Application of Perioperative Real-Time Fluorescence Imaging to Achieve High-Quality Debridement: A Randomized Control Trial.
Jui-Chen Hsu, Yi-Hung Chu, Yi-Chun Wu et al.
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In 30 seconds
This patient-blinded randomized clinical trial compared real-time fluorescence imaging (RTFI)-assisted with conventional surgical debridement in patients with chronic wounds. The groups did not differ significantly in preoperative residual bacterial area or high-quality debridement ratio. Postoperatively, residual bacterial area was lower with RTFI (6.83% ± 1.39% vs. 30.0% ± 12.37%; p < 0.001), and wound healing took fewer days (49.2 ± 25.3 vs. 63.0 ± 27.9; p < 0.001). RTFI procedures lasted longer, while reinfection, antibiotic-use days, and total hospital days were also lower in the RTFI group.
Key findings
- Postoperative residual bacterial area was 6.83% ± 1.39% with RTFI versus 30.0% ± 12.37% with conventional debridement (p < 0.001).
- Wound healing duration was 49.2 ± 25.3 days with RTFI versus 63.0 ± 27.9 days (p < 0.001).
- Reinfection occurred in 4 of 100 patients in the RTFI group versus 22 of 100 in the conventional group (p < 0.001).
- Mean operation duration was longer with RTFI: 33.5 ± 12.7 min versus 29.9 ± 10.4 min (p = 0.031).
Why it matters
The trial suggests that fluorescence-guided debridement can identify residual bacterial signals and is associated with lower postoperative bacterial area and improved wound-related outcomes. These findings are clinically relevant because they indicate a potential way to support wound-bed assessment, while the longer procedure time and need to interpret signals alongside clinical findings remain important considerations.
What to keep in mind
The abstract does not report follow-up beyond wound healing or provide details on blinding beyond patient blinding. RTFI signals may arise from normal skin components as well as bacterial metabolites, requiring clinical interpretation.