Handheld Fluorescence Imaging Device Aids Wound Management

A portable fluorescence imaging device enables real time point-of-care (POC) visualization of bacterial presence in wounds, digitally recording images and area measurements.

The MolecuLight (Toronto, Canada) i:X device aids visualization and quantitative tracking of bacterial contamination, wound healing, and connective tissue remodeling of surgical sites and wounds, by the analysis of intrinsic fluorescence signals resulting from illumination with a violet light. The narrow band emitted light causes endogenous fluorophores in the bacteria to fluoresce, without the need of contrast agents. Images can be captured and documented as either stills or videos, including in the surrounding areas where more potentially harmful bacteria may be lurking.

Studies have shown the device can enable real-time POC visualization of discrete focal areas of bacterial colonization in midline abdominal wounds, with a sensitivity of 80% and a specificity of 70%, helping to reduce the likelihood of administering unnecessary antibiotic treatment. Susceptible bacteria include methicillin-resistant Staphylococcus aureus (MRSA); Pseudomonas aeruginosa; Escherichia coli; Coagulase-negative staphylococci; multiple Enterococcus species; multiple Proteus species; Klebsiella pneumonia; Beta-hemolytic streptococci (Group B); and multiple Enterobacter species.

“Identifying wounds with bacterial loads higher than 104 CFU/g at the point-of-care enables the clinician using the MolecuLight i:X to provide more appropriate, targeted treatment,” said Anil Amlani, CEO of MolecuLight. “Our clinical study results demonstrate that the i:X used in combination with clinical signs and symptoms significantly increases the ability of clinicians to identify wounds with the presence of these bacterial loads, when compared with wound assessment based on clinical signs and symptoms alone.”

Low-intensity violet light in the 405 nm range excites tissues and bacteria within and around a wound, causing healthy tissues to fluoresce green, while bacteria fluoresce in either red or cyan. This enables their immediate localization; and while surface bacteria generally appear as a brighter red, subsurface bacteria at the maximal detectable depth of about 1.5 mm appear more blush-colored.

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