescence signature with targeted debridement and other treatments correlated with an average reduction in wound area of 27.7% per week (p<0.05), indicative of a healing trajectory.
Conclusion:
These results demonstrate that use of fluorescence imaging as part of routine wound care enhances assessment and treatment selection, thus facilitating improved wound healing.
The economic burden of wounds in the US costs Medicare an estimated $28.1 billion to $96.8 billion annually.1,2,3 The associated costs of care and risk for severe complications (such as infection or amputation) increases the longer a wound remains open.4,5 A stall in wound closure may be due to a variety of systemic and local factors, among them high bacterial burden.6 At bacterial loads of 104 colony-forming units (CFU) per gram of tissue, delayed wound healing is observed, and wound status worsens for each additional log increase in bacterial load.7 Wounds with bacterial loads that exceed 106 CFU/g are considered clinically infected.8 The presence of devitalised tissue further impairs wound healing by preventing new tissue from forming, thus creating a nidus for bacterial growth.9
Register now to continue reading
Thank you for visiting Wound Care Professional and reading some of our peer-reviewed resources for wound care professionals. To read more, please register today. You’ll enjoy the following great benefits:
What's included
-
Access to clinical or professional articles
-
New content and clinical updates each month