Spectral imaging
The present disclosure provides methods and apparatus for evaluating tissue structure in damaged or healing tissue. The present disclosure also provides methods of identifying a patient at the onset of risk of pressure ulcer or at risk of the onset of pressure ulcer, and treating the patient with anatomy-specific clinical interventions selected, based on spectral imaging (SI). The present disclosure also provides methods of stratifying groups of patients based on risk of wound development and methods of reducing incidence of tissue damage in a care facility. The present disclosure also provides methods to analyze trends of SI intensities to detect tissue damage before it is visible, and methods to compare bisymmetric SI intensities to identify damaged tissue.
1 . A method of identifying and treating a patient at risk of tissue damage, the method comprising the steps of:
a) evaluating a patient for a risk of tissue damage upon admission to a care facility, wherein the evaluating step comprises:
i) taking a first plurality of spectral imaging (SI) images in the patient;
ii) determining a first average SI intensity of the first plurality of SI images;
b) administering a first intervention of level-0 if the first average SI intensity is below or equal to a first threshold; and
c) administering a first intervention of level-N if the first average SI intensity is above the first threshold, where N is an integer and N has a value of 1 or greater.
2 . The method of claim 1 , further comprising the steps of:
a) taking a second plurality of SI images in the patient at a first pre-determined frequency corresponding to the first intervention of level-N;
b) determining a second average SI intensity of the second plurality of SI images;
c) determining whether the second average SI intensity value exceeds a second threshold;
d) continuing to administer the first intervention if the second average SI intensity does not exceed the second threshold;
e) continuing to take a plurality of SI images at the first pre-determined frequency if the second average SI intensity value does not exceed the second threshold;
f) administering a second intervention of level-M if the second average SI intensity value exceeds the second threshold, where M is an integer and M is greater than N; and
g) taking a plurality of SI images at a second pre-determined frequency corresponding to the second intervention of level-M if the second average SI intensity exceeds the second threshold.
3 . The method of claim 2 , further comprising the steps of:
a) determining whether the second average SI intensity is less than a third threshold;
b) continuing to administer the first intervention if the second average SI intensity is not less than the third threshold;
c) continuing to take a plurality of SI images at the first pre-determined frequency if the second average SI intensity value is not less than the third threshold;
d) administering a third intervention of level-L if the second average SI intensity is less than the third threshold and if the first intervention is not of level-0, where L is an integer and L is less than N; and
e) taking a plurality of SI images at a pre-determined frequency corresponding to level-L if the second average SI intensity is less than the third threshold.
4 . The method of claim 1 , wherein the first intervention of level-N is selected from the group consisting of a heel boot, a barrier cream, neuromuscular stimulation, a topical cream, therapeutic ultrasound, shockwave therapy, a 30-degree wedge, a composite dressing, a hybrid mattress, a dynamic mattress, a support surface, a silicone pad, a low-friction sheet cover, and a low-friction padded mattress surface.
5 . The method of claim 2 , wherein the second intervention of level-M is selected from the group consisting of a heel boot, a barrier cream, neuromuscular stimulation, a topical cream, therapeutic ultrasound, shockwave therapy, a 30-degree wedge, a composite dressing, a hybrid mattress, a dynamic mattress, a support surface, a silicone pad, a low-friction sheet cover, and a low-friction padded mattress surface.
6 . The method of claim 3 , wherein the third intervention of level-L is selected from the group consisting of a heel boot, a barrier cream, neuromuscular stimulation, a topical cream, therapeutic ultrasound, shockwave therapy, a 30-degree wedge, a composite dressing, a hybrid mattress, a dynamic mattress, a support surface, a silicone pad, a low-friction sheet cover, and a low-friction padded mattress surface.
7 . The method of claim 1 , wherein the first average SI intensity is determined from a subset of the first plurality of SI images.
8 . The method of claim 2 , wherein the second average SI intensity is determined from a subset of the second plurality of images.
9 . The method of claim 2 , wherein the second threshold is equal to the first threshold.
10 . The method of claim 3 , wherein the third threshold is equal to the first threshold.
11 . The method of claim 1 , wherein a level-0 tissue damage intervention further comprises an intervention selected from the group consisting of providing good nutrition, standard mattress, turning every 24 hours, and a combination thereof.
12 . The method of claim 1 , wherein a level-1 tissue damage intervention is providing a heel boot to the patient.
13 . The method of claim 1 , wherein a level-2 tissue damage intervention is changing the patient's support surface.
14 . The method of claim 1 , wherein a level-3 tissue damage intervention is applying dressing to the back or sides of patient's heel.
15 . The method of claim 1 , wherein a level-4 tissue damage intervention is changing the patient's sheet cover to a low-friction sheet cover.
16 . The method of claim 1 , wherein a level-5 tissue damage intervention is providing a low-friction padded mattress surface for the patient's lower leg.
17 . The method of claim 1 , wherein a level-6 tissue damage intervention is turning the patient at a shorter interval than currently provided for.
18 . The method of claim 1 , wherein a level-7 tissue damage intervention is applying a barrier cream to the patient's heel.
19 . The method of claim 1 , wherein a level-8 tissue damage intervention is applying a neuro-muscular stimulation to the patient's heel.
20 . The method of claim 1 , wherein a level-9 tissue damage intervention is applying a topical cream to the patient's heel to enhance perfusion.