Laser Speckle Integrated Multispectral Imaging System for In-Vivo Assessment of Diabetic Foot Ulcer Healing: A Clinical Study

Sheena Punai Philimon,Audrey Kah Ching Huong

doi:10.1109/access.2021.3055221

Abstract

The high prevalence of the world's population diagnosed with diabetes mellitus, with a significant number suffering from diabetic foot ulcer (DFU), has always been a global concern over the years. The rapid rise of this disease in the last decades is deemed increasingly alarming as it has left deleterious effects not only on affected patients but also on the society and nation. This paper aims to develop a reliable diagnostic tool to address the tremendous need for coordinated and efficient DFU management via prediction of transcutaneous oxygen saturation (StO 2 ) and relative blood perfusion (τ) in the affected limb. This system integrates the use of a multispectral imaging and laser speckle contrast imaging technique for two-dimensional (2D) mapping of tissue oxygen and blood perfusion level in ulcerated foot. Longitudinal study revealed a slightly higher mean StO 2 and τ level in healed ulcer than in impaired healing, despite the data indicating no statistical significance between these two groups (p - value > 0.05). It was observed that a mean StO 2 of at least 70 % and τ value of 1.5 (×10 3 ) are necessary during the proliferative phase to ensure progressive healing. Based on these findings, this study concluded that high tissue oxygenation and perfusion levels are pivotal to ensure progressive wound healing. This work provides a rationale for evaluating the healing outcomes of skin grafting procedures in diabetic ulcers based on observation of quantitative changes in blood perfusion and tissue oxygen level during its revascularization phase.

Highlights

A retrospective study by the World Health Organization (WHO) based on data sources collected from 221 countries and territories estimated at least 451 million adults aged 18 − 99 years old worldwide diagnosed with diabetes mellitus as of the year 2017 [1]
The final study sample approved for this research comprised of a total of eight Type 2 diabetic foot ulcer (DFU) subjects; four subjects with positive healing wound and four subjects with impaired healing wound
The data in this study are generally divided into two main groups, namely positive healing and impaired healing wounds that were yet to be discharged from the clinical follow-up, based on the decision of the consulting physician

Summary

Introduction

A retrospective study by the World Health Organization (WHO) based on data sources collected from 221 countries and territories estimated at least 451 million adults aged 18 − 99 years old worldwide diagnosed with diabetes mellitus as of the year 2017 [1]. This number was projected to increase to 693 million by the year 2045. A retrospective study by Raja [3] stated that diabetic foot ulcer (DFU), a microvascular complication of diabetes mellitus, constituted 15 % of all diabetes cases.

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