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Diagnostics
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The Rise of Diagnostics in the Treatment of Chronic Wounds:...
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The Rise of Diagnostics in the Treatment of Chronic Wounds: 3rd Edition

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: 31 March 2025 | Viewed by 1710

Special Issue Editor

Dr. Thomas E. Serena

E-Mail Website
Guest Editor
SerenaGroup, Cambridge, MA, USA
Interests: chronic wound; diabetic foot ulcer; venous leg ulcer; wound infections; pressure ulcer
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The specialty of chronic wound care, “woundology”, developed in the absence of diagnostics, yet the recent rise in diagnostic imaging techniques and biomarker detection promises to revolutionize the practice of wound care and point-of-care techniques that identify bacterial virulence factors are under study. In addition, fluorescence imaging can detect bacterial load at the bedside and devices that rapidly evaluate tissue oxygenation and perfusion will also play a role in evaluating chronic wounds. This Special Issue presents new research and reviews the evidence for diagnostics in the burgeoning field of wound healing.

Dr. Thomas E. Serena
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • chronic wound
  • imaging 
  • biomarker
  • point-of-care techniques

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Published Papers (1 paper)

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16 pages, 978 KiB  
Study Protocol
Assessing Biofilm at the Bedside: Exploring Reliable Accessible Biofilm Detection Methods
by Perry Mayer, Allie Clinton Smith, Jennifer Hurlow, Brian R. Morrow, Gregory A. Bohn and Philip G. Bowler
Diagnostics 2024, 14(19), 2116; https://doi.org/10.3390/diagnostics14192116 - 24 Sep 2024
Cited by 2 | Viewed by 1377
Abstract
Introduction: Biofilm is linked through a variety of mechanisms to the pathogenesis of chronic wounds. However, accurate biofilm detection is challenging, demanding highly specialized and technically complex methods rendering it unapplicable for most clinical settings. This study evaluated promising methods of bedside biofilm [...] Read more.
Introduction: Biofilm is linked through a variety of mechanisms to the pathogenesis of chronic wounds. However, accurate biofilm detection is challenging, demanding highly specialized and technically complex methods rendering it unapplicable for most clinical settings. This study evaluated promising methods of bedside biofilm localization, fluorescence imaging of wound bacterial loads, and biofilm blotting by comparing their performance against validation scanning electron microscopy (SEM). Methods: In this clinical trial, 40 chronic hard-to-heal wounds underwent the following assessments: (1) clinical signs of biofilm (CSB), (2) biofilm blotting, (3) fluorescence imaging for localizing bacterial loads, wound scraping taken for (4) SEM to confirm matrix encased bacteria (biofilm), and (5) PCR (Polymerase Chain Reaction) and NGS (Next Generation Sequencing) to determine absolute bacterial load and species present. We used a combination of SEM and PCR microbiology to calculate the diagnostic accuracy measures of the CSB, biofilm blotting assay, and fluorescence imaging. Results: Study data demonstrate that 62.5% of wounds were identified as biofilm-positive based on SEM and microbiological assessment. By employing this method to determine the gold truth, and thus calculate accuracy measures for all methods, fluorescence imaging demonstrated superior sensitivity (84%) and accuracy (63%) compared to CSB (sensitivity 44% and accuracy 43%) and biofilm blotting (sensitivity 24% and accuracy 40%). Biofilm blotting exhibited the highest specificity (64%), albeit with lower sensitivity and accuracy. Using SEM alone as the validation method slightly altered the results, but all trends held constant. Discussion: This trial provides the first comparative assessment of bedside methods for wound biofilm detection. We report the diagnostic accuracy measures of these more feasibly implementable methods versus laboratory-based SEM. Fluorescence imaging showed the greatest number of true positives (highest sensitivity), which is clinically relevant and provides assurance that no pathogenic bacteria will be missed. It effectively alerted regions of biofilm at the point-of-care with greater accuracy than standard clinical assessment (CSB) or biofilm blotting paper, providing actionable information that will likely translate into enhanced therapeutic approaches and better patient outcomes. Full article
(This article belongs to the Special Issue The Rise of Diagnostics in the Treatment of Chronic Wounds: 3rd Edition)
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