Use of voltammetric analysis for fast and objective discrimination of the etiology, evolution, and bacterial infection of lower limb ulcers

Abstract

The timely recognition of leg ulcers (LU) etiology and infection is pivotal to optimize management and accelerate healing. The objective of this proof-of-concept study was to test the diagnostic performance of voltammetric analysis (VA) on ulcer exudate to identify LU etiology, infection, and predict clinical course. We enrolled 25 patients aged ≥60 years, affected by 42 venous/arterial LU. Clinical examination (Leg Ulcer Measurement Tool score, LUMT), swab culture, and VA were performed at baseline and 30 days. The ability of VA to predict outcomes was tested using partial least square-discrimination analysis. Mean age was 75 years (SD 11.1), 9/25 were male. The accuracy, sensitivity, and specificity vs. etiology were 97.4, 100%, and 94.1%, respectively; the corresponding figures were 95.2%, 100%, 88.9%, for infection and 94%, 84.6%, 100% for predicted objective LUMT worsening. VA is a promising diagnostic/prognostic tool for management of LU that may allow a more timely targeted therapy.

Voltammetric analysis for distinguishing portal hypertension-related from malignancy-related ascites: A proof of concept study

“…[18] Similarly, VA showed an overall accuracy of 94% in detecting infections of leg ulcers. [19] Currently, we do not have a clear explanation for the reduced diagnostic performance of e-tongue with respect to WBC count in ascites.…”

“…Indeed, VA could satisfactorily disclose the infectious or non infectious state of cutaneous ulcers in only 25 patients and of the urine in 142 patients. [18,19] E-tongue showed rather poor predictive capacities towards both total WBC count and PMN count both in the whole population (RMSECV of 485 and of 846 for total cell and PMN count, respectively; Fig 2, panel A) and limited to the subgroup of cirrhotic patients (RMSECV of 384 and of 236 for total cell and PMN count, respectively; Fig 2, panel B). Since only 4 patients were finally diagnosed with SBP, the diagnostic accuracy of e-tongue towards SBP was not calculated.…”

“…Given the fully original application of VA, we had no preliminary information allowing to formally compute the sample size. However, based on the favorable performance of VA in different settings, [14][15][16][17][18][19][20] we assumed a number of 80 as functional to an exploratory analysis. Indeed, VA could satisfactorily disclose the infectious or non infectious state of cutaneous ulcers in only 25 patients and of the urine in 142 patients.…”

“…Recently, VA has proved effective also for detection of urinary tract infections, [17,18] and leg ulcer infections. [19,20] Moreover, a similar technology for exhaled breath analysis (dubbed e-nose) has shown encouraging discriminatory capacities in different clinical scenarios. [21][22][23][24] However, VA has never been tested on the ascitic fluid, and the currently tested instrument is a prototype.…”

Design of an Innovative Methodology for Cerebrospinal Fluid Analysis: Preliminary Results

“…This technique is based on a sensor system able to analyze many different biological fluids [ 8 , 9 ], already tested in numerous experiments in the medical field [ 10 , 11 , 12 , 13 ].…”