EVALUATION OF ENHANCED STO2 & PERFUSION USING NIRS WITH A NOVEL LOWER EXTREMITY THERAPEUTIC VASCULAR DEVICE

Jonathan A. Niezgoda, BS, CHWS, Kathleen M. Niezgoda, APNP, Sandeep Gopalakrishnan, PhD, MAPWCA and Jeffrey A. Niezgoda, MD, FACHM, MAPWCA, CHWS 

Pressure injury prevention begins with the identification of at-risk patients followed by initiation of care protocols. These protocols incorporate careful monitoring and aggressive pressure redistribution including the use of pressure reduction technologies. This case presentation demonstrates enhancement of tissue oxygenation (StO2) and perfusion using near-infrared spectroscopy (NIRS) following application of a vascular boot. The Vascular Boot is a pressure redistribution boot that provides the additional benefit of increasing lower extremity StO2. 

STUDY DETAILS

A patient with compromised lower extremity perfusion was enrolled in this study and treated with the vascular boot. SnapshotNIR was used to capture StO2 measures prior to and immediately post-boot application with a time duration of one hour with the patient in a seated position with the leg elevated. The test subject’s contralateral extremity was used as a control. The comparison of StO2 values between the left leg (intervention limb) and right leg (control limb) can be seen in the pre- and post-intervention images taken by SnapshotNIR (view PDF). 

STUDY OUTCOME

After using the vascular boot for a period of one hour, upon re-imaging with SnapshotNIR, the patient demonstrated increased StO2 measures. The medial calcaneal imaging demonstrated marked average increase of 23.4% compared to the control which increased only 8%. The slight increase in the control limb may have been due to the elevation of the limb and enhancement of venous return. 

IMPACT OF SNAPSHOTNIR

Identifying at-risk patients and completing an intervention prior to the development of a pressure injury or ulcer can greatly impact their quality of life and reduce burden on the healthcare system. Pressure redistribution and increasing tissue perfusion are critical in the management of chronic wounds and in preventing skin breakdown in patients at risk for pressure injury. Enhancement of tissue perfusion and oxygen clearly correlates with improved clinical outcomes. This case demonstrated successful utilization of SnapshotNIR to confirm suspected areas of low tissue oxygen saturation and to measure the effectiveness of the treatment.  

StO2 image pre- and post-boot application on the intervention limb with a marked increase in tissue oxygenation by 23.4%.