Diagnostics for Wound Infections.

SIGNIFICANCE Infections can significantly delay the healing process in chronic wounds placing an enormous economic burden on health care resources. Identification of infection biomarkers and imaging modalities to observe and quantify them has seen progress over the years. Recent Advances: Traditionally, clinicians determine the presence of infection through visual observation of wounds and confirm their diagnosis through wound culture. Many laboratory markers including white blood cell count, erythrocyte sedimentation rate, C-reactive protein, procalcitonin, presepsin, and bacterial protease activity have been quantified to assist diagnosis of infection. Moreover, imaging modalities like plain radiography, computed tomography, magnetic resonance imaging, ultrasound imaging, spatial frequency domain imaging, thermography, autofluorescence imaging, and biosensors, have emerged for real-time wound infection diagnosis and showed their unique advantages in deeper wound infection diagnosis. CRITICAL ISSUES While traditional diagnostic approaches provide valuable information, they are time-consuming and depend on clinicians' experience. There is a need for non-invasive wound infection diagnostics that are highly specific, rapid, accurate and do not require extensive training. FUTURE DIRECTIONS While innovative diagnostics utilizing various imaging instrumentation are being developed, new biomarkers have been investigated as potential indicators for wound infection. Products may be developed to either qualitatively or quantitatively measure these biomarkers. This review summarizes and compares all available diagnostics for wound infection including those currently used in clinics and still under development. This review could serve as a valuable resource for clinicians treating wound infections as well as patients and wound care providers who would like to be informed of the recent developments.