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Fluorescence Point-of-care Imaging for Diabetic Foot Ulcers; Improving the Standard of Care

Authors

 

Matthew M. Melin, MD, FACS, RPVI, FACCWS1; Thomas Serena, MD, FACS, FACHM, MAPWCA2

1Wound Healing Institute, M Health Fairview
2Serena Group Wound Care

Abstract Number
13

Purpose:
Diabetes mellitus (DM) rates and associated Diabetic Foot Ulcer (DFU) wound care costs in the United States continue to escalate despite the increased early recognition and interventions. Multiple potential associated factors contribute to this escalation including under recognition of micro and macro vascular disease, adequate consistent offloading and early recognition and appropriate intervention of wound bed biofilm and critical colonization with a high rate of progression to cellulitis. Infected wounds are both more labor and economic intensive to manage and increase recidivism rates. A recently introduced technology using 405 nm point-of-care, non-contact, no contrast, fluorescence imaging of DFU wounds has the ability to identify bacterial loads of >104 Colony Forming Units (CFU)/gram in wounds. This enables practitioners the clinical benefit of earlier detection of infection-causing bacteria. Earlier detection allows appropriate intervention of wound bed treatments that impact and diminish wound biofilm and critical colonization, improving antibacterial stewardship. The fluorescence imaging impact upon clinical cares has been validated in multiple peer reviewed studies to positively influence wound care management among experienced wound care providers. The purpose of this poster is to present 2 clinical cases (1 office based and 1 surgical based), the associated fluorescence imaging and impact on clinical management.

Material and Methods:
Presentation of 2 DFU clinical cases (1 office based and 1 surgical based).

Results:
Non-contact, non-contrast 405 nm fluorescence imaging of presented DFUs positively impacted point-of-care management.

Conclusions:
405 nm fluorescence point-of-care imaging of DFU enables real-time identification of biofilm and critical colonization, allows targeted debridement of DFU and immediate confirmation of pathologic bacterial reduction, periwound bacterial load identification and management, improved antimicrobial stewardship and appropriate application (or avoidance) of cellular/decellularized tissue products. These beneficial characteristics of DFU fluorescence have the potential to improve cost effective management. More studies are indicated to determine if these characteristics may ultimately improve DFU outcomes thru more efficient and value based wound healing, decreased recidivism rates and/or decreased amputation rates.

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