Blood perfusion is the supply of tissue with blood, and oxygen is a key factor in the field of minor and major wound healing. Reduced perfusion of a wound bed or transplant often causes various complications. Reliable methods for an objective evaluation of perfusion status are still lacking, and insufficient perfusion may remain undiscovered, resulting in chronic processes and failing transplants. Hyperspectral imaging (HSI) represents a novel method with increasing importance for clinical practice. Therefore, methods, software and algorithms for a new HSI system are presented which can be used to observe tissue oxygenation and other parameters that are of importance in supervising healing processes. This could offer an improved insight into wound perfusion allowing timely intervention.

Worldwide, chronic wounds are still a major and increasing problem area in medicine with protracted suffering of patients and enormous costs. Beside conventional wound treatment, for instance kinds of oxygen therapy and cold plasma technology have been tested, providing an improvement in the perfusion of wounds and their healing potential, but these methods are unfortunately not sufficiently validated and accepted for clinical practice to date. Using hyperspectral imaging technology in the visible (VIS) and near infrared (NIR) region with high spectral and spatial resolution, perfusion parameters of tissue and wounds can be determined. We present a new compact hyperspectral camera which can be used in clinical practice. From hyperspectral data the hemoglobin oxygenation (StO2), the relative concentration of hemoglobin [tissue hemoglobin index (THI)] and the so-called NIR-perfusion index can be determined. The first two parameters are calculated from the VIS-part of the spectrum and represent the perfusion of superficial tissue layers, whereas the NIR-perfusion index is calculated from the NIR-part representing the perfusion in deeper layers. First clinical measurements of transplanted flaps and chronic ulcer wounds show, that the perfusion level can be determined quantitatively allowing sensitive evaluation and monitoring for an optimization of the wound treatment planning and for validation of new treatment methods.

<b><i>Introduction:</i></b> Cold atmospheric plasma (CAP) has positive effects on wound healing and antimicrobial properties. However, an ongoing challenge is the development of specific modes of application for different clinical indications. <b><i>Objectives:</i></b> We investigated in a prospective pilot study the response and tolerability of a newly developed CAP wound dressing for the acute healing of split skin graft donor sites compared to conventional therapy. <b><i>Methods:</i></b> We applied both treatments to each patient (<i>n</i> = 10) for 7 days and measured 4 parameters of wound healing every other day (i.e., 1,440 measurements) using a hyperspectral imaging camera. Additionally, we evaluated the clinical appearance and pain levels reported by the patients. <b><i>Results:</i></b> The CAP wound dressing was superior to the control (<i>p</i> &#x3c; 0.001) in the improvement of 3 wound parameters, that is, deep tissue oxygen saturation, hemoglobin distribution, and tissue water distribution. CAP was well tolerated, and pain levels were lower in CAP-treated wound areas. <b><i>Conclusion:</i></b> CAP wound dressing is a promising new tool for acute wound healing.

Chronic non-healing wounds represent an increasing problem. In order to enable physicians and nurses to make evidence based decisions on wound treatment, the professional societies call for supporting tools to be offered to physicians. Oxygen supply, bacteria colonization and other parameters influence the healing process. So far, these parameters cannot be monitored in an objective and routinely manner. Existing methods like the microbiological analysis of wound swabs, mean a great deal of effort and partly a long delay. In this paper 42 fluorescence images from 42 patients with diabetic foot ulcer, recorded with a hyperspectral imaging system (TIVITA®), converted for fluorescence imaging, were analysed. Beside the fluorescence images, information about the bacterial colonization is available from microbiological analysis of wound swabs. After preprocessing, principal component analysis, PCA, is used for data analysis with a 405 nm excitation wavelength, the emission wavelength range 510 - 745 nm is used for analysis. After dividing the data into a training and a test dataset it could be shown, that bacteria are detectable in the wound area. A quantification in bacterial colonization counts (BCC) was not in the focus of the research in this study stage.

L iver transplantation (LT) is the only curative therapy for patients with end-stage liver disease. In recent decades, LT is characterized by an increasing waiting list mortality due to the lack of donor organs. 1 The utilization of extended criteria donor (ECD) organs has become frequent in order to overcome the severity of organ scarcity. 2 As ECD organs may be associated with an inferior outcome of LT, risk-minimizing strategies are sought after. 3 Normothermic machine perfusion (NMP) is a revived preservation technique nowadays frequently utilized in LT. NMP provides advantages over static cold storage (SCS) due to physiological temperature and organ function, inherent to this preservation method. Furthermore, it enables allograft viability testing before LT. [4][5][6] Commonly assessed viability parameters during liver graft NMP are perfusate lactate, perfusate pH, glucose metabolism, and production and viscosity of bile, as well as arterial inflow. 7-10 Current literature emphasizes perfusate lactate/lactate clearance as essential parameters assessing liver viability during NMP. [5][6][7][8]11 In NMP, hyperlactatemia is predominantly