I have been using a new multispectral infrared camera, the KD203 (Kent Imaging), for a few weeks now. My patients and I have been wowed by the images but I have been impressed more by the relevant clinical information I have available to me instantly while treating my wound care patients.
The device measures and displays quantified tissue oxygen saturation levels in superficial tissue. By obtaining an image prior to wound debridement, I can clearly see and quantify how much non-viable tissue I have in and around the wound. Sometimes after debriding in what I thought was a thorough manner, I would take another image and find there was still some non-viable tissue in the wound bed. So I would debride some more and the final image would show a completely perfused wound bed.
I can then calculate the percentage of oxygenation or lack of oxygenation in the area. Images show red or yellow where there are highly perfused areas, and blue where there is decreased oxygen saturation as you would expect in necrotic tissue or tissue with poor perfusion such as eschar and even callused tissue. If I had noted the entire limb or foot area to be blue prior to debridement, I would be concerned that there is poor perfusion of the foot and perhaps decide not to debride before getting a vascular consult with more complete testing.
There is more research that needs to happen with the use of the KD203 and similar devices that are now available. I am quite excited that I have something that can quantify patients’ progress, track treatment effectiveness and can even help me avoid potentially causing a complication. The camera is also non-invasive and available at chairside.
I can see using this multispectral infrared camera in not only podiatry but with plastic surgery procedures including flaps and grafts, with colorectal surgery, burns, and in cardiac specialties and trauma cases. Surgeons are already exploring the camera’s intraoperative uses when performing breast reconstruction procedures. Multispectral infrared technology may lead the way in limb salvage and wound care as we can use it to determine the best level of amputation if necessary, and indicate that we have achieved a thorough level of debridement to allow for wound healing.
There was one glitch when I first used the device. For people with dark pigmentation, the camera saw all areas of dark skin as low oxygenation. The updated software has now fixed this, eliminating the effect of high melanin content in the skin. Although the sales literature says the KD203 is lightweight, it is somewhat heavy. It would be better improved with handles. When my staff and I use it, dropping the camera is one of our greatest concerns.
Otherwise, I can take as many images as I want or need. There is no radiation exposure and no risks to the patient when taking more “pictures.” I look forward to using this technology more and discovering all of its potential uses.
Dr. Aung is in private practice at Aung FootHealth Clinic in Tucson, AZ. You can contact her at 520-886-9866 or http://www.healthy-feet.com/ .