Diagnosis and treatment of the invasive extension of bacteria (cellulitis) from chronic wounds utilising point-of-care fluorescence imaging.
Diagnosis and treatment of the invasive extension of bacteria (cellulitis) from chronic wounds utilising point-of-care fluorescence imaging.
复制标题
利用护理点荧光成像的慢性伤口的细菌侵入性扩展（纤维炎）的诊断和治疗。
DOI：
10.1111/iwj.13696
复制
发表时间：
2022-08
影响因子：
3.1
通讯作者：
Steffan, Rowena
中科院分区：
文献类型：
--
作者：
Andersen, Charles A.;McLeod, Katherine;Steffan, Rowena
伤口相关性蜂窝织炎的早期诊断具有挑战性，因为许多经典的感染体征和症状（红斑、疼痛、压痛或发热）可能不存在。此外，其他疾病（即慢性郁积性皮炎）可能会出现类似的临床表现。即时荧光成像以高灵敏度检测伤口内和周围的细菌负荷升高。这项前瞻性观察性研究检查了将荧光成像纳入标准护理对伤口相关蜂窝织炎诊断和管理的影响。本研究纳入了2020年1月至2021年4月期间访问门诊伤口护理中心的236名患者。患者接受常规细菌荧光扫描（范围：1 - 48次扫描/患者）。6.4%（15/236）的患者诊断为伤口相关蜂窝织炎。在这些患者中，荧光扫描显示红色（细菌）荧光的不规则图案延伸到伤口床和伤口周围，无法通过清洁或清创术清除，表明细菌的侵入性延伸（伤口相关蜂窝织炎）。床旁识别有助于快速启动解决荧光的治疗（源控制和抗生素，如有必要）。没有患者发生需要静脉注射抗生素和/或住院治疗的蜂窝织炎恶化。这些发现证明了床旁荧光成像在伤口相关蜂窝织炎的有效检测和主动、靶向管理中的实用性。
Early diagnosis of wound‐related cellulitis is challenging as many classical signs and symptoms of infection (erythema, pain, tenderness, or fever) may be absent. In addition, other conditions (ie, chronic stasis dermatitis) may present with similar clinical findings. Point‐of‐care fluorescence imaging detects elevated bacterial burden in and around wounds with high sensitivity. This prospective observational study examined the impact of incorporating fluorescence imaging into standard care for diagnosis and management of wound‐related cellulitis. Two hundred thirty‐six patients visiting an outpatient wound care centre between January 2020 and April 2021 were included in this study. Patients underwent routine fluorescence scans for bacteria (range: 1‐48 scans/patient). Wound‐related cellulitis was diagnosed in 6.4% (15/236) of patients. In these patients, fluorescence scans showed an irregular pattern of red (bacterial) fluorescence extending beyond the wound bed and periwound that could not be removed through cleansing or debridement, indicating the invasive extension of bacteria (wound‐related cellulitis). Point‐of‐care identification facilitated rapid initiation of treatments (source control and antibiotics, when warranted) that resolved the fluorescence. No patients had worsening of cellulitis requiring intravenous antibiotics and/or hospitalisation. These findings demonstrate the utility of point‐of‐care fluorescence imaging for efficient detection and proactive, targeted management of wound‐related cellulitis.
登录
查看更多内容
DOI：
10.3390/diagnostics10110927
发表时间：
2020-11-10
期刊：
Diagnostics (Basel, Switzerland)
影响因子：
--
作者：
Price N
通讯作者：
Price N
影响因子：
28.2
作者：
Figtree, M.;Konecny, P.;Miyakis, S.
通讯作者：
Miyakis, S.
影响因子：
3.6
作者：
Rennie, Monique Y.;Dunham, Danielle;Linden, Ron
通讯作者：
Linden, Ron
DOI：
10.3390/diagnostics11020280
发表时间：
2021-02-11
期刊：
Diagnostics (Basel, Switzerland)
影响因子：
--
作者：
Raizman R;Little W;Smith AC
通讯作者：
Smith AC
影响因子：
1.9
作者：
Rennie, M. Y.;Lindvere-Teene, L.;Linden, R.
通讯作者：
Linden, R.