Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Sep 1;37(9):471-479.
doi: 10.1097/ASW.0000000000000177. Epub 2024 Jul 17.

Improving Wound Healing and Infection Control in Long-term Care with Bacterial Fluorescence Imaging

Affiliations

Improving Wound Healing and Infection Control in Long-term Care with Bacterial Fluorescence Imaging

Martha R Kelso et al. Adv Skin Wound Care. .

Abstract

Background: High bacterial burden stalls wound healing and can quickly progress to infection and sepsis in complex, older-adult patients in long-term care (LTC) or skilled nursing facilities (SNFs).

Objective: To investigate the outcomes of point-of-care fluorescence (FL) imaging (MolecuLight i:X) of bacterial loads, which are frequently asymptomatic, to inform customized wound treatment plans for patients in LTC/SNFs.

Methods: In this retrospective pre/postinterventional cohort study, the authors compared the healing and infection-associated outcomes of 167 pressure injuries from 100 Medicare beneficiaries before and after implementation of FL imaging.

Results: Most patient demographics and wound characteristics did not differ significantly between the standard-of-care (SOC; n = 71 wounds) and FL (n = 96 wounds) cohorts. Significantly more wounds (+71.0%) healed by 12 weeks in the FL cohort (38.5%) versus the SoC cohort (22.5%). Wounds in the FL cohort also healed 27.7% faster (-4.8 weeks), on average, and were 1.4 times more likely to heal per Kaplan-Meier survival analysis (hazard ratio = 1.40; 95% CI, 0.90-2.12). Infection-related complications decreased by 75.3% in the FL cohort, and a significant shift from largely systemic to topical antibiotic prescribing was evidenced.

Conclusions: Fluorescence-imaging-guided management of wounds significantly improved healing and infection outcomes in highly complex and multimorbid patients in LTC/SNFs. Proactive bacterial infection management via local treatments was enabled by earlier, objective detection. These reported outcome improvements are comparable to randomized controlled trials and cohort studies from less compromised, selectively controlled outpatient populations. Fluorescence imaging supports proactive monitoring and management of planktonic and biofilm-encased bacteria, improving patient care in a complex, real-world setting.

Trial registration: ClinicalTrials.gov NCT#0606897.

PubMed Disclaimer

References

    1. Sen CK. Human wound and its burden: updated 2020 compendium of estimates. Adv Wound Care 2021;10(5):281–92.
    1. United Nations, Department of Economic and Social Affairs, Population Division. Government policies to address population ageing. 2020. https://www.un.org/development/desa/pd/sites/www.un.org.development.desa... . Last accessed May 14, 2024.
    1. Wicke C, Bachinger A, Coerper S, Beckert S, Witte MB, Königsrainer A. Aging influences wound healing in patients with chronic lower extremity wounds treated in a specialized wound care center. Wound Repair Regen 2009;17(1):25–33.
    1. Boutayeb A, Boutayeb S. The burden of non communicable diseases in developing countries. Int J Equity Health 2005;4(1):2.
    1. Beyene RT, Derryberry S, Barbul A. The effect of comorbidities on wound healing. Surg Clin North Am 2020;100(4):695–705.

Associated data

LinkOut - more resources