Routine Fluorescence Imaging to Detect Wound Bacteria Reduces Antibiotic Use and Antimicrobial Dressing Expenditure While Improving Healing Rates: Retrospective Analysis of 229 Foot Ulcers.
Routine Fluorescence Imaging to Detect Wound Bacteria Reduces Antibiotic Use and Antimicrobial Dressing Expenditure While Improving Healing Rates: Retrospective Analysis of 229 Foot Ulcers.
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DOI：
10.3390/diagnostics10110927
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发表时间：
2020-11-10
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--
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Price N
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Price N
足部溃疡及其细菌负担给国家医疗保健系统 (NHS) 带来了巨大压力。伤口感染评估的主观性使得适当的敷料选择具有挑战性。为了帮助即时检测细菌负荷，Whipps Cross 医院足病诊所引入了荧光成像设备 (MolecuLight i:X)。这项回顾性的前/后分析评估了荧光成像的实施如何影响（1）抗菌敷料和抗生素的使用以及（2）伤口愈合率。 2 年期间，共治疗了 229 处下肢伤口。在将荧光成像纳入常规实践之前（2018/2019）和之后（2019/2020）一年多的时间里，对伤口相关的结果和抗菌敷料成本进行了量化。荧光成像期间看到的伤口数量增加了 27%，但每年的抗菌敷料支出却减少了 33%。荧光成像的实施还与抗菌敷料处方减少 49%、抗生素处方减少 33% 以及 12 周内伤口愈合率提高 23% 相关（48% vs. 39%），这可能是由于更早的细菌检测和伤口卫生的改善。治愈率的提高预计将使年度伤口费用降低 10%（每位患者 762 英镑）。常规细菌成像似乎可以减轻患者和 NHS 的临床和经济负担。
Foot ulcers and their bacterial burden produce a significant strain on the National Healthcare System (NHS). Subjectivity of wound infection assessment makes appropriate dressing selection challenging. To aid point-of-care detection of bacterial burden, a fluorescence imaging device (MolecuLight i:X) was introduced to the Whipps Cross Hospital Podiatry clinic. This retrospective pre/post-analysis evaluated how implementation of fluorescence imaging impacted (1) antimicrobial dressings and antibiotics use and (2) wound healing rates. Over a 2-year period 229 lower extremity wounds were treated. Wound-related outcomes and antimicrobial dressing costs were quantified over 1-year before (2018/2019) and after (2019/2020) incorporating fluorescence imaging into routine practice. The period of fluorescence imaging saw a 27% increase in the number of wounds seen, yet annual antimicrobial dressing expenditure decreased by 33%. Implementation of fluorescence imaging was also associated with a 49% decrease in prescription of antimicrobial dressings, a 33% decrease in antibiotic prescriptions, and a 23% increase in wound healing rates within 12-weeks (48% vs. 39%), likely due to earlier bacterial detection and improved wound hygiene. This increased healing rate is projected to decrease annual wound costs by 10% (£762 per patient). Routine bacterial imaging appears to diminish clinical and economic burden to patients and the NHS.
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