Tissue Oxygenation Changes to Assess Healing in Venous Leg Ulcers Using Near-Infrared Optical Imaging

Rebecca Kwasinski, Cristianne Fernandez, Kevin Leiva, Richard Schutzman, Edwin Robledo, Penelope Kallis, Luis J. Borda, Robert Kirsner, Francisco Perez-Clavijo, Anuradha Godavarty

Research output: Contribution to journalArticle

Abstract

Venous leg ulcers (VLUs) comprise 80% of leg ulcers. One of the key parameters that can promote healing of VLUs is tissue oxygenation. To date, clinicians have employed visual inspection of the wound site to determine the healing progression of a wound. Clinicians measure the wound size and check for epithelialization. Imaging for tissue oxygenation changes surrounding the wounds can objectively complement the subjective visual inspection approach. Herein, a handheld noncontact near-infrared optical scanner (NIROS) was developed to measure tissue oxygenation of VLUs during weeks of treatment. Approach: Continuous-wave-based diffuse reflectance measurements were processed using Modified Beer-Lambert's law to obtain changes in tissue oxygenation (in terms of oxy-, deoxy-, total hemoglobin, and oxygen saturation). The tissue oxygenation contrast obtained between the wound and surrounding tissue was longitudinally mapped across weeks of treatment of four VLUs (healing and nonhealing cases). Results: It was observed that wound to background tissue oxygenation contrasts in healing wounds diminished and/or stabilized, whereas in the nonhealing wounds it did not. In addition, in a very slow-healing wound, wound to background tissue oxygenation contrasts fluctuated and did not converge. Innovation: Near-infrared imaging of wounds to assess healing or nonhealing of VLUs from tissue oxygenation changes using a noncontact, handheld, and low-cost imager has been demonstrated for the first time. Conclusion: The tissue oxygenation changes in wound with respect to the surrounding tissue can provide an objective subclinical physiological assessment of VLUs during their treatment, along with the gold-standard visual clinical assessment.

Original languageEnglish (US)
Pages (from-to)565-579
Number of pages15
JournalAdvances in Wound Care
Volume8
Issue number11
DOIs
StatePublished - Nov 1 2019

Keywords

  • handheld
  • near-infrared imaging
  • optical scanner
  • tissue oxygenation
  • venous leg ulcers
  • wound healing

ASJC Scopus subject areas

  • Emergency Medicine
  • Critical Care and Intensive Care Medicine

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    Kwasinski, R., Fernandez, C., Leiva, K., Schutzman, R., Robledo, E., Kallis, P., Borda, L. J., Kirsner, R., Perez-Clavijo, F., & Godavarty, A. (2019). Tissue Oxygenation Changes to Assess Healing in Venous Leg Ulcers Using Near-Infrared Optical Imaging. Advances in Wound Care, 8(11), 565-579. https://doi.org/10.1089/wound.2018.0880