J Clin Monit Comput - Multimodal noninvasive monitoring of soft tissue wound healing.

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Resumo

Here we report results of non-invasive measurements of indirect markers of soft tissue healing of traumatic wounds in an observational swine study and describe the quantification of analog physiological signals. The primary purpose of the study was to measure bone healing of fractures with four different wound treatments. A second purpose was to quantify soft tissue wound healing by measuring the following indirect markers: (1) tissue oxygenation, (2) fluid content, and (3) blood flow, which were all measured by non-invasive modalities, measured with available devices. Tissue oxygenation was measured by near infrared spectroscopy; fluid content was measured by bipolar bio-impedance; and blood flow was measured by Doppler ultrasound. Immediately after comminuted femur fractures were produced in the right hind legs of thirty anesthetized female Yorkshire swine, one of four wound treatments was instilled into each wound. The four wound treatments were as follows: salmon fibrinogen/thrombin-n?=?8; commercial bone filler matrix-n?=?7; bovine collagen-n?=?8; porcine fibrinogen/thrombin-n?=?7. Fractures were stabilized with an external fixation device. Immediately following wound treatments, measurements were made of tissue oxygenation, fluid content and blood flow; these measurements were repeated weekly for 3?weeks after surgery. Analog signals of each modality were recorded on both the wounded (right) hind leg and the healthy (left) hind leg, for comparison purposes. Data were processed off-line. The mean values of 10-s periods were calculated for right-left leg comparison. ANOVA was applied for statistical analysis. Results of the bone healing studies are published separately (Rothwell et al. in J Spec Oper Med 13:7-18, 2013). For soft tissue wounds, healing did not differ significantly among the four wound treatments; however, regional oxygenation of wounds treated with salmon fibrinogen/thrombin showed slightly different time trends. Further studies are needed to establish standards for healthy wound healing and for detection of pathological alterations such as infection. Non-invasive measurement and quantification of indirect markers of soft tissue wound healing support the goals and principles of evidence-based medicine and show potential as easy to administer tools for clinicians and battlefield medical personnel to apply when procedures such as the PET scan are not available or affordable. The method we developed for storing analog physiological signals could be used for maintaining electronic health records, by incorporating vital signs such as ECG and EEG, etc.

Resumo Limpo

report result noninvas measur indirect marker soft tissu heal traumat wound observ swine studi describ quantif analog physiolog signal primari purpos studi measur bone heal fractur four differ wound treatment second purpos quantifi soft tissu wound heal measur follow indirect marker tissu oxygen fluid content blood flow measur noninvas modal measur avail devic tissu oxygen measur near infrar spectroscopi fluid content measur bipolar bioimped blood flow measur doppler ultrasound immedi comminut femur fractur produc right hind leg thirti anesthet femal yorkshir swine one four wound treatment instil wound four wound treatment follow salmon fibrinogenthrombinn commerci bone filler matrixn bovin collagenn porcin fibrinogenthrombinn fractur stabil extern fixat devic immedi follow wound treatment measur made tissu oxygen fluid content blood flow measur repeat week week surgeri analog signal modal record wound right hind leg healthi left hind leg comparison purpos data process offlin mean valu s period calcul rightleft leg comparison anova appli statist analysi result bone heal studi publish separ rothwel et al j spec oper med soft tissu wound heal differ signific among four wound treatment howev region oxygen wound treat salmon fibrinogenthrombin show slight differ time trend studi need establish standard healthi wound heal detect patholog alter infect noninvas measur quantif indirect marker soft tissu wound heal support goal principl evidencebas medicin show potenti easi administ tool clinician battlefield medic personnel appli procedur pet scan avail afford method develop store analog physiolog signal use maintain electron health record incorpor vital sign ecg eeg etc

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