Approximately 34% of people with diabetes will experience a diabetic foot ulcer (DFU) at some point throughout their lifetime. The perfusion of oxygen to the DFU is critical for promoting wound healing and closure. However, complications from diabetes can compromise the oxygenated flow to the wound site. Techniques such as transcutaneous oximetry and laser Doppler imaging have been used to assess perfusion to DFUs at discrete point-locations in the peri-wound. Widearea measurements of temporal oxygenation changes, as an indirect measure of perfusion, can provide additional insight of the oxygenated flow in the (peri-)wound and background tissue. Herein, our objective is to assess the differences in oxygenation flow patterns in and around the DFU regions and in the feet of control subjects as a potential biomarker for monitoring wound healing. Breath-holding (BH), as a stimulus, holds the potential to induce oxygenated flow pattern changes in the presence of wounds. In this study, 10 DFU and 3 control subjects were imaged using a hand-held nearinfrared optical scanner (NIROS). Spatial-temporal oxygenation maps of hemoglobin-based parameters were acquired across an 120-second paradigm with 20 seconds of breath-hold. The oxygenation flow patterns obtained from Pearson'sbased correlation maps across controls, healing DFU, and non-healing DFU indicated that flow patterns varied distinctly. Ongoing work is to correlate oxygenated flow patterns to clinical assessment of healing status in DFUs.
Major challenges in diabetic foot ulcer (DFU) treatment include compliance and routine clinical visits to facilitate healing. Virtual Medicine (VM) can greatly impact DFU wound care management with tools for remote patient monitoring (RPM). Herein, a novel low-cost smartphone-based imaging device was developed to provide physiological (in terms of tissue oxygenation) and visual measurements of DFUs. Quantitative changes in tissue oxygenation between the wound and peri-wound in DFUs are obtained using SPOT device in an IRB approved pilot study. On a long-term, SPOT has potential to offer a low-cost alternative for VM and RPM in DFU wound care management.
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