School of Engineering, University of Warwick, Coventry CV4 7AL, UK.
Warwick Medical School, University of Warwick, Medical School Building, Coventry CV4 7HL, UK.
Biosensors (Basel). 2020 Feb 29;10(3):19. doi: 10.3390/bios10030019.
Surgical site infection represents a large burden of care in the National Health Service. Current methods for diagnosis include a subjective clinical assessment and wound swab culture that may take several days to return a result. Both techniques are potentially unreliable and result in delays in using targeted antibiotics. Volatile organic compounds (VOCs) are produced by micro-organisms such as those present in an infected wound. This study describes the use of a device to differentiate VOCs produced by an infected wound vs. colonised wound. Malodourous wound dressings were collected from patients, these were a mix of post-operative wounds and vascular leg ulcers. Wound microbiology swabs were taken and antibiotics commenced as clinically appropriate. A control group of soiled, but not malodorous wound dressings were collected from patients who had a split skin graft (SSG) donor site. The analyser used was a G.A.S. GC-IMS. The results from the samples had a sensitivity of 100% and a specificity of 88%, with a positive predictive value of 90%. An area under the curve (AUC) of 91% demonstrates an excellent ability to discriminate those with an infected wound from those without. VOC detection using GC-IMS has the potential to serve as a diagnostic tool for the differentiation of infected and non-infected wounds and facilitate the treatment of wound infections that is cost effective, non-invasive, acceptable to patients, portable, and reliable.
手术部位感染是英国国家医疗服务体系(NHS)面临的一个重大护理负担。目前的诊断方法包括主观的临床评估和伤口拭子培养,这可能需要数天才能得出结果。这两种方法都可能不够可靠,导致靶向抗生素的使用延迟。挥发性有机化合物(VOCs)是由微生物产生的,如感染伤口中的微生物。本研究描述了一种用于区分感染性伤口和定植性伤口产生的 VOC 的设备的使用。从患者身上收集有异味的伤口敷料,这些敷料既有术后伤口,也有血管性腿部溃疡。采集伤口微生物拭子,并根据临床需要开始使用抗生素。从接受皮肤移植(SSG)供体部位的患者身上收集了一组有异味但不臭的污染伤口敷料作为对照组。使用的分析仪是 G.A.S. GC-IMS。样本的结果具有 100%的灵敏度和 88%的特异性,阳性预测值为 90%。曲线下面积(AUC)为 91%,表明其具有出色的能力,可以区分感染性伤口和非感染性伤口。GC-IMS 检测 VOC 具有作为区分感染性和非感染性伤口的诊断工具的潜力,并有助于治疗感染性伤口,这种方法具有成本效益、非侵入性、患者可接受、便携和可靠的特点。