The BMJ Awards 2021: Diagnostics team of the year

Shining success of fluorescence imaging

Foot ulcers and their bacterial burden produce a considerable strain on the NHS. The NHS spends almost £970m ($1340m; €1140m) a year treating ulcers and related amputations. “Our caseload consists primarily of high risk patients with diabetes related foot ulcers,” says Nadine Price, care pathway lead for acute podiatry. “The impact of delays in identifying infection can be significant and costly, ultimately leading to amputation and/or death.”

The MolecuLight i:X, which was developed by a Canadian company, is a hand held fluorescence imaging device which shows areas of raised bacterial burden in wounds. Images displayed on a digital touch screen can be interpreted instantly by the wound clinician “to identify any regions of concern and determine an appropriate treatment plan,” says Price. “The images can then be uploaded to electronic patient records as required.”

In 2019, the MolecuLight was introduced into the diabetic foot clinic at Whipps Cross Hospital in north east London. Price says, “In the 12 months after it was incorporated into our standard clinical practice, we noted a 49% reduction in antimicrobial dressing usage, 33% reduction in antibiotic prescriptions, and a 23% improvement in the wound healing rates.” She says the use of fluorescence imaging in wound care clinics has become standard practice in the diabetic foot clinic, with additional devices now available in neighbouring diabetic foot clinics. “It’s fantastic to have our hard work recognised on a …