Point-of-Care Ultrasound as a Tool to Assess Wound Size and Tissue Regeneration after Skin Grafting
| Autor: | Yash Mantri, Jesse V. Jokerst, Jason Tsujimoto, Caesar A. Anderson, Pranav S. Garimella, William F. Penny |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Acoustics and Ultrasonics medicine.medical_treatment Point-of-Care Systems Wound size Clinical Sciences Biophysics Regenerative Medicine Cellularized 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Clinical Research Skin grafts medicine Humans Radiology Nuclear Medicine and imaging Process (anatomy) 030304 developmental biology Skin Ultrasonography 0303 health sciences Wound Healing Transplantation screening and diagnosis integumentary system Radiological and Ultrasound Technology business.industry Point of care ultrasound Ultrasound Echogenicity Skin Transplantation Acoustics Cellularized/tissue-based skin products Tissue regeneration and wound sizing Surgery 4.1 Discovery and preclinical testing of markers and technologies Detection Chronic wound care tissue-based skin products Skin grafting Biomedical Imaging Point of care ultrasound imaging Cadaveric spasm business Wound healing |
| Zdroj: | Ultrasound in medicine & biology, vol 47, iss 9 |
| Popis: | Chronic wounds can be difficult to heal and are often accompanied by pain and discomfort. Multiple skin substitutes or cellularized/tissue-based skin products have been used in an attempt to facilitate closure of complex wounds. Allografts from cadaveric sources have been a viable option in achieving such closure. However, early assessment of graft incorporation has been difficult clinically, often with delayed evidence of failure. Visual cues to assess graft integrity have been limited and remain largely superficial at the skin surface. Furthermore, currently used optical imaging techniques can penetrate only a few millimeters deep into tissue. Ultrasound (US) imaging offers a potential solution to address this limitation. This work evaluates the use of US to monitor wound healing and allograft integration. We used a commercially available dual-mode (US and photoacoustic) scanner operating only in US mode. We compared the reported wound size from the clinic with the size measured using US in 45 patients. Two patients from this cohort received an allogenic skin graft and underwent multiple US scans over a 110-d period. All data were processed by two independent analysts; one of them was blinded to the study. We measured change in US intensity and wound contraction as a function of time. Our results revealed a strong correlation (R2=0.81, p < 0.0001) between clinically and US-measured wound sizes. Wound contraction >91% was seen in both patients after skin grafting. An inverse relationship between wound size and US intensity (R2=0.77, p < 0 .0001) indicated that the echogenicity of the wound bed increases as healthy cells infiltrate the allograft matrix, regenerating and leading to healthy tissue and re-epithelization. This work indicates that US can be used to measure wound size and visualize tissue regeneration during the healing process. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|