Abstract
Vascular assessment is a critical component of wound care. Current routine noninvasive vascular studies have limitations which can give a false sense of security of the presence of adequate perfusion for healing. Near-infrared imaging modalities can serve as an additional diagnostic assessment of wounds in which adequate perfusion is a concern. Correct interpretation of near-infrared images obtained is critical as subtleties that exist in the acute and chronic wound population goes beyond the interpretation that increased signal is consistent with adequate perfusion for healing. The objective of this paper is to educate providers on the correct interpretation of this point-of-care imaging modality in day-to-day wound-care practice to guide clinical decision-making for rapid wound resolution.
Highlights
Acute and chronic wound care involves clinical decision-making based on a thorough history and physical examination and interpretation of laboratory, imaging, and other diagnostic tests performed to guide treatment toward timely resolution
The most common test obtained, if lower extremity vascular assessment via history and physical examination findings are concerning for peripheral arterial disease, involves comparison of ankle and toe pressure measurements to those of the upper extremity, the ankle brachial and toe brachial index, respectively
Understanding images obtained with near-infrared imaging in acute and chronic wound care goes beyond the simple binary interpretation that increased signal means adequate perfusion while reduced signal means healing is unlikely to occur
Summary
Acute and chronic wound care involves clinical decision-making based on a thorough history and physical examination and interpretation of laboratory, imaging, and other diagnostic tests performed to guide treatment toward timely resolution. The ability to determine tissue perfusion and oxygenation levels directly at the site of an acute or chronic wound with the objective, point-of-care, site-specific modality near-infrared imaging provides can aid in clinical decision-making for expedited wound resolution. Through years of experience and a multitude of image review of both invasive and noninvasive near-infrared imaging modalities from different facilities and clinicians, the authors have been able to discern characteristic imaging patterns for factors that can contribute to delayed healing and those that are positive prognostic indicators that a wound is responding to treatment and moving toward resolution Proper interpretation of these images can help guide clinical decision-making for expeditious and optimal patient outcomes. Explaining the characteristic appearance of chronic wounds on both types of near-infrared imaging techniques
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