Considering the morbidity associated with major lower extremity amputations (LEA), it is vital that we continually evaluate new modalities which can provide us tools in the management of patients with diabetic foot ulcers.

I recently had the opportunity to work with one such technology -hyperspectral imaging-which uses various wavelengths of light to evaluate relationship of oxyhemoglobin (oxyHb) and deoxyhemoglobin (deoxyHb) in tissues. The technology provides not only a specific numeric value for the oxyHb and deoxyHb present in tissues, but additionally the information is given in a spatial relationships that provides visual expression of tissue perfusion.

Thus, one can see specifically the efficacy of the microvasculature at a given location. Several studies have demonstrated significant correlations between oxyHb value and potential for healing -values greater than 65 have been shown to have a 91% healing rate.

The applications for this technology in diabetic limb salvage are significant. Imagine having the ability to evaluate a patient's wound margins to determine if there is adequate perfusion to heal a wound, or to maintain a flap across an amputation site!

Does anyone have any experience working with Hyperspectral imaging? Can you offer us any pearls (or pitfalls) to this modality?

This modality has the potential to be very versatile. While it currently
measures the wavelength emitted by hemoglobin, it might (emphasis
on might) just as well be modified to evaluate any other cell-- or even
single celled organism (ie bacteria). Our group (SALSA) continue to
watch this space very closely.

Cheers,

DGA

David G. Armstrong, DPM, PhD
Professor of Surgery
University of Arizona College of Medicine
1501 N. Campbell Avenue
Tucson AZ 85724-5072
United States of America
+1 520 360 0044
+1 520-423-3091 (FAX)
http://DiabeticFootOnline.com/


Director,
Southern Arizona Limb Salvage Alliance (SALSA)
at the University of Arizona and Southern Arizona Veterans Affairs
Health Care System

We are evaluating Hyperspectral Imaging at Georgetown right now. There seems to be much potential for this device and the concept of diagnosing tissue physiologic health rather than just the amount of oxygen. Hyperspectral imaging may eventually prove to be a device which can decrease the gap between the vastly emerging wound healing treatment options and the ability to properly assess what technology would be best suited for a particular site...