Application of Luminescence in the Detection of Infections in Wounds: An Emerging Diagnostic Tool, Case Report

Pressure ulcers in the sacral region represent one of the most frequent complications in patients with prolonged immobility, being associated with high morbidity and risk of infection. The differentiation between bacterial colonization and clinically significant infection continues to be a challenge, since classical signs may be absent in chronic wounds. In this context, luminescence imaging has emerged as a non-invasive tool that allows real-time detection of bacterial load through fluorescence induced by violet light. A case of a 68-year-old female patient with a history of cerebrovascular event and prolonged immobility is presented, who developed a sacral ulcer of approximately 25 x 25 cm, initially covered by necrotic eschar. Surgical cleaning with extensive debridement was scheduled; however, during the procedure, viable underlying granulation tissue was evidenced, so it was decided to limit the debridement. Given the suspicion of bacterial load not clinically evident, evaluation by luminescence was performed, observing green-blue fluorescence compatible with the presence of Pseudomonas aeruginosa, which guided management toward a targeted treatment.The use of luminescence allowed precise identification of the distribution of bacterial load, modification of surgical conduct, and avoidance of unnecessary resection of viable tissue. This tool provides significant value in intraoperative decision-making and in the optimization of the management of complex wounds. Luminescence is positioned as a useful complementary technology in the evaluation of pressure ulcers, allowing more precise, targeted, and real-time medicine, with potential impact on improving clinical outcomes.