Stiehl James B
St Mary's Hospital, Centralia, IL 62801, USA.
Diagnostics (Basel). 2021 May 7;11(5):839. doi: 10.3390/diagnostics11050839.
Pelvic pressure injuries in long-term care facilities are at high risk for undetected infection and complications from bacterial contamination and stalling of wound healing. Contemporary wound healing methods must address this problem with mechanical debridement, wound irrigation, and balanced dressings that reduce bacterial burden to enable the normal healing process. This study evaluated the impact of bacterial autofluorescence imaging to indicate wound bacterial contamination and guide treatment for severe stage 4 pelvic pressure injuries. A handheld digital imaging system was used to perform bacterial autofluorescence imaging in darkness on five elderly, high-risk, long-term care patients with advanced stage 4 pelvic pressure injuries who were being treated for significant bacterial contamination. The prescient findings of bacterial autofluorescence imaging instigated treatment strategies and enabled close monitoring of the treatment efficacy to ameliorate the bacterial contamination. Wound sepsis recurrence, adequate wound cleansing, and diagnosis of underlying periprosthetic total joint infection were confirmed with autofluorescence imaging showing regions of high bacterial load. By providing objective information at the point of care, imaging improved understanding of the bacterial infections and guided treatment strategies.
长期护理机构中的盆腔压力性损伤因细菌污染导致感染未被发现以及伤口愈合停滞而面临较高风险，会引发并发症。当代伤口愈合方法必须通过机械清创、伤口冲洗以及能减轻细菌负荷以促进正常愈合过程的平衡敷料来解决这一问题。本研究评估了细菌自发荧光成像对指示伤口细菌污染以及指导重度4期盆腔压力性损伤治疗的影响。使用手持式数字成像系统，在黑暗环境中对五名患有晚期4期盆腔压力性损伤且因严重细菌污染正在接受治疗的老年高危长期护理患者进行细菌自发荧光成像。细菌自发荧光成像的前瞻性结果促使了治疗策略的制定，并能够密切监测治疗效果以改善细菌污染情况。通过自发荧光成像显示高细菌负荷区域，证实了伤口败血症复发、伤口充分清洁以及潜在假体周围全关节感染的诊断。通过在护理点提供客观信息，成像改善了对细菌感染的认识并指导了治疗策略。
