HARNESSING TECHNOLOGY
Dr. Navin Gupta takes a modern approach to patient care.
Since the earliest days of his medical practice, Dr. Navin Gupta has been drawn to innovation. As a solo practitioner at ANP Foot and Ankle Clinic in Des Moines, Iowa, he has spent more than three decades using technology to help deliver more accurate diagnoses, more effective treatments, and better outcomes for his patients.
“I’ve always been interested in technology,” says Dr. Gupta. “If it makes my work a little easier and more precise, and my patients’ lives better, well, that’s really the point of it all.”
Whether it was pioneering the use of musculoskeletal ultrasound in podiatry 25 years ago or performing complex vascular evaluations from his office before it became standard, Dr. Gupta has never shied away from a new tool if it serves to help with recovery. So, when he learned about SnapshotNIR—a handheld imaging device that uses near-infrared light to measure soft tissue oxygenation at a wound site—he quickly recognized its potential to change the way wounds are understood, tracked and ultimately healed.
“In wound care, circulation is everything,” he says. “Before I acquired the Snapshot device, determining circulation in the wound bed was just a judgment call. If I debrided the wound and it bled, then obviously there was blood flow. Non-invasive vascular evaluations such as ABIs or segmental pressures do not reflect the vascular status of the actual wound bed. With SnapshotNIR, I can actually see if there’s adequate circulation and vascularization of the wound bed. And I can show it. That changes everything for my patients.”
Dr. Navin Gupta, ANP Foot and Ankle Clinic in Des Moines, Iowa
Show and Tell
Wound care has become the central focus of Dr. Gupta’s practice in recent years, largely because advancements in technology have helped to provide better treatment options and outcomes. “Typically, wound care patients come to me after they have not been able to find help or relief elsewhere,” he says. “We’ve even had a few people come in who were scheduled for amputations, and we’ve been able to reverse those situations and get them on a good path.”
According to Dr. Gupta, many health care professionals have a tendency to focus on wound management, rather than healing. But he and his team are committed to healing every chronic wound they see—no matter how grim those wounds may appear to be.
When a man in his mid 80s walked into ANP Foot and Ankle Clinic with four severe wounds on his lower leg, that were blackened and necrotic after 7 months of care at a wound clinic, he felt little hope that the wound would heal. The man’s wife had been managing his dressings between visits to their care provider, but the wounds had only continued to worsen.
“The patient told me that when he first came to us, he thought it was the end—that his wounds were how he was going to die,” recalls Amy Newberg, a medical assistant at ANP.
But SnapshotNIR helped change his mind.
Dr. Gupta showing patient SnapshotNIR’s unique 4-panel Hemoglobin view
Developed by Kent Imaging, SnapshotNIR provides real-time visualization of microvascular tissue oxygen saturation (StO2), oxyhemoglobin, deoxyhemoglobin, and total hemoglobin, allowing clinicians to easily identify and track wound tissue viability. This oxygenation data, combined with the device’s delivery of high-resolution photographic images and accurate wound measurement, gives providers a full picture of healing potential and progress.
Upon meeting his new patient, Dr. Gupta used SnapshotNIR to capture images of all four wounds. In Snapshot images, blue areas indicate low tissue oxygenation, while red areas indicate high tissue oxygenation. Not surprisingly, the patient’s images were riddled with blue.
“Patients are always interested in the Snapshot images, because it helps them understand what’s going on,” says Dr. Gupta. “When I show the images, I can point to a blue area and say, ‘We need this to be red in order for your wound to heal.’”
Once this particular patient understood what he was looking at, he was able to understand, and embrace, Dr. Gupta’s recommended treatment approach. This included non-contact ultrasound therapy to improve blood flow, as well as CAMPs (cellular, acellular and matrix-like products).
After six months of treatment at ANP Foot and Ankle Clinic, three out of four of the man’s wounds were healed completely, and the fourth one, which measured 49.8 cm2 to start, was down to 11.3 cm2.
“It’s looking very good now,” says Dr. Gupta, “The patient feels so much better, and he’s been able to understand his progress thanks to the SnapshotNIR images we show him during each visit.”
Amy Newberg
The Power of Precision
Among the other SnapshotNIR features that Dr. Gupta appreciates is its ability to take accurate measurements of a wound.
“Before Snapshot, one of my big challenges was getting a correct measurement for irregular wounds,” he says. “The standard measurement method is maximum length by maximum width, but nobody ever comes in with a wound that’s a perfect rectangle or a perfect square.”
One of Dr. Gupta’s patients, a woman in her early 70s, had spent years living with a large wound on her leg that began with a spider bite. She had been hospitalized with sepsis, treated by various wound care professionals, and seen little improvement. By the time she came to ANP Foot and Ankle Clinic, her wound had reached a staggering size—360 cm2 by traditional measurement methods.
Using SnapshotNIR, however, Dr. Gupta was able to measure the wound more accurately. “When we went through the different curves of the wound, we could see that it actually wasn’t quite that big,” he says.
After the first week of treatment, the patient’s wound was 288 cm2. Ten days later, after Dr. Gupta did compression dressings, he began taking segmental measurements, which indicated the wound was down to 180 cm2, then 150 on the next visit, and then, as time passed, under 10.
Today, that wound measures just 7.5 cm2. The difference isn’t just clinical, it’s emotional. “Being able to see the progress in hard numbers gives people hope,” says Amy Newberg. “Sometimes a wound doesn’t look that much better over a period of time, but when we show patients the data, they realize it’s healing. That motivates them to stick with the treatment plan.”
Proof Matters
SnapshotNIR has also helped Dr. Gupta improve how he collaborates with other specialists. Rather than sending patients off for vague assessments, he can now provide vascular and cardiovascular physicians with detailed imaging that prompts more targeted investigation.
“It helps us figure out when someone might need an angiogram, or if something else is going on that’s beyond wound care,” he says. “We can also avoid unnecessary referrals, unnecessary testing, and give patients peace of mind.”
Additionally, the device is highly effective when it comes to documentation. Treatments involving advanced therapies like CAMPs or ultrasound often require insurer approval. So when ANP can provide clear visual data showing a wound’s progress, there’s little room for doubt that a therapy is working.
“That documentation matters,” says Dr. Gupta. “If I can show an insurer a healing progress of 300-plus cm2 to seven square centimetres, it’s much more likely the insurance company won’t have a problem providing coverage for that patient.”
By leveraging tools like SnapshotNIR, Dr. Gupta and his team are working to provide their patients with the best possible outcomes.
“SnapshotNIR hasn’t necessarily changed my techniques,” says Dr. Gupta. “But it has given me added confidence in my assessments, providing me with the diagnostic evaluation that I need to ensure the right path forward.”
GAME CHANGERS: If you would like to share your experience with SnapshotNIR through an Ask the Expert Interview or Customer Story, contact Kent Imaging via email for more details or call TF: 1-833-733-5368