Wound Assessment & Monitoring with SnapshotNIR: Focus on Debridement
What is Debridement
Debridement is the removal of dead (necrotic) or infected skin tissue to assist with wound healing. Debridement isn’t necessarily required for all wounds but is an essential procedure for wounds that are not improving and stalled in healing. This could be a chronic ulcer that is not healing properly or a wound that has become infected. Once the necrotic tissue is removed, the wound can restart the healing process. This therapy will reduce bacteria in the wound and help healthy tissue grow.
Debridement of a callus from a reoccurring ulcer. (Images courtesy of Dr. Jeffrey Niezgoda, MD)
Several types of debridement methods can be utilized in a typical wound care clinic or hospital. Usually, a combination of therapies is integrated into a treatment plan. The clinician considers what therapies are the most appropriate based on several patient factors including the wound type, the age and health of the patient, and the patient’s overall risk for complications. Debridement can be done with live maggots, special dressings, or ointments that soften the tissue. However, sharp debridement is the most common type. Sharps debridement is when necrotic or nonviable tissue is cut off or removed using a scalpel, curette, laser, or ultrasonic device.
Near-infrared spectroscopy (NIRS) imaging with SnapshotNIR can be used to track and document the level of oxygen saturation (StO2) and tissue perfusion in the wound. This information is used to guide a change in the treatment plan and may contribute to a more effective wound healing process.
How does SnapshotNIR support the debridement process?
A sample debridement case study from Dr. Doug Toole, DPM., shows how SnapshotNIR can assist in charting a new course of action on a patient, saving time and money, and helping to produce a much more positive outcome for the patient.
Dr. Toole did a rapid objective assessment with SnapshotNIR on an 85-year-old female patient with a history of diabetes, vascular disease, and dementia. She presented at the clinic with a diabetic ulcer on the side of her left foot. Snapshot identified a lack of tissue viability of the foot helping to explain why the wound was not fully closing after initial treatment. With this new insight, Dr. Toole immediately altered the treatment plan to help close the wound. The new course of action included a combination of debridement and amnion injections to stimulate vascular growth.
Top (Fig 1A, 1B): Baseline clinical and StO2 images before CTP application. Bottom: One month after treatment (including debridement). Note the increase in tissue oxygenation of the wound and peri-wound sites. (Images courtesy of: Dr. Doug Toole, DPM)
Serial imaging was then performed using SnapshotNIR to track and document wound healing progress over several weeks. After a single week of treatment, the tissue oxygenation (StO2) images captured demonstrated that the area of previous concern was showing improved oxygenation. Debridement and amnion injections were continued for a month until the wound finally closed.
SnapshotNIR is portable for all points of care and is an effective tool that provides actionable insight for wound debridement. Rapid assessment allows a clinician to easily monitor the wound bed and peri-wound without the use of dyes and is completely non-invasive. Snapshot can identify non-viable tissue in and around the wound bed for debridement and confirm graft survival. Continuing with wound monitoring, clinicians can assess wound healing progress and evaluate wounds that are failing to improve. Finally, documenting and tracking with the imaging device compares the same patient throughout their care to evaluate the effect of treatment modalities. In the case of debridement, the economic burden of a failed CAMPs (cellular, acellular, and matrix products) application is high, both from the cost of the product and the extended period it will take to heal the wound. SnapshotNIR is the best assessment device to determine if the wound bed is fully prepared after debridement and viable for the successful application of a CAMP.
Visualizing the tissue oxygenation levels of a wound bed after debridement using SnapshotNIR prior to applying a CTP to a traumatic leg wound. (Image courtesy of Dr. Jeffrey Niezgoda, MD)
References:
Wound Debridement, https://www.healogics.com/wound-care-patient-information/wound-debridement/
Web CME, WCW: Applying a Kerecis Graft to a Traumatic Wound (SnapshotNIR), Dr. Jeffrey Niezgoda
Web CME, WCW: Serial Debridement of Heel Eschar, Dr. Jeffrey Niezgoda
To read more about the science behind SnapshotNIR and to watch an explainer video, click here.