Blumenthal Emily, Jeffery Steven L A
Division of Surgery & Interventional Science, University College London, United Kingdom.
Birmingham Burn Centre, Queen Elizabeth Hospital Birmingham, United Kingdom.
J Burn Care Res. 2018 Jan 1;39(1):154-161. doi: 10.1097/BCR.0000000000000565.
The MolecuLight i:X Imaging Device is a portable, noninvasive, real-time camera used to visualize the bacterial load in a wound. It uses violet light illumination and a dual bandpass optical filter to capture the fluorescence of endogenous structures in the tissue matrix and harmful bacteria. The MolecuLight i:X captures images of wounds and highlights potentially detrimental levels of bacteria. This is an initial evaluation of using the MolecuLight i:X camera in the management of burns to demonstrate the following: the ability of the device to guide clinicians in their management of the burn (ie, detect, identify, and specify swabbing locations). Burn wounds were photographed under standard light and violet light illumination to compare presentations of obvious infection signs and symptoms. Microbiology swab samples were obtained to correlate any bacterial presence to the images. The fluorescence images were used to guide swabs to where the bacteria were congregating. Twenty patients were imaged. Four patients did not have bacterial contamination based on their images and swab results. Sixteen patients showed growth of Staphylococcus aureus, Pseudomonas aeruginosa, or other bacteria. Nine of the patients, by definition, had infections. These findings were correlated with the typical signs and symptoms of infection, the fluorescence images, and the microbiology results. The efficacy of the MolecuLight i:X is evident due to the microbiology results correlating to the images. Further research is being done to test the device in terms of being an early intervention tool. With these early results and guidance of swab samples, the MolecuLight i:X may be able to detect bacterial load before an infection and subsequent graft failure, thereby shortening lengths of hospital stay and improving overall healing.
MolecuLight i:X成像设备是一种便携式、非侵入性的实时相机,用于观察伤口中的细菌载量。它利用紫光照明和双带通光学滤光片来捕捉组织基质中内源性结构和有害细菌的荧光。MolecuLight i:X可拍摄伤口图像,并突出显示潜在有害水平的细菌。这是对在烧伤治疗中使用MolecuLight i:X相机的初步评估,以证明以下几点:该设备在烧伤治疗中指导临床医生的能力(即检测、识别和指定拭子采集位置)。在标准光和紫光照明下拍摄烧伤伤口,以比较明显感染体征和症状的表现。获取微生物拭子样本,将任何细菌的存在与图像相关联。荧光图像用于指导拭子采集细菌聚集的部位。对20名患者进行了成像。根据图像和拭子结果,4名患者没有细菌污染。16名患者显示金黄色葡萄球菌、铜绿假单胞菌或其他细菌生长。根据定义,其中9名患者有感染。这些发现与感染的典型体征和症状、荧光图像以及微生物学结果相关。由于微生物学结果与图像相关,MolecuLight i:X的有效性显而易见。正在进行进一步的研究,以测试该设备作为早期干预工具的效果。基于这些早期结果和拭子样本的指导,MolecuLight i:X或许能够在感染及随后的移植失败之前检测到细菌载量,从而缩短住院时间并改善整体愈合情况。