Lights, fluorescence, action-Influencing wound treatment plans including debridement of bacteria and biofilms

High bacterial loads within chronic wounds increase the risk of infection and complication. Detection and localization of bacterial loads through point-of-care fluorescence (FL) imaging can objectively inform and support bacterial treatment decisions. This single time-point, retrospective analysis d...

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Bibliographic Details
Published in:International wound journal 2023-10, Vol.20 (8), p.3279-3288
Main Authors: Jacob, Ashley, Jones, Laura M, Abdo, Raymond J, Cruz-Schiavone, Sebastian F, Skerker, Robert, Caputo, Wayne J, Krehbiel, Nathan, Moyer-Harris, Audrey K, McAtee, Alyssa, Baker, Isabel, Gray, Micaela D, Rennie, Monique Y
Format: Article
Language:English
Subjects:
Accuracy
Antibiotics
Antimicrobial agents
Bacteria
Biofilms
Clinical trials
Data collection
Debridement
Diabetes
Foot diseases
Hospitals
Hygiene
Infections
Original
Patients
Surgery
Ulcers
Wound healing
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Summary:High bacterial loads within chronic wounds increase the risk of infection and complication. Detection and localization of bacterial loads through point-of-care fluorescence (FL) imaging can objectively inform and support bacterial treatment decisions. This single time-point, retrospective analysis describes the treatment decisions made on 1000 chronic wounds (DFUs, VLUs, PIs, surgical wounds, burns, and others) at 211 wound-care facilities across 36 US states. Clinical assessment findings and treatment plans derived from them, as well as subsequent FL-imaging (MolecuLight®) findings and any associated treatment plan changes, were recorded for analysis. FL signals indicating elevated bacterial loads were observed in 701 wounds (70.8%), while only 293 (29.6%) showed signs/symptoms of infection. After FL-imaging, treatment plans changed in 528 wounds as follows: more extensive debridement (18.7%), more extensive hygiene (17.2%), FL-targeted debridement (17.2%), new topical therapies (10.1%), new systemic antibiotic prescriptions (9.0%), FL-guided sampling for microbiological analysis (6.2%), and changes in dressing selection (3.2%). These real-world findings of asymptomatic bacterial load/biofilm incidence, and of the frequent treatment plan changes post-imaging, are in accordance with clinical trial findings using this technology. These data, from a range of wound types, facilities, and clinician skill sets, suggest that point-of-care FL-imaging information improves bacterial infection management.
ISSN:1742-4801
1742-481X
1742-481X
DOI:10.1111/iwj.14208