31P NMR spectroscopic analysis of wound healing: the effect of hydrocolloid therapy

With the advent of managed care, wound care professionals have limited time to heal chronic wounds. They need to know whether the repair process is progressing or stagnating in response to treatments. Phosphorus-31 (31P) nuclear magnetic resonance (NMR) spectroscopic measurements of chronic wound biochemistry yields rapid knowledge of whether a wound is generating, storing, or using energy. We used 31P NMR analysis on biopsy samples to explore the energy status of two chronic non-healing leg ulcers, before and after the first week of treatment with two low-pH hydrocolloid materials. Energy generation (i.e., energy "charge") was initially low in both wounds and was significantly elevated after 1 week of treatment. Earlier work has shown that leg ulcer pathophysiology is altered during the first week of hydrocolloid treatment. This work traces the origins of such effects deeper into the cellular biochemistry and correlates the measures with the final healing outcome. 31P NMR spectroscopy may provide a real-time biochemical "fingerprint" that shows clinicians the healing status of a questionable wound. Further study is needed to confirm the reliability and validity of 31P NMR spectroscopy as a predictor of healing outcomes in other wound environments.