Patients with positive fluorescent imaging had poorer wound-healing outcomes, even when treated with a CTP/skin substitute, compared with patients who had no evidence of fluorescence before application, as this author noted in her SAWC Spring study.

Key Takeaways

• CTPs/skin substitutes (wound care setting): Study evaluated changing application timing by first assessing the wound bed with fluorescent imaging and performing proper wound hygiene before skin substitute placement.
• Key findings: Patients with positive fluorescent imaging had poorer wound-healing outcomes, even when treated with a CTP/skin substitute, compared with patients who had no evidence of fluorescence before application.
• Clinical implications: Positive fluorescence may indicate a need to improve wound hygiene and optimize the wound bed before CTP placement. Delaying application until hygiene is optimized may improve outcomes and support more cost-effective use of skin substitutes.

Please note: This content is a direct transcript, capturing the authentic conversation without edits. Some language may reflect the flow of live discussion rather than polished text. 

Transcript

My name is Alicia Oropallo. I am a professor of surgery at Northwell Health and the School of Medicine, Zucker School of Medicine, at Northwell Health. I also am a professor of the Feinstein Institutes for Medical Research and the director of the Comprehensive Wound Healing Center at Northwell Health. 

Our study really looked at making a change in the practice of how we apply skin substitutes. So these CAMPs, as also referred to, or CTPs, are often applied as adjunctive therapy to help heal those wounds after 30 days. What we wanted to look at is could we change the efficacy, the outcome of that. So applying the skin substitute after we had looked at the patient's wound bed with fluorescent imaging and done proper wound hygiene, we noted that that made significant changes in the outcomes of the patient. In other words, those patients that had fluorescent, positive fluorescent imaging had poor outcomes in wound healing than those, even with a CTP or a skin substitute, than those that actually had no evidence of fluorescent imaging. and then had an application of a skin substitute. 

The fluorescent imaging definitely showed that there was a correlation that those had positive fluorescent imaging. And in this case, we actually placed the skin substitutes even if they had positive fluorescent imaging. And then we saw that they actually did worse on the outcomes. So how this should indicate to physicians is that those that are positive, those patients that are positive for fluorescent imaging, one has to think about either improving the wound hygiene or the wound bed before the application of the skin substitute. Or in other words, waiting until the wound bed is optimized from a hygiene perspective to have the best outcomes for those patients. 

We're always thinking about cost effectiveness as well. And in this case, patients that are not prepped sufficiently before the application of the skin substitute and having poor outcomes should be deferred until their hygiene is optimized for those better outcomes. And so we're not just placing the skin substitutes randomly, but we're actually making sure that they have the best possible chance to close that wound.