Recommended Citation
Ononenyi A, Banks B, Riutta S, Wankowski D, Lamptey M, Gesell L. Influence of Microvascular Fluorescence Angiography in the Deliberations of the Hyperbaric and Wound Care Physician. Presented at Scientific Day; May 21, 2025; Park Ridge, IL.
Abstract
Background/Significance:
Microvascular Fluorescence Angiography (MFA) allows for visualization of blood flow by injecting dye into the bloodstream. It is used in Hyperbaric and Wound Care (HWC) to assess the status of blood flow around a wound and determine the wound’s healing potential. Currently, the use of MFA is not a standardized practice in the field of HWC. Some physicians rely more on their clinical exam, while others feel the need to use MFA. Within the HWC field, it is unclear if MFA is ultimately useful considering the high cost of purchase. MFA is utilized by most HWC physicians at Aurora St. Luke’s Medical Center (ASLMC). There is a need to objectively measure if there are changes to a physician’s assessment and plan for the same wound after they’ve used MFA compared to immediate prior clinical exam.
Purpose:
To discover whether MFA affects the physician’s decisions on wound status and Hyperbaric Oxygen Therapy (HBOT) plan with the intention of obtaining objective data that would contribute meaningfully to discussion of usefulness of MFA, and thus the practice of MFA usage, both at ASLMC and the larger Advocate health.
Methods:
Physicians at ASLMC’s HWC department were given pre- and post-MFA surveys with questions regarding the patient’s wound status, whether HBOT duration will be changed, and the provider’s level of confidence (Likert scale) in their decision to modify the HBOT treatment duration. Physicians’ answers between the pre- and post-MFA surveys were compared to determine if their answers changed following MFA.
Results:
25 physician surveys were collected and analyzed. Compared to clinical assessment, 32% of physicians changed the wound impression, 36% of physicians changed the planned HBOT duration, and 48% of physicians changed their level of confidence after using MFA.
Conclusion:
Our results suggest MFA provides clinicians with information about wounds that may not be apparent on clinical exam. One-third of physicians changed their wound impression, as well as planned HBOT duration. Of note, nearly half of physicians shifted their confidence level following MFA. It’s important to realize that using MFA could have provided reassurance and/or altered the confidence for the physicians who made no changes to the impression and plan. In addition, we cannot discount the potential positive impact in the wound healing process because of MFA influencing the extending or shortening of HBOT course, as this plays a role in the discussion of usefulness of MFA. Further studies are ongoing.
Presentation Notes
Presented at Scientific Day; May 21, 2025; Park Ridge, IL.
Full Text of Presentation
wf_yes
Document Type
Poster
Influence of Microvascular Fluorescence Angiography in the Deliberations of the Hyperbaric and Wound Care Physician
Background/Significance:
Microvascular Fluorescence Angiography (MFA) allows for visualization of blood flow by injecting dye into the bloodstream. It is used in Hyperbaric and Wound Care (HWC) to assess the status of blood flow around a wound and determine the wound’s healing potential. Currently, the use of MFA is not a standardized practice in the field of HWC. Some physicians rely more on their clinical exam, while others feel the need to use MFA. Within the HWC field, it is unclear if MFA is ultimately useful considering the high cost of purchase. MFA is utilized by most HWC physicians at Aurora St. Luke’s Medical Center (ASLMC). There is a need to objectively measure if there are changes to a physician’s assessment and plan for the same wound after they’ve used MFA compared to immediate prior clinical exam.
Purpose:
To discover whether MFA affects the physician’s decisions on wound status and Hyperbaric Oxygen Therapy (HBOT) plan with the intention of obtaining objective data that would contribute meaningfully to discussion of usefulness of MFA, and thus the practice of MFA usage, both at ASLMC and the larger Advocate health.
Methods:
Physicians at ASLMC’s HWC department were given pre- and post-MFA surveys with questions regarding the patient’s wound status, whether HBOT duration will be changed, and the provider’s level of confidence (Likert scale) in their decision to modify the HBOT treatment duration. Physicians’ answers between the pre- and post-MFA surveys were compared to determine if their answers changed following MFA.
Results:
25 physician surveys were collected and analyzed. Compared to clinical assessment, 32% of physicians changed the wound impression, 36% of physicians changed the planned HBOT duration, and 48% of physicians changed their level of confidence after using MFA.
Conclusion:
Our results suggest MFA provides clinicians with information about wounds that may not be apparent on clinical exam. One-third of physicians changed their wound impression, as well as planned HBOT duration. Of note, nearly half of physicians shifted their confidence level following MFA. It’s important to realize that using MFA could have provided reassurance and/or altered the confidence for the physicians who made no changes to the impression and plan. In addition, we cannot discount the potential positive impact in the wound healing process because of MFA influencing the extending or shortening of HBOT course, as this plays a role in the discussion of usefulness of MFA. Further studies are ongoing.
Affiliations
Aurora St. Lukes Medical Center, Aurora UW Medical Group, Aurora Sinai Medical Center