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Laser Doppler Perfusion Imaging for the Assessment of Healing in Pressure Ulcers
Author(s) -
Kekan M.,
Feldman D.
Publication year - 2008
Publication title -
wound repair and regeneration
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.847
H-Index - 109
eISSN - 1524-475X
pISSN - 1067-1927
DOI - 10.1111/j.1067-1927.2005.130216bv.x
Subject(s) - medicine , laser doppler velocimetry , perfusion , provocation test , wound healing , blood flow , surgery , pathology , alternative medicine
Clinically the outcome of pressure ulcers is predicted by the severity/stage of the ulcer, patient health and health care options. These factors, however, cannot be used to accurately evaluate the prognosis and healing in these ulcers, thus delaying any required change in the treatment plan. Techniques are needed that can help in the assessment of healing and improve the clinical management of these ulcers. Studies of tissue health such as angiogenesis, by measuring blood flow in the ulcer at different time points, has been examined as a way to evaluate the state of healing ulcers. Although the Laser Doppler Perfusion Imager (LDPI) has been used to assess various wounds, there is a need to validate it as a predictor of wound healing. The standard clinical outcome parameter for skin wounds has been time to heal. To validate the LDPI as predictor of healing, however, a measure that gives periodic feedback such as healing rate is a more useful outcome measure. The goal of this study therefore was to determine a protocol for the LDPI and evaluate its ability to predict healing in pressure ulcers. Previous studies have indicated that perfusion values obtained after heat stress may reflect the blood flow more accurately than absolute perfusion values. It was hypothesized that the difference in the blood perfusion after heat provocation is expected to correlate with the healing rate. The selected heat provocation (increase of 20 °F) was evaluated on five spinal cord injured pressure ulcer patients. The LDPI assessment and healing rate measurements were done weekly for 5 weeks. Preliminary results suggest a relationship between the difference in the perfusion and the healing rate for the following week. Further studies will be necessary to determine the exact relationship. This tool has the potential to play a critical role in the clinical management of pressure ulcers as well as other skin ulcers. Acknowledgments: This project was funded by Biofisica and the CDC through NCIPC.