Hyperspectral Imaging As A Novel Diagnostic Tool For Sternal Wound Infections
Martin Oberhoffer, Abdullah Al Awad, Angela Kornberger, Andres Beiras Fernandez, Christian Friedrich Vahl.
Department of Cardiothoracic and Vascular Surgery, Mainz, Germany.
Background Sternal wound infection is a serious complication in cardiac surgery. Diagnosis is based on visual wound inspection with the lack of standardization and comparability due to interindividual variations. We investigated Hyperspectral Imaging (HSI) as a noninvasive and fast method to visualize postoperative sternal wound healing by determining perfusion and parameters and evaluated the predictive value of the system to detect the occurrence of sternal wound infections in the early postoperative period. Methods: HSI was prospectively applied in 107 patients following median sternotomy. Hemoglobin oxygenation (StO2), tissue hemoglobin index(THI), near-infrared perfusion index (NIR) and tissue water index(TWI) were obtained by HSI every second day after surgery. We visually analyzed differences in images retrospectively and divided the patients in group A (regular wound healing) and group B (wound infection ) . Results: Sternal wound infection occurred in 8% (9/107) of the patients . Postoperative serial HSI visual analysis in group A showed a clear decline in the area of elevated StO2, THI and NIR, whereas in group B an increase occurred , indicating an ongoing inflammatory process. TWI proofed to be inappropriate for discrimination between groups. Conclusions: In 107 patients undergoing median sternotomy serial visual analysis of Hyperspectral Imaging data demonstrated to be a fast and easy- to- apply tool in the surveillance of sternal wounds and has the potential for early detection of infections, which might have an impact on patient outcome and economic burden.
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