Our Mission

TO INCREASE THE EFFECTIVENESS OF DEBRIDEMENT PERFORMED BY INEXPERIENCED SURGEONS WHEN REPAIRING OPEN FRACTURE

To repair an open fracture, orthopaedic surgeons will peform open reduction internal fixation (ORIF) —a surgical procedure to align the bones and stabilize them with special hardware like plates, screws and rods.

About 150,000 ORIF procedures are performed on patients with open fractures in the US each year. A critical step in this procedure is a thorough debridement—the term used to describe removal of dead and devitalized tissue that is prone to infection and prevents proper healing. Proper debridement is crucial for preventing infection, which is a devastating complication of open fracture.

Nevertheless, about 5-30% of these fractures become infected after ORIF surgery, with high-energy open fractures (Gustilo Grade IIIA-C) being more succeptible to deep surgical site infection. Half of these readmitted patients will undergo a series of repeated surgeries and antibiotic treatments in an effort to manage the chronic infection. Long term disability, poor quality of life and often, conversion to amputation is the outcome for these patients.

There is a huge variation in outcomes between more and less experienced surgeons, resulting in an excess of readmissions.

Trauma can occur anywhere, and specialists are not always accessible. Half of ORIFs are performed by less-experienced surgeons, often at smaller hospitals without access to state-of-the-art imaging. Even at larger hospitals and designated trauma centers, patient complexity isn't always matched perfectly to practicioner skill, and new surgeons must gain experience through practice.

Surgeons who perform more than 250 ORIF surgeries each year have about a 5% rate of infection in their patients, compared with inexperienced surgeons (less than 100 ORIFs per year), who have an infection rate of 30% or more. This variation in treatment accounts for about 22,000 unnecessary infections each year, at a total cost of $40,000 per patient, or $880 million per year.

This variation in care is unacceptable and unnecessary with advanced fluorescence guided surgery technology. FWD Imaging Inc. aims to develop hardware and analytic software to provide all surgeons with enhanced guidance during this critical procedure. In doing so, we hope to eliminate the burden of unnecessary infections that occur in tens of thousands of patients each year and cost our healthcare system 1.2 billion dollars annually.

Our Technology

TECHNOLOGY ENGINEERED FROM DECADES OF SCIENTIFIC RESEARCH AND CLINICAL EXPERIENCE

State-of-the-Art Fluorescence Guided Surgery—using FWD Imaging Inc's proprietary quantification methods and superior hardware—can provide surgeons with live intraoperative assessment of tissue viability. The fluorescence camera system is based on a proprietary approach to ultra-fast, overdriven LED illumination gated to an advanced state-of-the-art CMOS chip, that allows for suppression of background light while maximizing signal-to-noise and dynamic range of tissue fluorescence. This means that the system can be run off battery power in a lighted environment. In all relevant benchmarks (limits of ICG detection, linear range, noise floor, and weight) our system outperforms the competitor Stryker and Storz systems, while costing less than $10k.

Our publications and intellectual property below provide publically-disclosed details of our unique approach to managing patient variability and producing quantitative information. If you'd like to further discuss our technology within the context of an NDA, please email us using the addres below.

Publications and Intellectual Property

Patents & Patent Applications

Gitajn IL, Elliott JT, Bruza P, Jiang S, Renk J, Tang Y, Sottosanti JS. Camera System And Method For Identifying Nonviable Tissue Using Fluorescent Tracer And Pulsed High-Intensity Fluorescent Excitation. US Patent Application No. 63/456,904. 2023 Apr 4.

Elliott JT, Gitajn IL, Jiang S, Pogue B. Method and apparatus to measure bone hemodynamics and discriminate healthy from diseased bone, and open reduction internal fixation implant with integrated optical sensors. US Patent Application No. 17/290,991. 2022 Mar 31.

Journal Publications

Elliott JT, Addante RR, Slobogean GP, Jiang S, Henderson ER, Pogue BW, Gitajn IL. Intraoperative fluorescence perfusion assessment should be corrected by a measured subject-specific arterial input function. Journal of biomedical optics. 2020 Jun 1;25(6):066002. doi: 10.1117/1.JBO.25.6.066002

Han X, Demidov V, Vaze VS, Jiang S, Gitajn IL, Elliott JT. Spatial and temporal patterns in dynamic-contrast enhanced intraoperative fluorescence imaging enable classification of bone perfusion in patients undergoing leg amputation. Biomedical Optics Express. 2022 Jun 1;13(6):3171-86. doi: 10.1364/BOE.459497

Gitajn IL, Elliott JT, Gunn JR, Ruiz AJ, Henderson ER, Pogue BW, Jiang S. Evaluation of bone perfusion during open orthopedic surgery using quantitative dynamic contrast-enhanced fluorescence imaging. Biomedical Optics Express. 2020 Nov 1;11(11):6458-69. doi: 10.1364/BOE.399587

Elliott JT, Jiang S, Pogue BW, Gitajn IL. Bone‐specific kinetic model to quantify periosteal and endosteal blood flow using indocyanine green in fluorescence guided orthopedic surgery. Journal of biophotonics. 2019 Aug;12(8):e201800427. doi: 10.1002/jbio.201800427