Hurley Ciaran M, McClusky Pat, Sugrue Ryan M, Clover James A, Kelly Jason E
Department of Plastic and Reconstructive Surgery, Cork University Hospital, Cork, Ireland.
Department of Wound Care, Cork University Hospital, Cork, Ireland.
J Wound Care. 2019 Jul 2;28(7):438-443. doi: 10.12968/jowc.2019.28.7.438.
Subsurface bacterial burden can be missed during standard wound examination protocols. The real-time bacterial fluorescence imaging device, MolecuLight i:X, visualises the presence of potentially harmful levels of bacteria through endogenous autofluorescence, without the need for contrast agents or contact with the patient. The intended use of the imaging device is to assist with the management of patients with wounds by enabling real-time visualisation of potentially harmful bacteria. The aim of this study was to establish the accuracy of the wound imaging device at detecting pathogenic bacteria in wounds.
A single-centre, prospective observational study was conducted in Cork University Hospital in an outpatient plastic surgery wound care clinic. Patients had their wounds photographed under white and autofluorescent light with the imaging device. Auto-fluorescent images were compared with the microbiological swab results.
A total of 33 patients and 43 swabs were included, of which 95.3% (n=41) were positive for bacteria growth. was the most common bacterial species identified. The imaging device had a sensitivity of 100% and specificity of 78% at identifying pathological bacteria presence in wounds on fluorescent light imaging. The positive predictive value (PPV) was 95.4%. The negative predictive value (NPV) was 100%. It demonstrated a sensitivity and specificity of 100% at detecting the presence of spp.
The imaging device used could be a safe, effective, accurate and easy-to-use autofluorescent device to improve the assessment of wounds in the outpatient clinic setting. In conjunction with best clinical practice, the device can be used to guide clinicians use of antibiotics and specialised dressings.
在标准伤口检查方案中可能会遗漏皮下细菌负荷。实时细菌荧光成像设备MolecuLight i:X通过内源性自发荧光可视化潜在有害水平细菌的存在，无需使用造影剂或与患者接触。该成像设备的预期用途是通过实时可视化潜在有害细菌来辅助伤口患者的管理。本研究的目的是确定伤口成像设备检测伤口中致病细菌的准确性。
在科克大学医院的门诊整形手术伤口护理诊所进行了一项单中心前瞻性观察研究。使用成像设备在白光和自发荧光下拍摄患者的伤口照片。将自发荧光图像与微生物拭子结果进行比较。
共纳入33例患者和43份拭子，其中95.3%（n = 41）细菌生长呈阳性。 是最常见的鉴定出的细菌种类。在荧光成像中，该成像设备在识别伤口中病理性细菌存在方面的敏感性为100%，特异性为78%。阳性预测值（PPV）为95.4%。阴性预测值（NPV）为100%。在检测 spp.的存在方面，其敏感性和特异性均为100%。
所使用的成像设备可能是一种安全、有效、准确且易于使用的自发荧光设备，可改善门诊环境中伤口的评估。结合最佳临床实践，该设备可用于指导临床医生使用抗生素和特殊敷料。
