Lower temperature at the wound edge detected by thermography predicts undermining development in pressure ulcers: a pilot study

Kanazawa, Toshiki; Kitamura, Aya; Nakagami, Gojiro; Goto, Taichi; Miyagaki, Tomomitsu; Hayashi, Akitatsu; Sasaki, Sanae; Mugita, Yuko; Iizaka, Shinji; Sanada, Hiromi

doi:10.1111/iwj.12454

Cited by 26 publications

(18 citation statements)

References 21 publications

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“…New technologies that may provide an objective approach to identifying PIs need to be evaluated. Current technologies undergoing scrutiny range from simple measures, such as colour photography, to the implementation of more complex technological solutions, such as thermal imaging devices that can interface with smartphones . Other suggestions include the use of impedance‐sensing devices and ultrasound elastography that can monitor human soft tissue behaviour .…”

Section: Detection/identification Related Challengesmentioning

confidence: 99%

Pressure injury identification, measurement, coding, and reporting: Key challenges and opportunities

Weller

Gershenzon

Evans

et al. 2017

International Wound Journal

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Pressure injury (PI) rates are a commonly used indicator of performance of health care facilities, both in acute and subacute settings. However, measuring PI rates in an accurate and reproducible fashion has been challenging. The consequences of poor measurement may include failure to identify poorly performing institutions or incorrect accusations of poor quality care. In this article, we describe the main challenges in identification, coding, and reporting of PIs. Issues include inconsistent identification of PIs at the time of admission, variations in the intensity of PI detection, and differing approaches to coding and the adjustment for differing risks amongst different patient population. These are compounded by differences in the epidemiological approach because rates will differ according to whether patients are surveyed cross-sectionally (eg, on a set day per month) or if the survey is undertaken at discharge. In some cases, financial incentives may also influence PI reporting. We also discuss potential strategies for improving data collection and benchmarking as an aid to reducing PI prevalence.

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Section: Detection/identification Related Challengesmentioning

confidence: 99%

Pressure injury identification, measurement, coding, and reporting: Key challenges and opportunities

Weller

Gershenzon

Evans

et al. 2017

International Wound Journal

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“…The low‐temperature wounds which usually indicate ischaemia in early stage of PI do not produce excessive inflammation enough so as to increase the skin surface temperature at this stage. If deep tissue injury or inflammation occurs, the wound temperature may increase (Kanazawa et al, 2016). Accordingly, skin temperature appears to be a non‐visual characteristic with the potential to predict stage 1 PI (Guihan et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Application of infrared thermography in the early warning of pressure injury: A prospective observational study

Cai

Jiang

Hou³

et al. 2021

Journal of Clinical Nursing

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Aims and objectives To verify the ability of infrared thermography in objectively identifying pressure injury and its application value in the early warning of pressure injury. Background There is subjectivity in assessing the risk of pressure injury as well as diagnosis in clinical settings, which makes early detection and prevention difficult. Design Prospective, cohort study. Method Four hundred and fifteen patients admitted to the adult intensive care units were enrolled by a convenience sampling method, and they received a follow‐up monitoring for 10 days. The risk of pressure injury was assessed via Braden scale, and thermal images of sacral area were obtained by infrared thermal imager once a day. The predictive effects of infrared thermography and Braden scale on pressure injury were compared by the receiver operating characteristic curve from which the optimal cut‐off value of skin temperature for predicting pressure injury was determined. The effect of skin temperature on pressure injury was described and compared, using Kaplan–Meier curve and Cox proportional hazard regression model, respectively. We followed STROBE checklist for reporting the study. Results The relative temperature of sacral area was negatively correlated with the risk of pressure injury. The efficiency of infrared thermography for diagnosing pressure injury was better than that of Braden scale. Based on the relative temperature optimal cut‐off value (−0.1°C), Kaplan–Meier curve and Cox proportional hazard regression model analysis showed the incidence of pressure injury with relative temperature below −0.1°C was higher than the group with relative temperature above −0.1°C. Conclusions Infrared thermography can objectively and accurately identify local hypothermia warnings of pressure injury before visual recognition. The application of infrared thermography into routine pressure injury risk assessment provides a timely and reliable method for nursing practitioners. Relevance to clinical practice Infrared thermography has great value of clinical application in daily pressure injury assessment. It is of great significance to make a faster and more objective clinical judgement for patients at risk of pressure injury.

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“…36 To the our best knowledge, in the previous literature, similar observations have not been described in relation to VLU; hence, it is difficult for us to refer to other studies. Several researchers have described the use of IRT to predict the development of a wound or its complications (including pressure ulcers and leg ulcers), 16,17,[19][20][21][24][25][26] and a few have assessed therapy effectiveness, 18,20 but none has determined the prognosis of the healing process. Available studies refer to acute wounds, most often postoperative wounds.…”

Section: Discussionmentioning

confidence: 99%

“…IRT has been shown to be a highly predictive tool in diagnosing superficial and deep surgical site infections and developing infections of chronic wounds, even before clinical signs have appeared . IRT can be used to predict areas of potential necrosis in spots subjected to pressure and to identify undermining of the wound, abscesses, or other spaces that need debridement . To the best of our knowledge, no previous report has been published on the application of IRT to evaluate the healing process dynamics of VLUs.…”

Section: Introductionmentioning

confidence: 99%

“…24 IRT can be used to predict areas of potential necrosis in spots subjected to pressure and to identify undermining of the wound, abscesses, or other spaces that need debridement. [24][25][26] To the best of our knowledge, no previous report has been published on the application of IRT to evaluate the healing process dynamics of VLUs. IRT is a noninvasive and noncontact method that is safe and repetitive, providing many diagnostical opportunities.…”

Section: Introductionmentioning

confidence: 99%

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Infrared thermography to prognose the venous leg ulcer healing process—preliminary results of a 12‐week, prospective observational study

Cwajda‐Białasik

Mościcka

Jawień

et al. 2019

Wound Repair Regeneration

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Venous leg ulcers are complex, and their multifactorial etiology make successful treatment a difficult and long process. Nonhealing ulcers are the greatest challenge because they are resistant to standard therapies. In this study, we analyzed whether monitoring the temperature of the ulcered limb wound area could benefit the diagnosis of the wound's tendency to heal (estimating the presence of a healing or nonhealing wound) in patients with two‐sided venous leg ulcers. This prospective, 12‐week observational study included 57 adult individuals with chronic venous leg ulcers. The dynamics of wound healing was assessed by planimetry and infrared thermography every two weeks. We analyzed temperatures measured at three marked areas—the wound, the periwound skin, and the reference area. An initial wound area larger than 1 cm2 was associated with a temperature increase of 0.027 °C in the periwound skin. A 1‐cm2 decrease in the wound area was associated with a 0.04 °C decrease in the temperature difference between the periwound skin and wound. A strong positive relationship was identified for both the bacteriology variables (the presence of bacteria: temperature increase in the periwound skin of 0.4 °C, p < 0.001; the number of bacterial species in a wound, temperature increase of 0.95 °C, p < 0.001). The temperature in the reference area was significantly correlated with the failure of the superficial and perforating veins (temperature increase of 0.69 °C, p = 0.04). This study reports that the assessment of the temperature a limb may be beneficial in predicting whether an ulcer is a healing or a nonhealing ulcer. The decrease in the temperature differences between the areas referred to as healing wounds was the only beneficial prognostic marker. Other temperature differences in the periwound skin were caused by disorders, such as multibacterial wound infections and superficial venous inflammation.

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Lower temperature at the wound edge detected by thermography predicts undermining development in pressure ulcers: a pilot study

Cited by 26 publications

References 21 publications

Pressure injury identification, measurement, coding, and reporting: Key challenges and opportunities

Pressure injury identification, measurement, coding, and reporting: Key challenges and opportunities

Application of infrared thermography in the early warning of pressure injury: A prospective observational study

Infrared thermography to prognose the venous leg ulcer healing process—preliminary results of a 12‐week, prospective observational study

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