Chronic wounds, which fail to heal over several months, are a medical concern for over 6.5 million Americans. These wounds often contain bacteria that can potentially lead to serious infections, and in the case of limbs, could necessitate amputations if not promptly identified and eliminated.
This risk is particularly higher in diabetic patients who suffer from foot ulcers or open sores; a condition that affects one-third of diabetic individuals. As per the American Diabetes Association, an alarming 20% of such patients will eventually need a lower-extremity amputation.
Physicians traditionally use a process called debridement to clean out a wound and remove as much bacteria as they can. However, one significant limitation is the inability to visually detect all bacteria, which could result in some being overlooked during the debridement.
Emerging research from Keck Medicine of USC, as published in Advances in Wound Care, introduces a promising technique to detect bacteria during wound debridement. Autofluorescence (AF) imaging is a technology where a handheld device illuminates bacteria, previously invisible to the human eye, by using violet light to light up cell wall molecules. This method helps physicians instantly identify the volume and type of bacteria present in the wound as different bacterial strains emit different colours.
“We believe this innovative technology can significantly enhance surgeons’ ability to accurately identify and subsequently remove bacteria from wounds, thereby improving patient outcomes, especially those with diabetic foot ulcers,” said David G. Armstrong, DPM, PhD, a podiatric surgeon and limb preservation specialist with Keck Medicine and the senior author of the study. He emphasized on the criticality of early detection and removal of bacteria from a wound to prevent avoidable amputations.
The research, which reviewed 25 studies scrutinizing the efficacy of AF imaging in treating diabetic patients with foot ulcers, found that AF imaging could identify bacteria in wounds that traditional clinical assessments missed in approximately 9 out of 10 patients.
Conventionally, physicians would debride wounds and send tissue samples to a lab to determine the specific types of bacteria present. Based on these results, which could take several days, they would then initiate appropriate treatments, such as antibiotics or specialized wound dressings. This delay could, however, allow infections to set in.
With AF imaging, physicians can make informed decisions during the wound debridement itself, eliminating the need to wait for lab results before initiating treatment. Additionally, early detection of bacteria could potentially spare the patient from prolonged antibiotic treatment, thereby reducing the risk of developing antibiotic resistance.
“This real-time intervention has the potential to expedite and enhance wound treatment,” said Armstrong.
Keck Medicine physicians are already leveraging this technology to treat patients with chronic wounds, including diabetic foot ulcers. Armstrong anticipates further research in this area, with hopes of AF imaging becoming the standard of care for wound treatment in the foreseeable future.
This study has been partially supported by the National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, and the National Science Foundation (NSF) Center to Stream Healthcare in Place.
Comments are closed for this post.