New findings indicate there might be a better way to identify bacteria during the process of wound debridement.
In the United States, over 6.5 million individuals suffer from chronic wounds—injuries that do not heal after several months. Nearly all of these wounds harbor bacteria, which, if not identified and eliminated, can result in serious infections and complications, potentially leading to limb amputations.
This issue is particularly prevalent among patients with diabetic foot ulcers (open sores), affecting approximately one-third of those with diabetes. The American Diabetes Association reports that around 20% of individuals with diabetic foot ulcers may require a lower-limb amputation.
During the debridement process, doctors aim to clear away as much bacteria as possible. However, they encounter a significant challenge—some bacteria are not visible to the naked eye and might be overlooked during treatment.
New research from Keck Medicine of USC, published in Advances in Wound Care, reveals a potentially more effective method for detecting bacteria during wound cleaning. This involves autofluorescence (AF) imaging, which utilizes a handheld device to illuminate bacteria that are typically unseen. By using violet light, the device highlights the molecules in the cell walls of various bacteria. Different bacteria emit different colors, enabling doctors to quickly assess the quantity and types of bacteria present in the wound.
“We are optimistic that this innovative technology can assist surgeons in improving their precision in identifying and removing bacteria from wounds, which can enhance patient outcomes, especially for those with diabetic foot issues,” stated David G. Armstrong, DPM, PhD, a foot and ankle surgeon and limb preservation expert at Keck Medicine, and lead author of the study. “Early detection and removal of bacteria from wounds are crucial in preventing unwanted amputations.”
The study, reviewed literature from 25 investigations into the effectiveness of AF imaging for treating diabetic patients with foot ulcers, indicates that this imaging method can detect bacteria in wounds in about 90% of cases that traditional assessments may miss.
Traditionally, doctors would debride wounds and send tissue samples to a laboratory for bacterial identification, which could take days. During this time, there’s a risk of infection developing, according to Armstrong.
With AF imaging, doctors can make treatment decisions during the debridement process itself, rather than having to wait for laboratory results before starting treatment.
Additionally, early detection of bacteria may mean that patients could avoid a lengthy course of antibiotics, potentially reducing the risk of antibiotic resistance.
“This immediate intervention may lead to quicker and more effective wound treatment,” Armstrong noted.
Physicians at Keck Medicine are already employing this technology successfully for patients with chronic wounds, including diabetic foot ulcers.
“I am eager for more investigations in this field as we hope to see AF imaging becoming the standard approach in wound care soon,” said Armstrong.
The study received partial funding from the National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Award Number 1R01124789-01A1 and the National Science Foundation (NSF) Center to Stream Healthcare in Place (#C2SHiP) CNS Award Number 2052578.
