(DLS-019) Fluorescence-based evaluation of bacterial load in lower leg wounds: a comparison between compressive multilayer bandage and zinc oxide bandage

Giorgia Salvia, MD; flavia Manzo Margiotta, MD; Giammarco Granieri, MD – University of Pisa; Cristian Fidanzi, MD; Matteo Bevilacqua, MD; Valentina Dini, MD, PhD; Marco Romanelli, MD, PhD

Introduction: A novel fluorescence imaging device has recently allowed real-time detection of bacteria in different kinds of wounds through endogenous autofluorescence (1). The fluorescence signals detected by the device provide health workers with a visual indication of the presence, load and distribution of bacteria. In particular, the detection of red color is typically associated with the presence of potentially pathogenic levels of bacteria while cyan color is generally associated with the presence of Pseudomonas aeruginosa. The aim of our study was to evaluate the level of bacterial colonization in patients affected by lower leg wounds treated with two different types of bandages: compressive multilayer bandage and zinc oxide bandage (2,3).

Methods: We enrolled 14 patients with venous insufficiency and lymphedema, divided in two groups: group A treated with compressive multilayer bandage and group B with zinc oxide bandage. We evaluated patients 2 times a week for 3 weeks using a fluorescent device able to detect potentially harmful bacteria in wound bed and perilesional skin. Evaluations were performed in a quali-quantitative way by two experienced operators on the frames taken at individual injuries.

Results: We observed a reduction in the bacterial colonization levels of the wound bed and perilesional skin of 67% and 57.15% for group A and 71.16% and 61.54% for group B. We obtained a reduction in Numerical Rating Scale (NRS) for pain of 65% and 67% for group A and group B, respectively.

Discussion: Although the improvement of bacterial load and NRS was evident in both groups, our study demonstrated that the application of zinc oxide bandage provided a higher reduction in bacterial load in the wound bed and perilesional skin (4). In addiction, we found no difference between the two bandages in terms of pain symptom reduction.