Visualisierung von Bakterien auf Verbrennungswunden und
                    Spalthauttransplantaten nach der MEEK/MESH-Technik – Eine Pilotstudie mit ersten
                    Erfahrungen der klinischen Wundbeurteilung durch Autofluoreszenz

Alawi, Seyed Arash; Limbourg, Anne; Strauß, Sarah; Vogt, Peter M.

doi:10.1055/a-0584-7488

Cited by 5 publications

(5 citation statements)

References 32 publications

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“…Interestingly, the studies that focused on burns reported better diagnostic accuracy measures compared to the average of all the papers. A sub-analysis of the 4 burn studies [49,[53][54][55] demonstrated higher sensitivity (91%), accuracy (85%) and NPV (82%) with only minor decreases in PPV and specificity. This might suggest that the burn population, in particular, would see a large benefit from fluorescence imaging.…”

Section: Diagnostic Accuracy Of Fluorescence Imagingmentioning

confidence: 96%

“…To date, 11 publications, representing a total of 613 wounds, have reported on the diagnostic accuracy measures of the MolecuLight i:X to detect bacterial loads of ≥10 4 CFU/g (Table 2) [7,[35][36][37][49][50][51][52][53][54][55]. The diagnostics accuracy measures reported here include the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy.…”

Section: Diagnostic Accuracy Of Fluorescence Imagingmentioning

confidence: 99%

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Diagnosing Burn Wounds Infection: The Practice Gap & Advances with MolecuLight Bacterial Imaging

Farhan

Jeffery

2021

Diagnostics

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Burn injuries constitute a critical economic burden on healthcare infrastructures worldwide. They are often associated with high mortality rates due to severe complications. Infection is the most common complication, highlighting the importance of prompt and precise diagnosis in order to prevent detrimental consequences and to optimize patient outcomes. Here we examine the current standard of care for diagnosing infection in both burn and chronic wounds followed by an investigation into the research surrounding a relatively new technique for bacterial detection, fluorescence imaging. With five years of published research on bacterial fluorescence imaging (MolecuLight i:X device), we have summarized and analysed the validity of the procedure and compared it to the current standard of care; clinical assessment and microbiological analysis. We highlight the benefits that could be obtained through the use of this technology as well as the limitations and the feasibility of incorporating this novel procedure into the standard of care.

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Section: Diagnostic Accuracy Of Fluorescence Imagingmentioning

confidence: 96%

Section: Diagnostic Accuracy Of Fluorescence Imagingmentioning

confidence: 99%

Diagnosing Burn Wounds Infection: The Practice Gap & Advances with MolecuLight Bacterial Imaging

Farhan

Jeffery

2021

Diagnostics

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“…Moreover, the percentage of enrolled patients that were true negatives based on microbiology (bacterial load <10 4 CFU/g, 1/19 patients) was surprisingly low, preventing statistical testing of specificity and challenging the ability to determine NPV in this patient cohort (though these have been reported in other studies; recent reports of NPV have ranged from 90 to 100%). 27,60,61 This may have been due, at least in part, to the study's exclusion of patients on antibiotics. Patients actively taking systemic or oral antibiotics would be anticipated to have low bacterial loads.…”

Section: Limitationsmentioning

confidence: 99%

Real-time bacterial fluorescence imaging accurately identifies wounds with moderate-to-heavy bacterial burden

et al. 2019

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Objective: Clinical evaluation of signs and symptoms (CSS) of infection is imperative to the diagnostic process. However, patients with heavily colonised and infected wounds are often asymptomatic, leading to poor diagnostic accuracy. Point-of-care fluorescence imaging rapidly provides information on the presence and location of bacteria. This clinical trial (#NCT03540004) aimed to evaluate diagnostic accuracy when bacterial fluorescence imaging was used in combination with CSS for identifying wounds with moderate-to-heavy bacterial loads. Methods: Wounds were assessed by study clinicians using NERDS and STONEES CSS criteria to determine the presence or absence of moderate-to-heavy bacterial loads, after which the clinician prescribed and reported a detailed treatment plan. Only then were fluorescence images of the wound acquired, bacterial fluorescence determined to be present or absent and treatment plan adjusted if necessary. Results: We examined 17 VLUs/2 DFUs. Compared with CSS alone, use of bacterial fluorescence imaging in combination with CSS significantly improved sensitivity (22% versus 72%) and accuracy (26% versus 74%) for identifying wounds with moderate-to-heavy bacterial loads (≥104 CFU/g, p=0.002). Clinicians reported added value of fluorescence images in >90% of study wounds, including identification of wounds incorrectly diagnosed by CSS (47% of study wounds) and treatment plan modifications guided by fluorescence (73% of study wounds). Modifications included image-guided cleaning, treatment selection, debridement and antimicrobial stewardship. Conclusion: Findings from this pilot study suggest that when used in combination with CSS, bacterial fluorescence may: (1) improve the diagnostic accuracy of identifying patients with wounds containing moderate-to-heavy bacterial loads and (2) guide more timely and appropriate treatment decisions at the point-of-care.

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“…However, STSGs’ covering time should not exceed over five to seven days. As long-top dressing may provide an environment for growth of microorganisms and increase risk of infection [ 24 ], in this study, the first dressing was carried out at day five to seven after surgery and NPWT was removed from the NPWT group.…”

Section: Discussionmentioning

confidence: 99%

Application of Negative Pressure Therapy on Skin Grafts after Soft-Tissue Reconstruction: A Prospective Observational Study

Mandili

Aljubairy

Alsharif

et al. 2022

Clinics and Practice

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A split-thickness skin graft (STSG) is one of the main tools used in the reconstruction of skin defects. Negative-pressure wound therapy (NPWT) has been widely used as adjunct therapy for wound healing for decades. Few studies have conducted the outcomes of NPWT use as a postoperative dressing for STSGs. This study aimed to compare the outcomes of the application of NPWT versus conventional dressing on STSGs after soft-tissue reconstruction. A prospective observational study was performed at the King Abdullah Medical City. A total of 18 patients with STSGs for acute or chronic skin defects were recruited. Patients from the two groups—10 patients in the NPWT group and 8 in the No-NPWT group—were postoperatively evaluated for three weeks. Assessment included the STSG take rate, wound healing, pain, infection, hematoma formation, and the need to re-graft the same recipient area. Our data demonstrated a higher mean skin graft take rate in the second and third weeks of the No-NPWT group compared to the NPWT group, but it was not statistically significant (p > 0.05). No significant differences between the two groups in terms of wound healing, pain, infection, hematoma formation, and the need to re-graft (p > 0.05) were found. Our study showed that the conventional dressing of STSGs is not inferior to NPWT. In addition, conventional dressing was shown to be easier to use and less expensive to apply, as well as having a higher skin graft take rate and lower infection rate.

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Visualisierung von Bakterien auf Verbrennungswunden und Spalthauttransplantaten nach der MEEK/MESH-Technik – Eine Pilotstudie mit ersten Erfahrungen der klinischen Wundbeurteilung durch Autofluoreszenz

Cited by 5 publications

References 32 publications

Diagnosing Burn Wounds Infection: The Practice Gap & Advances with MolecuLight Bacterial Imaging

Diagnosing Burn Wounds Infection: The Practice Gap & Advances with MolecuLight Bacterial Imaging

Real-time bacterial fluorescence imaging accurately identifies wounds with moderate-to-heavy bacterial burden

Application of Negative Pressure Therapy on Skin Grafts after Soft-Tissue Reconstruction: A Prospective Observational Study

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