Predicting Clinical Outcomes in a Diabetic Foot Ulcer Population Using Fluorescence Imaging
1John W. Lindberg, MD, CWSP, is Medical Director, Emanate Health Wound Center, Covina, California. Acknowledgment: Medical writing support was provided by Jordanna Bermack, PhD. Stryker provided funding to support limited study costs. The author has disclosed no other financial relationships related to this article. Submitted November 3, 2020; accepted in revised form January 26, 2021.
Objective:
To retrospectively evaluate a cohort of patients with diabetic foot ulcers to determine if the rate of microcirculatory flow detected by fluorescence imaging within the wound and surrounding tissue is associated with healing outcomes.
Methods:
Tissue perfusion parameters used for the current analysis were the ingress rate (IR) within the wound bed (R01) and in an area remote from the wound (REF), as well as time to first blush. Wounds were then categorized based on their outcome (healed, healing, chronic nonhealing, partial foot amputation, proximal amputation below the knee) and compared between patients with positive or negative wound healing outcomes.
Results:
The final study cohort included 61 wounds and demonstrated that a higher IR within R01 and REF areas was significantly associated with positive outcomes, whereas time to first blush was not. A two-predictor logistic model found a significant relationship between IR (R01 and REF) and odds of wound healing.
Conclusions:
Fluorescence imaging evaluation of a diabetic foot ulcer can provide valuable information on healing outcomes that can help determine if a wound is progressing toward healing and therefore may help inform the need for advanced wound modalities, referrals, and amputation.
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