Wound assessment paradigm shift: incorporating point-of-care bacterial fluorescence imaging into standard of care

摘要

The clinical signs and symptoms of infection in acute and chronic wounds are unreliable. Similarly, swab cultures areinaccurate in this population. Tissue biopsies and polymerase chain reaction (PCR) are more accurate but the resultsrequire several days to obtain. As a result, the clinician is forced to treat patients empirically. This has led to the overuseof antibiotics and the failure of advanced therapies due to unrecognized infection. To address this problem a point-ofcarediagnostic was developed to identify bacteria in acute and chronic wounds. The MolecuLight procedure (MiX)exposes the wound bed to violet light at 405 nm. Bacterial fluorophores absorb the light. In turn they fluoresce atspecific wavelengths: porphyrins (red) and pyoverdines (cyan). The device detects bacteria in the wound bed at a levelgreater than 104 by measuring the amounts of red and or cyan fluorescence. A robust body of literature has demonstratedthat elevated bacterial levels impede wound healing. The MiX can detect elevated bacteria burden in a wound allowingthe clinician to address the infection. In addition, the device can guide advanced wound therapies such as antibiofilmagents, negative wound pressure therapy and preparation of the wound bed for grafting.