Autofluorescence Imaging in Chronic Wound Treatment

Learn about how autofluorescence imaging allows real-time bacterial identification and offers a significant advancement in managing chronic wounds.

More than 6.5 million Americans suffer from chronic wounds that do not heal within a few months. Many of these wounds are infected with bacteria, and if left untreated, they can lead to serious illness and complications, including the possibility of amputation if a limb is affected.

When physicians clean out a wound (debride), they aim to eliminate as much bacteria as possible. However, they have a significant limitation: not all germs can be detected by the human eye, and some may be overlooked during debridement. This is common in diabetic foot ulcers, which are open sores, that affect one-third of all diabetics. According to the American Diabetes Association, around 20% of diabetic foot ulcers require a lower-extremity amputation.

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Autofluorescence Imaging in Bacterial Detection

Autofluorescence (AF) imaging, where a handheld device “lights up” bacteria previously invisible to the human eye, uses violet light to illuminate molecules in the cell walls of any bacteria. Different types of bacteria turn different colors, allowing physicians to immediately determine how much and which types of bacteria are in the wound().

New Keck Medicine of USC research published in Advances in Wound Care suggests that autofluorescence imaging can be a more effective method to detect bacteria during wound debridement.

"We’re hopeful this new technology can help surgeons improve their accuracy when pinpointing and consequently removing bacteria from wounds and therefore improve patient outcomes, particularly for those with diabetic foot wounds,” said David G. Armstrong, DPM, PhD, a podiatric surgeon and limb preservation specialist with Keck Medicine and senior author of the study. “The early detection and removal of bacteria from a wound is vital to preventing avoidable amputations.”

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The research, a literature review of 25 studies examining the effectiveness of AF imaging in treating diabetic patients with foot ulcers, reveals that AF imaging can identify bacteria in wounds in approximately 9 in 10 patients that traditional clinical assessments miss.

Standard Wound Debridement

Traditionally, physicians debride wounds and then send tissue samples to the lab to identify specific types of bacteria present in the wound and determine the best treatment protocol based on those findings, such as starting the patient on antibiotics or providing a special type of wound dressing. This process can take days, during which time an infection can set in, said Armstrong.

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With AF imaging physicians can make medical decisions during the wound debridement, rather than waiting for lab results to initiate treatment.

Another benefit to the technology is that if bacteria is caught early, the patient may avoid being prescribed antibiotics, which in wound care can be prolonged, thus avoiding possible antibiotic resistance.

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“This real-time intervention may allow for faster, more effective treatment for wounds,” said Armstrong.

Keck Medicine physicians are already using the technology to successfully treat patients with chronic wounds, including diabetic foot ulcers.

“I look forward to more research in this area as we hope to see AF imaging become the standard of care for wound care shortly,” said Armstrong.

Reference:

Current and Future Directions in Fluorescence Imaging-Guided Debridement - (https:www.liebertpub.com/doi/10.1089/wound.2024.0067)

Source-Eurekalert