Infrared Thermal Imaging Has the Potential to Reduce Unnecessary Surgery and Delays to Necessary Surgery in Burn Patients

Abstract

Clinical distinction between superficial and deep burns is problematic. The authors determined whether an infrared thermal imaging (IRTI) camera could predict burn depth. Burn depth was assessed by an experienced surgeon, and the burns were imaged with a portable, lightweight IRTI camera that measures heat emission from the skin using long infrared wavelengths (7.5-13 μm). Burns were considered "deep" if they were surgically excised and confirmed to be of full thickness on microscopic evaluation or if they did not heal spontaneously within 21 days of injury. All other burns were considered "nondeep." There were 39 burns that had both days 1 and 2 IRTI measurements and available outcome. Of these, 16 were "deep" burns and 23 were "nondeep." The mean temperatures of "nondeep" burns between days 1 and 2 increased from 30.6 ± 2.7 to 32.1 ± 3.0°C (difference of 1.5 ± 2.3°C). The mean temperatures of "deep" burns decreased from 32.3 ± 2.0 to 30.8 ± 1.3°C (difference of -1.5 ± 2.0°C) between days 1 and 2. Any decrease in temperatures between days 1 and 2 was predictive of a deep wound, and any increase between days 1 and 2 was predictive of a nondeep burn. Using the ultimate burn depth as the criterion standard, the overall accuracy of IRTI was considerably higher than that of clinical assessment; 87.2% (95% CI: 71.8-95.2) vs 54.1% (95% CI: 37.1-70.2). Any decrease in temperatures between days 1 and 2 was predictive of a deep wound. Our results suggest that thermography using IRTI is more accurate than clinical examination in predicting burn depth and could potentially reduce unnecessary surgery as well as reduce delays to surgery when necessary.

Validity of thermography for measuring burn wound healing potential

“…This finding falls within the range of the results of other studies, reporting Pearson's correlation coefficients of 0.50 ( P = <.01) and 0.73 ( P = <.01) . The Δ T cutoff values that were selected in this study differ from cutoff values selected in other studies . The reason for this difference is that we based our cutoff value on the preferred specificity, whereas in other studies cutoff values were selected with both the highest sensitivity and specificity.…”

“…In this study, we included carefully outlined measurement points, and excluded measurements that contained heterogeneous healing potential areas, whereas in the previous study a relatively large area was assessed within the burn wound. Furthermore, the observed healing time (i.e., >95% epithelialization) was chosen as a reference standard in the previous study, as well as in other clinical studies . We believe this reference standard has several limitations.…”

Detection of Suspicious of Diabetic Feet using Thermal Image

“…The thermal images show the thermal composition of a body or objective, in addition to identifying in which areas there is a higher temperature, also, the thermal cameras have software in which the images can be processed to provide accurate data of the pixels of the image [10]. These thermal images have many applications being one of the most necessary in the field of medicine because the temperature variation of the human body is a key to the development of the same and the detection of diseases or internal sutures.…”

Burn Wound Healing and Tissue Engineering

“…A recent clinical study of 39 burns found that the overall accuracy of static thermography (using a hand held, commercially available camera) in predicting burn depth was considerably higher than that of clinical assessment; 87.2% (95% CI: 71.8–95.2) vs. 54.1% (95% CI: 37.1–70.2), as early as 48 hours after injury. 17 Active dynamic thermography, which measures the ability of tissue to conduct heat transfer relative to its surroundings, has also been explored in animal models with promising results. 18 Another promising modality is dermoscopy, which allows visualization of the microanatomy of the skin’s vasculature using a small, hand-held device.…”