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Evidence Category:
Debridement/Wound Hygiene

Debridement/Wound Hygiene

UPPER and LOWER CSS checklists were developed to distinguish between local & systemic infection

Addition of fluorescence imaging led to more judicious application of antimicrobials & more thorough wound bed preparation

95% sensitivity when fluorescence imaging was added over signs and symptoms alone (p<0.01)

24% of VLU periwound area was colonized by high bacterial loads pre-debridement

99% reduction of bacterial signal in the wound bed after debridement using fluorescence guidance

36% of periwound bacterial signal is left behind after standard debridement in VLUs (without
the guidance of fluorescence)

This case series describes the utility of fluorescence imaging for detection of bacterial burden in an adult burn center

Fluorescence imaging informed decision making on dressings, antimicrobials and antibiotics used at point of care

Swabs confirmed accuracy of imaging results (positive or negative) in all 10 cases

Fluorescence images for identifying bacterial loads of concern was 100% vs 63% sensitivity of CSS

Fluorescence images for identifying bacterial loads of concern was 92% compared to 82% accuracy of CSS

Fluorescence correctly identified all 8 wounds that were positive for significant bacterial growth on cultures