Non-invasive diagnostics in wound healing: where are we now and where should we go?

Marco Romanelli, MD, PhD

Michela Iannone, MD

Diagnosing hard-to-heal wounds can be a real challenge. The use of non-invasive diagnostics could be very helpful in real life to improve initial diagnosis, support clinical decisions, explore the wound bed, to manage infections, exudate and the surrounding skin, monitor the effects of treatment to determine healing rates and improve patients outcomes.

Wound assessment is becoming more and more sophisticated. The most exciting technologies developed are real-time fluorescence signals from bacteria and wound tissues, and biomedical sensors for monitoring and early detection of infections. The development of ultra-high frequency ultrasounds allows the estimation of the amount of granulation tissue, depth of necrotic tissue, physical wound dimensions, wound volumes and structural components. Laser Doppler imaging systems evaluate skin microcirculation and alterations in perfusion. Other important devices are the pH measurement instruments, confocal microscopy, optical coherence tomography and magnetic resonance imaging (MRI).

The latest generation of biomedical sensors are wearable sensors capable of continuously monitoring the wound healing process without patient hospitalisation. Wound parameters are collected in a database with remote communication allowing real-time clinical support. This exciting technology will provide a tailored-based therapeutic approach, early identification and resolution of potential wound healing problems and an improved quality of life for patients.