Practice Innovations
A healed wound is the definition of success and a primary study end-point in wound care, however there is no standardized definition. Federal guidance recommends defining complete wound closure as “skin reepithelialization without drainage or dressing requirements confirmed at two consecutive study visits 2 weeks apart”. Despite this recommendation, the definition of a healed wound in high-level clinical studies varies significantly.
While a healed wound is a critical clinical and study end-point signifying successful intervention, failure to maintain a healed wound remains high.
The ability to have an objective point-of-care measurement indicating full-thickness healing could potentially decrease the recurrence rate.
Methods:
To evaluate if point-of-care near infrared spectroscopy (NIRS) can be used as an objective measure for wound healing, thirteen patients in an outpatient wound care clinic were followed with serial NIRS studies. Full-thickness healing was defined as the resolution of deep tissue inflammation as measured by NIRS. The time between epithelialization and resolution of inflammation, as measured by NIRS, was recorded.
Results:
The average time to see resolution of the inflammation below the area of epithelization averaged 25 days with a range of 8 to 84 days.
Discussion:
Complete epithelization of a DFU is not a good indicator that it is safe to transition a patient back to protective shoe gear use and increased activities. Time is needed to allow for deep dermal healing and increase in skin tensile strength to occur once a wound is fully re-epithelialized.
Deep dermal healing, occurring after reepithelization, is associated with inflammation and associated increase tissue oxygenation saturation levels. This study demonstrates how NIRS may be used to provide visualization and an objective measure of deep dermal microvascular oxygenation to assist the clinician in knowing when deep dermal healing occurred
Trademarked Items:
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