OBJECTIVE: Foot ulceration remains a major health problem for diabetic patients and has a major impact on the cost of diabetes treatment. We tested a hyperspectral imaging technology that quantifies cutaneous tissue hemoglobin oxygenation and generated anatomically relevant tissue oxygenation maps to assess the healing potential of diabetic foot ulcers (DFUs). RESEARCH DESIGN AND METHODS: A prospective single-arm blinded study was completed in which 66 patients with type 1 and type 2 diabetes were enrolled and followed over a 24-week period. Clinical, medical, and diabetes histories were collected. Transcutaneous oxygen tension was measured at the ankles. Superficial tissue oxyhemoglobin (oxy) and deoxyhemoglobin (deoxy) were measured with hyperspectral imaging from intact tissue bordering the ulcer. A healing index derived from oxy and deoxy values was used to assess the potential for healing. RESULTS: Fifty-four patients with 73 ulcers completed the study; at 24 weeks, 54 ulcers healed while 19 ulcers did not heal. When using the healing index to predict healing, the sensitivity was 80% (43 of 54), the specificity was 74% (14 of 19), and the positive predictive value was 90% (43 of 48). The sensitivity, specificity, and positive predictive values increased to 86, 88, and 96%, respectively, when removing three false-positive osteomyelitis cases and four false-negative cases due to measurements on a callus. The results indicate that cutaneous tissue oxygenation correlates with wound healing in diabetic patients. CONCLUSIONS: Hyperspectral imaging of tissue oxy and deoxy may predict the healing of DFUs with high sensitivity and specificity based on information obtained from a single visit.

Subungual melanoma is a rarer form of melanoma encountered in clinical practice that often has a poor prognosis because it presents with advanced disease. We report a case of a 46-year-old male with a circumferential osteoinvasive melanoma that invaded the superior and lateral aspects of the periosteum of the distal phalanx. We discuss pathologic findings and common physical exam findings to facilitate earlier diagnosis of subungual melanoma.

Timely recognition of intraoperative bleeding can support visualization and hemostatic response. This narrative review organizes representative systems by temporal purpose - anticipation, detection, and post-hoc assessment - while treating input sources separately. Video classifiers, object detectors, segmentation-assisted models, and synchronized device - video pipelines demonstrate distinct capabilities, but their reported metrics are not interchangeable. One device-associated detector achieved 81.0% sensitivity with 4.6% precision, corresponding to roughly eight false alerts per operation, whereas other studies evaluated event counts, duration, or warning lead time. We distinguish offline testing, streaming feasibility, and prospective intraoperative evaluation, and relate these evidence levels to event-level accuracy, alert burden, and response time. Current evidence remains limited by small datasets, uncertain transfer across procedures and institutions, workflow integration, and surgeon interaction. Future studies should test transferable contextual cues and determine prospectively whether alerts improve recognition or hemostatic response without excessive interruption.