A Scoping Review of Fluorescence Imaging: A Promising New Technology for Bacterial Detection in Burn Wounds.

Abstract

Burns are complex injuries with devastating long-term impacts. Despite advancements in burn care, infections remain the leading cause of morbidity and mortality. Early and accurate detection of bacterial burden is critical for effective intervention, yet traditional diagnostic methods have limitations. Fluorescence imaging has emerged as an effective tool to enhance bacterial detection and guide infection management in burn wound management. This scoping review summarizes current evidence on fluorescence imaging-guided detection of bacterial loads in burn wounds and explores its potential role across different stages of burn care. A comprehensive literature search was conducted in PubMed using the inclusion and exclusion terms ("fluorescence" OR "autofluorescence") AND ("burn" OR "burns") AND "imaging" AND "bacteria" NOT "microscopy". This search yielded 30 publications, which were further filtered to exclude pre-clinical studies, review articles, or articles that were not specific to burns. A total of 6 articles investigating the diagnostic accuracy of fluorescence imaging (MolecuLight) in burn patients were identified. This evidence suggests that fluorescence imaging improves the accuracy of bacterial detection in burns compared to clinical assessment alone, facilitating targeted wound sampling and debridement, enhancing antimicrobial stewardship, and guiding timely interventions. Additionally, burn wound surgical planning may be optimized by fluorescence imaging-guided identification of areas requiring excision and grafting. Fluorescence imaging shows promise in enhancing bacterial detection in burn wounds, aiding clinical decision-making and infection management. However, further statistically powered studies are needed to evaluate its impact on burn patient outcomes.