Quantitative analysis of blood cells and inflammatory factors in wounds.

OBJECTIVE: The aim of this study was to quantify blood cells and inflammatory markers, involved in the healing process, in exudates from wounds in different healing phases, to assess these markers in order to identify the inflammatory phase of the wounds. METHOD: Patients who presented with postsurgical wounds, which closed by first and second intention, and those who presented with pressure ulcers (PUs), which were closed by second intention, were included in the study. RESULTS: We examined wounds from 37 patients and collected samples from 52 wounds in the inflammatory phase, 30 in the proliferative phase and 29 in the maturation phase. The number of neutrophils and platelets in the exudate collected from wounds in the inflammatory phase was significantly higher (p<0.001), while the number of lymphocytes, was significantly lower in exudate from wounds in the inflammatory phase (p<0.001). Wound c-reactive protein (CRP) and immunoglobulin G (IgG) levels were higher in the inflammatory group (p<0.001). We found a significantly positive correlation between CRP levels and the percentage of neutrophils and monocytes (r=0.346, p=0.004; r=0.293, p=0.015), and a significantly negative correlation between CRP levels and the percentage of lymphocytes (r=-0.503, p<0.001). A stepwise logistic regression analysis was used to identify an optimal combination of these biomarkers. The optimal biomarker combinations were neutrophils + monocytes + platelets + IgG + CRP, with an area under the curve (AUC) of 0.981 [confidence interval (CI) 95%: 0.955-1.000, p<0.001] for the diagnosis of wounds in the inflammatory phase. The optimal cutpoint yielded 96.9 % sensitivity and 94.6 % specificity. The biomarker combination predicted the inflammatory phase and was superior to individual biomarkers. CONCLUSION: Our findings suggest that the combination of the markers, percentage of neutrophils and monocytes, platelets, CRP and IgG levels could be useful prognostic indicators of the inflammatory phase.

[Assessment of a 3D digital orthoptic test platform]. / Évaluation d'une plateforme d'orthoptie numérique 3D.

PURPOSE: To compare standard orthoptic tests with a novel digital 3D orthoptic platform, 3DeltaEasy(©) from Orthoptica(®). MATERIALS AND METHODS: This study tests the 3D digital orthoptics platform, 3DeltaEasy(©) from Orthoptica(®) and compares it to the corresponding standard orthoptic tests. This platform consists of a computer equipped with dedicated software, a video projector and 3D liquid crystal glasses. Three tests were compared: Wirt test, measurement of horizontal and vertical phorias, and the horizontal fusional amplitude in convergence and divergence. A total of 102 subjects, 53 males (52 %) and 49 females (48 %), aged between 9 years and 72 years (mean age 33±16.4 years) were examined at the ophthalmologic department of the Brest Hospital (France) and included in this observational cross-sectional study. Subjects recruited in this study were patients requiring orthoptic screening or therapy. Patients without their optimal visual corrections were excluded. All patients underwent both ophthalmological and orthoptic examination including Wirt fly stereotest with polarizing spectacles, cover tests to evaluate and measure the horizontal and vertical deviation of the lines of sight, horizontal vergence ranges using prism bar and their equivalent tests implemented in the digital 3D orthoptic tests 3DeltaEasy(©) from Orthoptica(®). RESULTS: All data were processed using MedCalc Statistical Software version 14.12.0 (MedCalc Software bvba, Ostend, Belgium). The main result of this study is that 3DeltaEasy(©) and the classical Wirt test are correlated (Spearman's coefficient of rank correlation: ρ=0.74; P<0.0001), cover tests are equivalent for intermediate and far vision (paired t-test; P=0.46 and P=0.51), and horizontal and vertical vergence range are comparable for distance vision (paired t-test; P=0.34 and P=0.94). CONCLUSION: New digital 3D tools could easily substitute for some orthoptic tests with better ergonomics. Eventually, by increasing the number of tests performed, it could substitute for nearly all tests.