Assessing Pediatric Burn Wound Infection Using a Point-of-Care Fluorescence Imaging Device
Evan Turner1,2, Charis Kelly1, Jennifer Zuccaro1
1Division of Plastic and Reconstructive Surgery, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada.
Insights
The MolecuLight device aids in detecting pediatric burn wound infections by using autofluorescence imaging. This technology improves infection detection when combined with visual assessment, potentially enhancing healing and antimicrobial stewardship.
Area of Science:
- Pediatric Burn Care
- Medical Imaging Technology
- Infectious Disease Management
Background:
- Wound infection is a primary complication in pediatric burn patients, risking delayed healing and mortality.
- Current standard assessments involve visual inspection for signs of infection and microbial sampling.
- Early and accurate diagnosis of burn wound infection is critical for effective patient management.
Purpose of the Study:
- To evaluate the utility of the MolecuLight autofluorescence imaging device in managing pediatric burn wounds.
- To determine the correlation between MolecuLight findings and traditional methods (visual signs/symptoms and microbial sampling).
- To assess the impact of incorporating MolecuLight on infection detection sensitivity and specificity.
Main Methods:
- Retrospective review of 178 pediatric patients (0-18 years) with 218 burn wounds assessed using MolecuLight.
- Data collected from November 1, 2020, to June 8, 2023.
- Comparison of MolecuLight fluorescence findings with visual signs and symptoms of infection (VSSI) and microbial sampling results.
Main Results:
- MolecuLight fluorescence correlated with VSSI in 81% of wounds and microbial findings in 82% of wounds.
- Combining MolecuLight with VSSI improved infection detection sensitivity by 39% compared to VSSI alone.
- Specificity decreased by 19% when MolecuLight was used in conjunction with VSSI.
Conclusions:
- The MolecuLight device shows promise in enhancing the detection of pediatric burn wound infections.
- Integrating MolecuLight into standard assessments can improve diagnostic accuracy for infections.
- Enhanced infection detection may lead to better wound healing outcomes and support antimicrobial stewardship efforts.
Abstract:
Wound infection is the most common complication among pediatric burn patients. When not treated promptly, burn wound infection may lead to delayed healing, failure of skin grafts, or death. Standard burn wound assessment includes inspection for visual signs and symptoms of infection (VSSI) and microbial sampling. To aid in the assessment of burn wound infection, the MolecuLight, a point-of-care autofluorescence imaging device, was introduced at our pediatric burn program in 2020. The MolecuLight uses violet light to illuminate the wound bed, causing clinically relevant quantities of 29 different species of bacteria (>104 CFU/g) to fluoresce in real time. The objectives of this study were to evaluate the role of the MolecuLight in the management of pediatric burn wounds and determine if the findings from the MolecuLight corresponded to VSSI and/or microbial sampling. A retrospective review of patients 0-18 years who had burn wounds assessed with the MolecuLight between November 1, 2020 and June 8, 2023 was conducted. Data were extracted from the medical records of 178 eligible patients with 218 wounds imaged with the device. Fluorescence corresponded with VSSI in 81% of wounds and microbial findings in 82% of wounds. MolecuLight fluorescence, in combination with VSSI, improved sensitivity for detecting wound infections by 39% and decreased specificity by 19% compared to visual signs and symptoms in isolation. Incorporation of the MolecuLight in standard burn wound assessments can improve the detection of infections, which may promote improved wound healing outcomes and antimicrobial stewardship.
