Int Wound J · 2022
Uncovering the high prevalence of bacterial burden in surgical site wounds with point-of-care fluorescence imaging
Sandy-Hodgetts, K., Andersen, C.A., Al-Jalodi, O., Serena, L., Teimouri, C., & Serena, T.E.
International Wound Journal (received Oct 2021, accepted Dec 2021)
In brief
This post hoc analysis of 58 surgical site wounds from the multicenter FLAAG clinical trial compared clinical signs and symptoms of infection with point-of-care fluorescence imaging for detecting high bacterial loads, which were confirmed by tissue biopsy. High bacterial loads were found in 44 wounds, but only 3 of 44 showed signs of infection (sensitivity 6.8%); fluorescence imaging improved sensitivity 5.7-fold (P = .0005), and when three clinicians experienced in reading the images reviewed them, sensitivity was 11.3-fold higher than clinical signs alone (P < .0001). The authors conclude that surgical wounds referred to wound specialists often carry high bacterial loads without symptoms, and that imaging may improve surgical site monitoring.
The SerenaGroup Research Foundation conducted the FLAAG trial behind this analysis, sponsored by MolecuLight.
Plain-language summary by SerenaGroup. See the full text for complete methods and results.
Abstract
Detection of bacterial burden within or near surgical wounds is critical to reducing the occurrence of surgical site infection (SSI). A distinct lack of reli- 2 Centre for Molecular Medicine & Innovative Therapeutics, Murdoch University, Murdoch, Western Australia, Australia 3 able methods to identify postoperative bioburden has forced reliance on clinical signs and symptoms of infection (CSS). As a result, infection management has been reactive, rather than proactive. Fluorescence imaging of bacterial Wound Care Clinic, Madigan Army Medical Center, Joint Base LewisMcChord, Renton, Washington, USA burden (FL) is positioned to potentially flip that paradigm. This post hoc analysis evaluated 58 imaged and biopsied surgical site wounds from the multi- 4 centre fluorescence imaging assessment and guidance clinical trial. Diagnostic SerenaGroup Research Foundation, Cambridge, Massachusetts, USA 5 Beaver Valley Foot Clinic, Pittsburgh, Pennsylvania, USA
Keywords
bacteriadiagnosisfluorescence imagingMolecuLightsurgical site infection
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