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Detection of Bacterial Burden, Chronic Wounds

MolecuLight i:X: A new tool for wound infection diagnosis

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

Background. The MolecuLight i:X device is intended to assist healthcare practitioners managing patients with wounds by enabling real-time visualisation of potentially harmful bacteria. Healthcare practitioners are provided with a visual indication of bacterial presence, load and location within and around wounds.
Objectives. We decided to use the device in a cohort of burns patients in an attempt to test its effectiveness and applicability in an adult burn centre.
Methods. We were given permission by our hospital to use the MolecuLight i:X device for a test period of 1 month, and elected to do a pilot observational study to test its application on burn wounds. A total of 10 patients were assessed for presence of infection (red or green flare).
Results. Seven patients showed either cyan or red fluorescence. Pseudomonas aeruginosa was confirmed on wound swabs in the 4 patients with cyan fluorescence. The red fluorescence in 3 patients showed on wound swabs as either MRSA, Streptococcus pyogenes or Proteus mirabilis. The remaining 3 patients did not show any fluorescence, and there was no growth on wound swabs.
Conclusion. The MolecuLight i:X is a new device for identifying Gram-positive and Gram-negative bacteria on an open wound. It is of great practical benefit to the surgeon in making decisions about the adequacy of debridement before subsequent skin grafts, and it also identifies target areas for antiseptics.

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