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Case Series/Study
Diabetes is related to numerous comorbidities, including the severe complications of wound healing, often resulting in chronic ulceration and consequent limb amputation. Diabetic foot ulcers (DFUs) represent a significant global health challenge, affecting 166 million individuals (Armstrong et al., 2020) and 1 in 6 patients with a DFU may confront lower limb amputation (Boulton et al., 2020). This not only has consequences for the affected individuals but also imposes a substantial annual cost for the healthcare system (Rice et al., 2014; Barshes et al., 2013). The study was designed to incorporate and assess the potential of mobile multispectral near-infrared spectroscopy (NIRS) imaging technology into nurse-led outreach diabetic foot care initiatives for older adults residing in remote areas (Rickards et al., 2023).
Methods: The Mobile Seniors' Wellness Network (MSWN) conducted an intervention study between November 2020 and December 2022. The study enrolled 366 seniors living within a 90-minute radius of the city’s community health center, visited by certified foot care nurses (CFCNs) and a Registered Social Worker. A subset of 22 high-risk participants was analyzed. NIRS and thermal imaging device* was integrated into the foot care workflow. This study was reviewed by Research Ethics Board (#2020-026, #2020-2916) .
Results: The study’s analysis included 22 participants, with an age range of 69.36 ± 9.32, with a subset of 13 participants diagnosed with diabetes. Within diabetic group, 7 participants exhibited DFUs and 2 displayed signs of hyperemia. The study highlighted the association between impaired tissue oxygenation and the severity of DFUs. Individuals with chronic DFUs showed temperature differentials. This observation implies that temperature variations may be indicative of underlying foot health issues in diabetic patients.
Discussion: This study discusses the role of integrating mobile multispectral near-infrared spectroscopy imaging in a nurse-led outreach foot care program for seniors in rural areas. It is shown that NIRS imaging has been instrumental in enhancing assessments and providing real-time feedback, particularly in the context of DFUs. Beyond its diagnostic utility, it served as an educational catalyst, reinforcing self-care practices.