Exploring the utility of point-of-care ultrasound as a tool for wound assessment.

Objectives: Diabetes-related foot ulcers (DRFU) are a common, costly and devastating consequence of diabetes (1,2). Currently, wound management decisions are based largely on visual observations of superficial wound tissues (3). To date ultrasound has not been extensively tested in populations with DRFU'S except in a small case series (4) This study explores the ability of podiatrists to interpret ultrasound wound images. Methods: Following a short briefing session, podiatrists with previous musculoskeletal ultrasound-imaging training were asked to review a number of static sonographic images of active DRFU. Their written reports were coded and grouped into themes for analysis. Ethical approval for the study was obtained (RESP/17/49 and HERC/15/LPOOL/297) Results: Podiatrists from the UK and Australia with training in using ultrasound were consistently able to identify and describe characteristics associated with DRFU from a single wound ultrasound image. The reported findings between podiatrists was found to be similar between raters, especially in regards to bone morphology. However greater variability was seen in the reporting of more wound specific soft-tissue observations. Conclusions: This series of studies highlights the utility of ultrasound as an adjunct to traditional wound assessment which can provide diagnostically meaningful information to assist in clinical decision making. Future research will be needed to determine if routine incorporation of ultrasound to wound assessment improves patient outcomes. With the establishment of appropriate protocols and training pathways is it envisaged that moving forwards, ultrasound will be able to facilitate more timely, appropriate patient care and improve health outcomes for those with DRFU. [ABSTRACT FROM AUTHOR]