A Pilot Study Comparing Clinical Visual Judgement to Using MolecuLight i:X Imaging Device as Decision Support for Patients Receiving Cellular Tissue Product for Wound Closure: Can the Camera Be a Predictive Tool for Cost Saving?

Aim: To assess effectiveness of clinical examination versus MolecuLight imaging device in patients undergoing weekly wound care, then receiving skin substitute or skin graft to determine if clinician visual inspection alone is adequate to predict effectiveness of the tissue substitute and/or skin graft procedure.

Method: Five patient were imaged at weekly visits during debridement periods using the MolecuLight imaging camera, leading up to the decision for skin substitutes application. Four additional weekly images are taken after the application to assess wound progression. The clinician is blinded to the images on skin substitute application date and the four weeks following application.

Results: Five patients were imaged as described, where images showed bacterial colonization at the periwound sites without colonization in the wound bed. The skin substitute applications failed to make progress, even though the clinician felt the wounds were “ready” for tissue substitute application.

Discussion: Using the MolecuLight i:X is similar to use of an iPod touch display with proprietary MolecuLight image capture software installed. The device hardware includes two high-efficiency violet (405 nm) LEDs and a dual bandpass optical filter placed over the camera sensor, which allows photo and/or video capture of FL signals in real time. The research has significant implication for cost containment and overutilization. By detecting bacteria in the wound bed, we may be able to predict if costly tissue substitutes are utilized when the wound bed has not been sufficiently prepared, reducing the likelihood of “graft failure,” and thus leading to cost savings to the patient and the health system. The MolecuLight camera provides guidance for clinicians by identifying the type of bacteria to be treated and pinpointing the location of the colonization for more accurate debridement prior to use of expensive tissue substitutes.