Detecting Bacteria on Wounds with Hyperspectral Imaging in Fluorescence Mode

AbstractChronic non-healing wounds represent an increasing problem. In order to enable physicians and nurses to make evidence based decisions on wound treatment, the professional societies call for supporting tools to be offered to physicians. Oxygen supply, bacteria colonization and other parameters influence the healing process. So far, these parameters cannot be monitored in an objective and routinely manner. Existing methods like the microbiological analysis of wound swabs, mean a great deal of effort and partly a long delay. In this paper 42 fluorescence images from 42 patients with diabetic foot ulcer, recorded with a hyperspectral imaging system (TIVITA®), converted for fluorescence imaging, were analysed. Beside the fluorescence images, information about the bacterial colonization is available from microbiological analysis of wound swabs. After preprocessing, principal component analysis, PCA, is used for data analysis with a 405 nm excitation wavelength, the emission wavelength range 510 - 745 nm is used for analysis. After dividing the data into a training and a test dataset it could be shown, that bacteria are detectable in the wound area. A quantification in bacterial colonization counts (BCC) was not in the focus of the research in this study stage.

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1548. Association of bacterial colonization in ulcerative lesions of the diabetic foot together with the cicatrization process

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1728 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S773-S775

Author(s):

Alexander A Ozoria Loveras ◽

Jacques Paré Espinal ◽

David de luna ◽

Noemi Acevedo

Keyword(s):

Diabetic Foot ◽

Bacterial Colonization ◽

Healing Process ◽

Foot Ulcer ◽

Primary Source ◽

Diabetic Foot Ulcer ◽

Care Program ◽

Antimicrobial Treatment ◽

Control Group ◽

Experimental Group

Abstract Background In 2018, a review of the scientific literature identifed biofilm studies in the past 3 years. Wherein, the role of the biofilm in the progression of the diabetic foot ulcer with the presence of biofilm is reviewed. As a result, tissue sampling is more effective than transcure, Levin, and aspiration. A study in Cuba evaluate the effectiveness of a new proposal for antimicrobial treatment in patients with diabetic foot infection in 2017. The method used was a experimental type of two groups. The control group, was treated with the treatment scheme proposed in the Comprehensive Care Program for the patient with diabetic foot ulcer (PAIPUPD). Instead, the other experimental group was treated according to the scheme based on the local microbial map. They used a random distribution. Using the Wagner classification, there were patients classificate with a grade of W2 (13% of patients), W3 (66%) and W4 (12%). The most frequent germs found were Staphylococcus aureus, Escherichia coli and Enterobacter sp. The experimental group required less days with hospitalization. Methods This is an observational study of primary source with a non-probability sample with 58 patients. Adult patients diagnosed with type 2 diabetes mellitus, with diabetic foot, Wagner classification 1, 2 and 3, who attended the healing area of the Institute of Diabetes of Santiago were included. After identifying the colonized pathogen, its cicatrization process was evaluate for four weeks. Results Of the total sample, 12.07% belonged to Wagner 1, 43.1% to Wagner 2 and 44.83% to the Wagner 3 classification. In the case of the Wagner 3 group, S. aureus and Pseudomona aeruginosa were present in 6 cases. Despite the infectious processes detected by the culture, the patients showed a successful cicatrization process after four weeks of evaluation. Graph 1: Isolated Microorganism Vs Wagner’s Degree (n=60) Graph 2: Gram positive microorganism vs. healing process per week in patients with diabetic foot (n=22) Graph 3: Gram-negative microorganism vs. healing process (n=33) Conclusion During the four weeks of clinical evaluation, more than 88% of patients progressed positively to clinical recovery, regardless of the type of bacteria colonized and/or their resistance to antibiotics. Disclosures All Authors: No reported disclosures

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Comparative investigation of the Diabetic foot ulcer microbiome

10.1101/2021.01.21.427721 ◽

2021 ◽

Author(s):

Amr T. M. Saeb ◽

Hamsa T. Tayeb ◽

Samir Ouizi ◽

Majed S. Nassar ◽

Assim Alfadda ◽

...

Keyword(s):

Diabetic Foot ◽

Biological Diversity ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Principal Component ◽

Diversity Indices ◽

Comparative Investigation ◽

Microbiological Analysis ◽

Tissue Quality ◽

Cross Sectional

AbstractBackgroundMany factors may affect wound healing in Diabetic foot ulcer, namely, microbial density, microorganisms, microbial synergy, the host immune response, and infected tissue quality.MethodologyThis study used a cross-sectional design. We assessed 38 Subjects with DFUs, 23 neuroischaimic, and 15 neuropathic, for microbiota colonizing the DFU utilizing traditional cultures and 16S gene sequencing methods. All the relevant clinical factors were collected. Wound swabs were collected for both traditional microbiological analysis, direct swab (DSM), and cultured (CM) microbiome analysis. DNA isolation, and 16SrRNA hypervariable regions were amplified. Bioinformatics analysis was performed using IonReporter Software, statistical analysis, and diversity indices were computed with vegan R-package.ResultsThe traditional microbiological method was able to detect a maximum of one or two pathogens, and, in some cases, no pathogen was detected. The total number of the observed species was 176. The number of identified species was higher in the cultured microbiome (155) than the direct swab microbiome (136). Diversity analysis indicated that biological diversity is higher in the cultured microbiome compared with the DSM. The Shannon H index was 2.75 for the cultured microbiome and 2.63 for DSM. We observed some differences in the major bacterial taxa amongst neuroischaimic and neuropathic DFU microbiomes.ConclusionsCultured microbiome is superior to both the traditional method and direct swab microbiome. The Neuroischaimic group showed higher values for the tested diversity indices than the Neuroischaimic group. Neither Cluster Analysis nor Principal Component Analysis showed apparent clustering amongst the two types of ulcers.

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Pork Quality Classification Using a Hyperspectral Imaging System and Neural Network

International Journal of Food Engineering ◽

10.2202/1556-3758.1089 ◽

2007 ◽

Vol 3 (1) ◽

Cited By ~ 9

Author(s):

Qiao Jun ◽

Michael Ngadi ◽

Ning Wang ◽

Aynur Gunenc ◽

Mariana Monroy ◽

...

Keyword(s):

Neural Network ◽

Hyperspectral Imaging ◽

Imaging System ◽

Objective Assessment ◽

Principal Component ◽

Pork Quality ◽

Pca Analysis ◽

Error Frequency ◽

Quality Classification ◽

Average Reflectance

Pork quality is usually determined subjectively as PSE, PFN, RFN, RSE and DFD based on color, texture and exudation of the meat. In this study, a hyperspectral-imaging-based technique was developed to achieve rapid, accurate and objective assessment of pork quality. The principal component analysis (PCA) and stepwise operation methods were used to select feature waveband from the entire spectral wavelengths (430 to 980 nm). Then the feature waveband images were extracted at the selected feature wavebands from raw hyperspectral images, and the average reflectance (R) was calculated within the whole loin-eye area. Artificial neural network was used to classify these groups. Results showed that PCA analysis had a better performance than that of stepwise operation for feature waveband images selection. The 1st derivative data gave a better result than that of mean reflectance spectra data. The best classified result was 87.5% correction. The error frequency showed that RSE samples were easier to classify. The PFN and PSE samples were difficult to separate from each other.

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Efek Terapi Oksigen Hiperbarik (TOHB) pada Penyembuhan Ulkus Kaki DM Tipe 2 Berdasarkan Skor PEDIS

JURNAL BIOMEDIK (JBM) ◽

10.35790/jbm.11.2.2019.23323 ◽

2019 ◽

Vol 11 (2) ◽

pp. 110

Author(s):

Ekanova R. N. Sumarauw ◽

Mendy J. Hatibie ◽

Djony E. Tjandra ◽

Fredrik G. Langi

Keyword(s):

Wound Healing ◽

Diabetic Foot ◽

Controlled Trial ◽

Healing Process ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Control Group ◽

Wound Healing Process ◽

Holistic Treatment ◽

The Third

Abstract: Diabetic foot ulcer (DFU) is still a health problem related to the extent amount of time in wound healing process hence increasing the treatment cost. Given any methods that are not sat-isfying, encourage the search of other methods that would increase the wound healing rate, in which hyperbaric oxygen therapy (HBOT) is amongst them. The DFU patient that receives HBOT shows a significant increase in angiogenesis process markedly by faster epithelialization and granulation process. This study was aimed to prove that HBOT could accelerate the wound healing process among DFU patients measured by wound size and depth of PEDIS score. This was a ran-domized controlled trial study, conducted at Surgery Department of Prof. Dr. R. D. Kandou Gen-eral Hospital from September 2018 to March 2019. There were 20 DFU patients divided into two groups, each of 10 patients. The control group received a holistic treatment, meanwhile the HBOT group received a holistic treatment added with the inclusion of HBOT. PEDIS score assessment of DFU in HBOT group was measured before and after the third HBOT session, meanwhile the con-trol group was measured on the first and the third day. The results showed that the difference in PEDIS score value was markedly found in HBOT group compared to the control group (2 vs. 0, P=0.001). Conclusion: HBOT could enhance the wound healing process in DFU patients based on the declined PEDIS score.Keywords: HBOT, PEDIS score, diabetic foot ulcerAbstrak: Ulkus kaki diabetik (UKD) masih merupakan masalah kesehatan terkait proses penyembuhan lama sehingga biaya pengobatan meningkat. Belum adanya metode penanganan yang memuaskan, mendorong pencarian metode percepatan penyembuhan luka, salah satunya ialah terapi oksigen hiperbarik (TOHB). Penderita UKD yang menjalani tambahan TOHB diketahui mengalami peningkatan proses angiogenesis yang menghasilkan proses epitelialisasi dan granulasi yang lebih cepat. Tujuan penelitian ialah untuk membuktikan bahwa TOHB dapat mempercepat proses penyembuhan UKD, dinilai berdasarkan ukuran dan kedalaman luka melalui skor PEDIS. Penelitian ini menggunakan randomized controlled trial dan dilaksanakan di Bagian Bedah RSUP Prof. Dr. R.D. Kandou Manado sejak September 2018 sampai dengan Maret 2019. Subyek penelitian sebanyak 20 penderita UKD, dibagi dalam dua kelompok, masing-masing 10 penderita. Kelompok kontrol menjalani penanganan holistik UKD, sedangkan kelompok TOHB menjalani penanganan holistik UKD dengan TOHB. Penilaian skor PEDIS terhadap UKD pada kelompok TOHB dilakukan sebelum dan sesudah TOHB sesi ke-3, sedangkan pada kelompok kontrol dilakukan penilaian pada hari ke-1 dan hari ke-3 sesudahnya. Hasil penelitian mendapatkan bahwa perubahan skor PEDIS yang terjadi antara kedua pengukuran terlihat lebih besar pada kelompok TOHB dibandingkan kelompok kontrol (2 vs 0, P=0,001). Simpulan. TOHB mempercepat proses penyembuhan UKD dinilai dari penurunan skor PEDIS.Kata kunci: TOHB, skor PEDIS, ulkus kaki diabetik

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The importance of oxygen release in diabetic foot ulcer wounds

Bioengineering International ◽

10.33263/bioegnineering11.002011 ◽

2019 ◽

Vol 1 (1) ◽

pp. 002-011

Keyword(s):

Diabetic Foot ◽

Therapeutic Process ◽

Healing Process ◽

Foot Ulcer ◽

Essential Element ◽

Diabetic Foot Ulcer ◽

Wound Dressings ◽

Self Healing ◽

Healthy Human ◽

Affected Tissue

Oxygen is the essential element required for proper physiological function of cells, tissues and organs within healthy human body. Thanks to its intricate structure, the skin provides a multiprotective barrier against traumatic and non-traumatic injuries, but also a complex and successful self-healing process of the affected tissue. In the particular case of chronic skin wounds, such as diabetic foot ulcer wounds, there is an immediate demand to develop alternative procedures that prevent infection, speed up healing and eliminate any disrupting factor that may interfere with the therapeutic process. Given the importance of oxygen during wound healing cascade, impressive attention was oriented towards the fabrication of oxygen-releasing wound dressings.

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Comparison of Collagen Granule Dressing Versus Conventional Dressing in Patients With Diabetic Foot Ulcer

The International Journal of Lower Extremity Wounds ◽

10.1177/1534734620938988 ◽

2020 ◽

pp. 153473462093898

Author(s):

Bayram Colak ◽

Serdar Yormaz ◽

Ilhan Ece ◽

Akin Çalişir ◽

Kazım Körez ◽

...

Keyword(s):

Diabetic Foot ◽

Healing Process ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Duration Of Treatment ◽

Collagen Group ◽

Physiological Serum ◽

Better Than

Background. Diabetic foot ulcer (DFU) is a difficult, chronic wound with a significant long-term influence on the morbidity, mortality, and quality of life of patients. There is much information about the biochemical features of collagen and its function in wound healing. The aim of this study was to compare the results of DFU patients treated with and without collagen. Methods. A retrospective evaluation was made of the data of patients with DFU who underwent collagen treatment and physiological serum (PS) treatment. The patients were followed-up for a minimum of 12 weeks, and all complications, healing process, and wound characteristics were recorded. Results. Of the total 64 DFU patients included in the study, 30 were treated with PS and 34 with collagen. Complete closure was achieved in 17 (56.6%) of the PS group patients after 12 weeks of treatment. The rate was 25 (73.5%) in the collagen group. The mean duration of treatment was 9.2 weeks (range = 6-12 weeks) in the PS group and 8.08 weeks (range = 5-12 weeks) in the collagen group. The recovery time and recovery rates were determined to be better in the collagen group than in the PS group. Conclusion. A significant reduction in wound size was seen in the collagen group compared with the PS group. The results of this study demonstrated that collagen dressings are better than conventional dressings with regard to early granulation tissue and shorter hospital stay.

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A Hyperspectral Imaging System for Identification of Faecal and Ingesta Contamination on Poultry Carcasses

Journal of Near Infrared Spectroscopy ◽

10.1255/jnirs.373 ◽

2003 ◽

Vol 11 (4) ◽

pp. 269-281 ◽

Cited By ~ 55

Author(s):

Kurt C. Lawrence ◽

William R. Windham ◽

Bosoon Park ◽

R. Jeff Buhr

Keyword(s):

Real Time ◽

Hyperspectral Imaging ◽

Near Infrared ◽

Imaging System ◽

Principal Component ◽

Ccd Camera ◽

Sample Population ◽

Multivariate System ◽

Ratio Image ◽

On Line

A method and system for detecting faecal and ingesta contaminants on poultry carcasses were demonstrated. A visible/near infrared monochromator, which measured reflectance and principal component analysis were first used to identify key wavelengths from faecal and uncontaminated skin samples. Measurements at 434, 517, 565 and 628 nm were identified and used for evaluation with a hyperspectral imaging system. The hyperspectral imaging system, which was a line-scan (pushbroom) imaging system, consisted of a hyperspectral camera, fibre-optic line lights, a computer and frame grabber. The hyperspectral imaging camera consisted of a high-resolution charge coupled device (CCD) camera, a prism-grating-prism spectrograph, focusing lens, associated optical hardware and a motorised controller. The imaging system operated from about 400 to 900 nm. The hyperspectral imaging system was calibrated for wavelength, distance and percent reflectance and analysis of calibrated images at the key wavelengths indicated that single-wavelength images were inadequate for detecting contaminants. However, a ratio of images at two of the key wavelengths was able to identify faecal and ingesta contaminants. Specifically, the ratio of the 565-nm image divided by the 517-nm image produced good results. The ratio image was then further processed by masking the background and either enhancing the image contrast with a non-linear histogram stretch, or applying a faecal threshold. The results indicated that, for the limited sample population, more than 96% of the contaminants were detected. Thus, the hyperspectral imaging system was able to detect contaminants and showed feasibility, but was too slow for real-time on-line processing. Therefore, a multivariate system operating at 565 and 517 nm, which should be capable of operating at real-time on-line processing speed, should be used. Further research with such a system needs to be conducted.

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Micronutrients and Natural Compounds Status and Their Effects on Wound Healing in the Diabetic Foot Ulcer

The International Journal of Lower Extremity Wounds ◽

10.1177/1534734617737659 ◽

2017 ◽

Vol 16 (4) ◽

pp. 244-250 ◽

Cited By ~ 15

Author(s):

Kanokwan Kulprachakarn ◽

Sakaewan Ounjaijean ◽

Jukkrit Wungrath ◽

Raj Mani ◽

Kittipan Rerkasem

Keyword(s):

Wound Healing ◽

Diabetic Foot ◽

Healing Process ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Herbal Remedies ◽

Current Evidence ◽

Wound Healing Process ◽

Impaired Wound Healing ◽

Wide Range

The diabetic foot ulcer (DFU) is an invariably common complication of diabetes mellitus, it is also a significant cause of amputation as well as extended hospitalization. As most patients with DFU suffer from malnutrition, which has been related to improper metabolic micronutrients status, alterations can affect impaired wound healing process. Micronutrients and herbal remedies applications present a wide range of health advantages to patients with DFU. The purpose of this review is to provide current evidence on the potential effect of dietary supplementations such as vitamins A, C, D, E, magnesium, zinc, copper, iron, boron, and such naturally occurring compounds as Aloe vera, Naringin, and Radix Astragali (RA) and Radix Rehmanniae (RR) in the administration of lower extremity wounds, especially in DFU, and to present some insights for applications in the treatment of DFU patients in the future.

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Mobile Application for Ulcer Detection

The Open Biomedical Engineering Journal ◽

10.2174/1874120701812010016 ◽

2018 ◽

Vol 12 (1) ◽

pp. 16-26 ◽

Cited By ~ 7

Author(s):

Luay Fraiwan ◽

Jolu Ninan ◽

Mohanad Al-Khodari

Keyword(s):

Mobile Application ◽

Imaging System ◽

Smart Phone ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Diabetic Patients ◽

Thermal Camera ◽

Number Of Patients ◽

The Difference ◽

Thermal Imaging System

Purpose: The number of patients who are suffering from diabetes nowadays is increasing significantly. In some countries, the percentage of population who suffer from this disease can reach up to 20%. Diabetic patients have to deal with their medical conditions and any further complications that this disease may cause. One of the most common conditions is the Diabetic Foot Ulcer (DFU). The early detection of these ulcers can help and may save the life of diabetic patients. Methods: This work proposes a mobile application for the detection of possible ulcers using a smart phone along with a mobile thermal camera (FLIR ONE). The proposed system captures thermal images of the feet from the thermal camera. The app that identifies ulcers was built using Android studio. The images were acquired to the Samsung S6 smart phone using the FLIR ONE SDK. Image processing techniques were deployed based on Open CV Library. The procedure of detecting possible ulcers was implemented based on analyzing the thermal distribution on the two feet. The developed application compares the difference between the temperature distribution on the two feet and checks if there is a Mean Temperature Difference (MTD) greater than 2.2oC (the value which indicates a possible ulcer development). Results: The system was tested under simulated conditions by heating different locations of the subjects’ feet to different temperature ranges; one image with temperature less than 2.2oC and another three images with temperature greater than 2.2oC. The system has successfully identified possible ulcer regions along with an image showing the location of the possible ulcers. Conclusions: This work is a very first step in developing a complete mobile thermal imaging system that can be validated clinically in the future.

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Case Study: Diabetic Foot Ulcer Nursing Management Using Ozone Regional Non-Invasive (ORNI)Therapy as A Combination Of Care

Jurnal Keperawatan Soedirman ◽

10.20884/1.jks.2021.16.2.1647 ◽

2021 ◽

Vol 16 (2) ◽

Author(s):

Irma Puspita Arisanty ◽

Debie - Dahlia

Keyword(s):

Assessment Tool ◽

Wound Care ◽

Healing Process ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Wound Healing Process ◽

Nursing Management ◽

Ozone Therapy ◽

Average Growth ◽

Non Invasive

Background: DFU patients must be treated properly less than 30 days to prevent infection spread to the bone, causes smaller opportunity to recovery and higher risk for amputation. Ozone therpay has a clearer clinical effect, affects the wound healing process, it can be seen by decreasing the length of stay. Method: Case studies of 3 DFU patients who were given ORNi therapy. Wound evaluation using Bettes-Jenssen Assessment tool skoring system. Results: There were significant improvement in these cases after given a noninvasive regional ozone therapy (ORNi) as a combination in standard treatment for 5 – 7 times. There are no sign of infection, granulation and epithelization processes were running optimal and exudate production was controlled. Conclusions and recommendation: Using ORNi therapy as an adjunct to standard care has shown a significant improvement. The rate of granulation and epithelization during 15 days of treatment has an average growth rate of granulation and epithelization up to 22%. Researchers recommend to do more research with suficcient sample size related to the use of ozone therapy as an adjunct in wound care.

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