Pressure ulcers (sores) can occur when there is constant pressure being applied to tissue for extended periods of time. Immobile people are particularly prone to this problem. Ideally, pressure damage is detected at an early stage, pressure relief is applied and the pressure ulcer is averted. One of the hallmarks of pressure damaged skin is an obliterated blanch response due to compromised microcirculation near the surface of the skin. Visible reflectance spectroscopy can noninvasively probe the blood circulation of the upper layers of skin by measuring the electronic transitions arising from hemoglobin, the primary oxygen carrying protein in blood.
A spectroscopic test was developed on a mixed population of 30 subjects to determine if the blanch response could be detected in healthy skin with high sensitivity and specificity regardless of the pigmentation of the skin. Our results suggest that a spectroscopic based blanch response test can accurately detect the blanching of healthy tissue and has the potential to be developed into a screening test for early stage I pressure ulcers.
The process of taking a concept to a clinical device begins with the idea for a technological solution to an unmet clinical challenge. Burns are one of the most destructive insults to the skin causing damage, scarring, and in some cases death. The approach most commonly used to evaluate burns is based on the appearance of the wound. This technique is somewhat subjective and unreliable, relying on clinical experience to assess the burn. Instrument based diagnostic techniques as an adjunct to current practices has the potential to enhance the quality and timeliness of decisions concerning wound assessment and treatment. Near Infrared Spectroscopy is a promising technique that can track changes within the tissue, and can therefore provide insight as to how deep the burn actually penetrates before visual signs become apparent. Preliminary bench and animal studies were used to prove the concept of a near infrared based method of burn assessment. This study demonstrated the ability of near infrared imaging to detect and monitor the hemodynamics of burn injuries in the early post-burn period. Based on this study, a pre-prototype near infrared spectroscopic system was built with the goal of developing a reliable yet simple system that could be used in a clinical setting. A pilot clinical study was designed and implemented at the Ross Tilley Burn Center (Toronto, Canada) in order to assess the feasibility of our strategy in the clinical realm. The goal of this preliminary clinical study was to determine if the pre-prototype could be integrated into the strict regiment of an active burn centre. Both the instrument performance in a clinical setting and the injury assessment based on the analysis of near infrared reflectance measurements were a success.