Approximately 30.3 million individuals are diagnosed with Diabetes Mellitus (DM) in the United States, with approximately 25% of this population expected to develop a Diabetic Foot ulcer (DFU) at some point during their life. A major impasse in improving the wound management process is the lack of a validated tissue oxygenation parameter to assess healing. Despite efforts, the current gold-standard approach in DFU assessment remains visual inspection using a 50% reduction in wound size across 4 weeks to denote healing. The objective of this 2-year F31 fellowship is to develop and validate a static and dynamic wound healing index for acute (non-diabetic) and DFU wounds using two-dimensional tissue oxygenation and dynamic correlation maps from a non-contact, wide field near infrared optical scanner (NIROS) for near real-time assessment of DFUs. Validation and calibration of oxygenation-based parameter(s) from in-vivo studies on controls using NIROS will be conducted. Utilizing the calibrated NIROS, tissue oxygenation (TO)-based indices will be developed to predict wound healing potential and oxygenation flow adequacy. Oxygenation measurements will be correlated to visual signs of healing, and thresholds will be developed to indicate the healing status in acute wounds. Once established, DFU healing indices will be developed using the same methodology, and employing the acute wound indices as a baseline. The development of DFU healing indices, in turn, could serve as a valuable tool for clinicians to assess the state of the wound and better cater/modify the treatment plan as needed.
Developing tissue oxygenation-based healing indices provides subclinical information on regions with poor oxygenation flow and assesses potential to heal in diabetic foot ulcers (DFUs). The subclinical physiological information obtained via oxygenation measurements using a near-infrared optical imaging approach complements the clinical gold-standard visual assessment of DFU healing. These quantitative oxygenation based healing indices can potentially be used by clinicians to cater and improve treatment during DFU wound care management.
