The Use of an Innovative Fluorescence Imaging System to Aid in Bioburden-targeted Debridement and Management in the Treatment of Chronic Wounds of the Lower Extremity

Background: Acute wounds heal by a progression through a complex, but orderly series of physiologic and molecular processes. In contrast, chronic wounds are characterized as having stalled in this healing progression due to a variety of systemic and local factors. These include high microbial burden and excessive devitalized tissue. Optimal wound-bed preparation of chronic ulcers consist of debridement, control of infection, and establishment of a balanced healing environment. 

Objective: The aim of this case series was to evaluate the use of a novel point-of-care fluorescence imaging system* to aid in bacterial-targeted debridement and bioburden management in the treatment of chronic wounds of the lower extremity.

Method: This was a 10-case prospective, single center study evaluating the effectiveness of bacterial fluorescence imaging3 to identify wound bacterial burden, as well as the need for and effectiveness of wound debridement. Weekly wound measurements and fluorescence images taken with the device were collected on each patient to assess wound healing and bacterial burden. Images positive for bacterial fluorescence (regions of red or cyan) were used to guide debridement to those regions. Upon case completion the data collected was analyzed determine the usefulness of the innovative imaging system in ascertaining the effectiveness of debridement, directing the clinical treatment course and calculating the rates of healing in each wound. 

Conclusion: Use of this innovative imaging device appeared to have a positive impact on healing outcomes in the management of non-healing ulcers by aiding in debridement and bioburden management in the treatment of chronic wounds of the lower extremity. Randomized, controlled trials in a larger sample of patients are required to validate these preliminary findings.