Autofluorescence imaging may be ‘valuable’ in management of diabetic foot ulcers

The use of bacterial autofluorescence imaging could be a useful tool alongside standard care in the management of diabetic foot ulcers, a new study has suggested.

The UK study set out to evaluate how the use of autofluorescence imaging affected the decision-making in the treatment of DFUs, along with the healing rates.

The single centre, randomised trial saw 56 people with DFU assigned to either treatment as usual informed by autofluorescence imaging (intervention), or treatment as usual alone (control).

Running from November 2017 to November 2019, the study looked at the percentage of ulcers healed at 12 weeks, along with wound area reduction at 4 and 12 weeks; patient quality of life; and change in management decisions after autofluorescence imaging.

The team, which included clinicians from the Diabetes Limb Salvage Service at Leeds Teaching Hospitals NHS Trust and Leeds Institute of Cardiovascular and Metabolic Medicine, at the University of Leeds, reported: “The proportion of ulcers healed at 12 weeks in the autofluorescence arm was 45% (n = 13 of 29) vs. 22% (n = 6 of 27) in the control arm. Wound area reduction was 40.4% (autofluorescence) vs. 38.6% (control) at 4 weeks and 91.3% (autofluorescence) vs. 72.8% (control) at 12 weeks. Wound debridement was the most common intervention in wounds with positive autofluorescence imaging. There was a stepwise trend in healing favouring those with negative autofluorescence imaging, followed by those with positive autofluorescence who had intervention, and finally those with positive autofluorescence with no intervention.”

To the authors knowledge, it is the first trial assessing the use of autofluorescence imaging in DFU management, and they concluded that “autofluorescence may be valuable in addition to standard care in the management of DFU”.

The findings have been published in Diabetes Care.

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