The usual cleaning practice protocol for open wounds includes wiping with gauze pads soaked in irrigation solution starting in the center of the wound and working toward the outside.1 No particular attention is paid to the periphery of the wound, and the suggested technique may relocate debris and bacteria from the center to the creases of the wound periphery.
With this 56-year-old patient, cleaning was typically focused on the center of the wound, as shown in Figure 1. By incorporating the MolecuLight i:X (in Fluorescence Imaging ModeTM) into the cleaning protocol, the practitioner was able to visualize moderate/heavy bacterial load in the creases and at the periphery of the wound (Figure 2 & Video A) in real-time. She therefore focused on cleaning those edges and creases (Video B) and used MolecuLight i:X images to instruct the home caregiver (patient’s husband) on where to focus cleaning.
After two weeks of cleaning every 2-3 days with the guidance of the MolecuLight i:X, there was a remarkable decrease in red (bacterial) fluorescence at the periphery of the wound (Figure 4). Furthermore, the wound bed began to granulate with the successful use of a Negative Pressure Wound Therapy (NWPT) device, which had previously failed with this patient.