Diagnostic accuracy of a fluorescence imaging device in diabetic wounds: a pilot study using a tissue culture system.

INTRODUCTION: DFUs are challenging chronic wounds that are vulnerable to infections. A fluorescence imaging device was developed to detect bacterial presence in wounds. This device utilizes the principle that when illuminated by violet light, some bacteria emit red fluorescence and others, such as Pseudomonas aeruginosa, emit cyan fluorescence. Several studies have reported the accuracy of this device. However, to the best of the authors' knowledge, no studies have examined the correlation between bacterial presence and tissue biopsy culture results in diabetic wounds. OBJECTIVE: This study aimed to investigate the diagnostic accuracy of a fluorescence imaging device using a tissue culture system. MATERIALS AND METHODS: Thirty-five patients (48 wounds) were included. Wounds were sampled using tissue culture methods and photographed using the fluorescence imaging device. Culture outcomes were categorized into non-Pseudomonas bacterial, Pseudomonas bacterial, both bacterial, and no-growth groups. Image outcomes were categorized into red, cyan, both colors, and negative groups. RESULTS: For detecting the presence of bacteria, the fluorescence imaging device showed a sensitivity, specificity, PPV, and NPV of 64.1%, 55.6%, 86.2%, and 26.3%, respectively, with an accuracy of 62.5%. For P aeruginosa, the device showed a sensitivity, specificity, PPV, and NPV of 66.7%, 87.2%, 54.6%, and 91.9%, respectively, with an accuracy of 83.3%. For non-Pseudomonas bacteria, the device showed a sensitivity, specificity, PPV, and NPV of 43.8%, 62.5%, 70.0%, and 35.7%, respectively, with an accuracy of 50.0%. CONCLUSION: The fluorescence imaging device can help to detect the bacterial bioburden; however, its accuracy may be lower than that reported in previous studies of diabetic wounds.

The turbocharged wide anterolateral thigh perforator flap to reconstruct massive soft tissue defects in traumatized lower extremities: A case series.

Background: Extensive traumatic soft tissue defects in the lower extremities typically require complete coverage of exposed bone because inadequate coverage, such as partial flap loss, may result in bony infection and ultimately lead to limb salvage failure. To achieve complete coverage of these defects, we used the wide anterolateral thigh perforator flap in which the turbocharging procedure augments the blood flow. Herein, we describe our turbocharging technique and discuss its effectiveness. Methods: From January 2014 to December 2020, the turbocharged wide ALTP free flaps were used to treat 13 patients with massive traumatic soft tissue defects in the lower extremities, ranging in size from 22 × 10 cm2 (220 cm2) to 21 × 17 cm2 (357 cm2) (mean, 270 cm2). All ALTP flaps were supplied by perforators from both the transverse branch of the lateral circumflex artery (TB-LCFA) and descending branch of the lateral circumflex artery (DB-LCFA) simultaneously. The turbocharging procedure by connecting the TB-LCFA to a side branch of the DB-LCFA was carried out in all these flaps. A retrospective review of medical records for each patient was performed. Results: The size of the transferred ALTP flap ranged from 23 × 12 cm2 (276 cm2) to 23 × 19 (437 cm2) (mean, 331 cm2). The total number of perforators included in the flaps was three on average. All ALTP flaps survived completely without partial necrosis. The postoperative course was uneventful except for two cases with minor complications, including hematoma and partial necrosis of the recipient's skin. Conclusion: Free transfer of the turbocharged wide ALTP flap can be a reliable and effective reconstructive method to obtain complete coverage of extensive traumatic soft tissue defects in the lower extremities and achieve successful limb salvage.

Effect of dietary ß-mannanase on productive performance, egg quality, and utilization of dietary energy and nutrients in aged laying hens raised under hot climatic conditions.

OBJECTIVE: The objective of this experiment was to investigate the effect of dietary ß-mannanase on productive performance, egg quality, and utilization of dietary energy and nutrients in aged laying hens raised under hot climatic conditions. METHODS: A total of 320 84-wk-old Hy-line Brown aged laying hens were allotted to one of four treatments with eight replicates in a completely randomized design. Two dietary treatments with high energy (HE; 2,800 kcal/kg nitrogen-corrected apparent metabolizable energy [AMEn]) and low energy (LE; 2,700 kcal/kg AMEn) were formulated. Two additional diets were prepared by adding 0.04% (MN4) or 0.08% ß-mannanase (MN8) to LE treatment diets. The feeding trial was conducted for 28 d, covering a period from July to August in South Korea. The average daily room temperature and relative humidity were 29.2°C and 83%, respectively. RESULTS: Productive performance, egg quality, and cloacal temperature were not influenced by dietary treatments. The measured AMEn values for MN8 diets were similar to those for HE diets, which were greater (p<0.05) than those for LE and MN4 diets. However, the AMEn values for MN8 diets did not differ from those for LE and MN4 diets. CONCLUSION: The addition of ß-mannanase to low energy diets increases energy values for diets fed to aged laying hens. However, this increase has little positive impacts on performance and egg quality. These results indicate that dietary ß-mannanase does not mitigate the heat stress of aged laying hens raised under hot climatic conditions.

Effect of dietary net energy concentrations on growth performance and net energy intake of growing gilts.

OBJECTIVE: This experiment investigated the effect of dietary net energy (NE) concentrations on growth performance and NE intake of growing gilts. METHODS: Five diets were formulated to contain 9.6, 10.1, 10.6, 11.1, and 11.6 MJ NE/kg, respectively. A metabolism trial with 10 growing pigs (average body weight [BW] = 15.9±0.24 kg) was conducted to determine NE concentrations of 5 diets based on French and Dutch NE systems in a 5×5 replicated Latin square design. A growth trial also was performed with five dietary treatments and 12 replicates per treatment using 60 growing gilts (average BW = 15.9±0.55 kg) for 28 days. A regression analysis was performed to predict daily NE intake from the BW of growing gilts. RESULTS: Increasing NE concentrations of diets did not influence average daily gain and average daily feed intake of growing gilts. There was a quadratic relationship (p = 0.01) between dietary NE concentrations and feed efficiency (G:F), although the difference in G:F among treatment means was relatively small. Regression analysis revealed that daily NE intake was linearly associated with the BW of growing gilts. The prediction equations for NE intake with the BW of growing gilts were: NE intake (MJ/d) = 1.442+(0.562×BW, kg), R2 = 0.796 when French NE system was used, whereas NE intake (MJ/d) = 1.533+(0.614×BW, kg), R2 = 0.810 when Dutch NE system was used. CONCLUSION: Increasing NE concentrations of diets from 9.6 to 11.6 MJ NE/kg have little impacts on growth performance of growing gilts. Daily NE intake can be predicted from the BW between 15 and 40 kg in growing gilts.