Optimize Closure Timing of Major Limb Amputations by Visualizing Bacteria with the MolecuLight i:X™

Of all surgical wounds, the highest rate of surgical site infection occurs with lower limb amputations.1 Infection complications include rupture of the suture line, cellulitis, delayed healing and further surgery. It is vital to aggressively monitor amputation wounds for clinical signs and symptoms of infection.

Clinical Synopsis: Both patients had an above knee amputation following severe traumatic injury. They each reported severe pain and developed an abscess ~6 weeks post-amputation. Stumps were opened, washed out, and treated with irrigation and negative pressure wound therapy. MolecuLight i:X images were acquired 1-week post secondary surgery, prior to stump closure.

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Patient 1: Absence of red color in the Fluorescence Imaging Mode™ image (center) suggested no bacteria present (later confirmed via swabs). As a result, the stump was closed and healed completely within 2 weeks.

 

optimize-closure-timing-of-major-limb-patient-2-standard-imaging-mode optimize-closure-timing-of-major-limb-patient-2-fluorescence-imaging-mode optimize-closure-timing-of-major-limb-patient-2-drained-pus optimize-closure-timing-of-major-limb-patient-2-red-fluorescing-pus
Patient 2: Red color (circled) in the Fluorescence Imaging Mode™ image identified localized bacterial contamination in real-time. Swabs later confirmed E. coli and P. mirabilis. As a result, further wash-out was performed prior to closure.

Patient’s General Care Paradigm
  • Wound irrigation
  • Negative pressure wound therapy
Clinician Stated Utility of the MolecuLight i:X
  • Allowed for confidence when closing a wound that significant levels of bacteria were not present
  • Real-time identification and localization of bacteria prevented closure of a contaminated stub and almost certain future abscess
Images provided by Lt Col Steven Jeffery, The Royal Centre for Defence Medicine, Birmingham, UK
MolecuLight Clinical Case 0014.

1. Surgical Site Infection Surveillance Service. CDR Weekly 2006; 14(21): 1-5