Monitoring Microcirculatory Blood Flow In Chronic Diabetic And Venous Ulcers With Diffuse Correlation Spectroscopy
Michael Neidrauer1, Michael S. Weingarten1, Alec Lafontant1, Keyanna Bynum1, Christine Wojciechowicz1, Elizabeth Mintz1, Leonid Zubkov1, David Margolis2, Rose Ann DiMaria-Ghalili1, Peter A. Lewin1.
1Drexel University, Philadelphia, PA, USA, 2University of Pennsylvania, Philadelphia, PA, USA.
Purpose: This report presents a preliminary analysis of an ongoing study to determine whether changes in microcirculatory blood flow in diabetic ulcers (DU) and venous ulcers (VU) correlate to wound healing outcomes. Background: The standard method for assessing the efficacy of chronic wound treatments is reduction of wound size during the first four weeks of treatment, but the positive predictive value of this method is reported below 60%. A more reliable method of assessing wound healing trajectory would allow clinicians to discontinue ineffective treatments and may lead to reduced morbidity and healthcare costs. Methods: Diffuse Correlation Spectroscopy (DCS) is a non-invasive optical technology that provides information about aggregate motion of blood cells in the microvasculature of dermal and subcutaneous tissue. We developed a DCS device that determines a blood flow index (BFI) at tissue depths ranging from 2-10mm. Patients with VUs (n=60) or DUs (n=60) are being recruited for an ongoing double-blinded randomized controlled trial to determine the effects of low frequency (20kHz), low intensity (<100mW/cm2) ultrasound on chronic wound healing and quality of life. Each subject was seen weekly for 16 weeks or until complete wound closure. DCS was used to measure blood flow each week in wound tissue and non-wound control tissue. Results: Here, we analyze DCS data from the first 28 enrolled subjects. In DUs (n=6) and VUs (n=22), blood flow in wound tissue was significantly higher (p<0.001) than in non-wound tissue. Blood flow values decreased systematically in healing DUs and VUs as values approach those of non-wound tissue. Conclusions: This preliminary analysis suggests that microcirculatory blood flow may serve as an indicator of healing trajectory for chronic wounds. Acknowledgements: Supported by NIH-NINR grant 5R01NR015995. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH-NINR.
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