Case Series/Study

(CS-087) Hyperspectral imaging as an adjunct for targeted debridement

Co-Author(s):

Robert Fraser, MN, RN – Swift Medical; Amy Lorincz, BEng, MS – Swift Medical; Robert Bartlett, MD, CPE, MAPWCA, FAPWH, UHM, FACEP – Swift Medical; Gennadi Saiko, PhD – Swift Medical; Jose Ramirez-GarciaLuna, MD, PhD – Swift Medical

Introduction: To stimulate the healing process in chronic wounds, debridement is a common treatment which includes the removal of necrotic tissue, foreign debris, bacterial growth, wound bed tissue, or callus from wounds. This enables the healing process to ensue by removing cells that are not responsive to endogenous healing stimuli in healthy cells. Hyperspectral imaging (HSI) involves the simultaneous acquisition of images at different wavelengths of the electromagnetic spectrum. HSI allows the identification of tissue perfusion, inflammation, and bacterial contaminants. Here we describe our experience in using HSI for targeted debridement.

Methods: A series of 3 patients with wounds that underwent HSI imaging and targeted debridement is presented in this abstract.

Results: Patient 1 is a male with type 2 diabetes who presented with an ulcer over the lateral malleolus of the right foot. The ulcer showed very high bacterial fluorescence. Debridement with a curette showed persistent fluorescence in the wound bed and deeper tissue layers. Because of this, tissue samples were biopsied and microbiological analysis reported Pseudomonas aeruginosa contamination.

For Patient 2, the use of HSI imaging prevented the removal of scabs or necrotic tissue, preventing further iatrogenic tissue loss.

For Patient 3, the use if HSI enabled the identification of a deep abscess and supported amputation planning of the toe.

Discussion:
Through the use of HSI imaging, tissue that is necessary to debride can be easily identified. It appears as hypoxic tissue, with significant bacterial burden, with or without inflammation. We hypothesize that the use of HSI for targeted debridement can be a tool to make clinical assessments objective in tissue removal decisions and offer reimbursement and insurability protection.

Trademarked Items:

References: Canadian Agency for Drugs and Technologies in Health. Debridement Procedures for Managing Diabetic Foot Ulcers: A Review of Clinical Effectiveness, Cost-effectiveness, and Guidelines. (2014).

Ramirez-GarciaLuna JL, Bartlett R, Arriaga-Caballero JE, Fraser RDJ, Saiko G. Infrared Thermography in Wound Care, Surgery, and Sports Medicine: A Review. Frontiers in Physiology (2022) [cited 2022 Mar 12];13. Available from: https://www.frontiersin.org/article/10.3389/fphys.2022.838528

Oropallo AR, Andersen C, Abdo R, Hurlow J, Kelso M, Melin M, et al. Guidelines for Point-of-Care Fluorescence Imaging for Detection of Wound Bacterial Burden Based on Delphi Consensus. Diagnostics (Basel). 2021 Jul 6;11(7):1219.

Saiko, G., Lombardi, P., Au, Y., Queen, D., Armstrong, D., and Harding, K. (2020). Hyperspectral imaging in wound care: A systematic review. International Wound Journal 17, 1840–1856. doi: 10.1111/iwj.13474.