Kent State University College of Podiatric Medicine, Independence OH, US.
J Wound Care. 2020 Jul 1;29(Sup7):S44-S52. doi: 10.12968/jowc.2020.29.Sup7.S44.
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.
This observational case series investigated use of point-of-care fluorescence imaging to detect bacteria (loads >10CFU/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.
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.
These results demonstrate that use of fluorescence imaging as part of routine wound care enhances assessment and treatment selection, thus facilitating improved wound healing.
理想的创面准备包括定期清创，以去除失活组织、减少细菌负荷，并创造促进愈合的环境。然而，在护理点缺乏诊断信息限制了清创的效果。
本观察性病例系列研究调查了在护理点使用荧光成像来检测细菌（负荷>10CFU/g）并指导创面准备。下肢难以愈合的伤口在 12 周内进行细菌荧光和伤口面积的成像。
共有 11 个伤口纳入研究。10 个伤口存在细菌荧光，在研究过程中平均持续 3.7 周。细菌的红色或青色荧光特征的存在与每周平均增加 6.5%的伤口面积相关，表明伤口愈合停滞或延迟。荧光成像信息有助于确定清创和其他治疗的位置和范围，以及选择敷料和/或抗菌药物。通过有针对性的清创和其他治疗消除细菌荧光特征与每周平均减少 27.7%的伤口面积相关（p<0.05），表明有愈合趋势。
这些结果表明，将荧光成像作为常规伤口护理的一部分使用可以增强评估和治疗选择，从而促进伤口愈合。
