Infrared thermography to prognose the venous leg ulcer healing process—preliminary results of a 12‐week, prospective observational study (original) (raw)
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Thermal imaging potential and limitations to predict healing of venous leg ulcers
2021
Area analysis of thermal images can detect delayed healing in diabetes foot ulcers, but not venous leg ulcers (VLU) assessed in the home environment. This study proposes using textural analysis of thermal images to predict the healing trajectory of venous leg ulcers assessed in home settings. Participants with VLU were followed over twelve weeks. Digital images, thermal images and planimetry of wound tracings of the ulcers of 60 older participants was recorded in their homes by nurses. Participants were labelled as healed or unhealed based on status of the wound at the 12th week follow up. The weekly change in textural features was computed and the first two principal components were obtained. 60 participants (aged 80.53 ± 11.94 years) with 72 wounds (mean area 21.32 ± 51.28cm2) were included in the study. The first PCA of the change in textural features in week 2 with respect to week 0 were statistically significant for differentiating between healed and unhealed cases. Textural an...
Journal of Clinical Medicine
Visual and empirical assessments do not enable the early detection of wound deterioration or necroses. No suitable objective indicator for predicting poor wound-healing is currently available. We used infrared thermography to determine the association between wound temperature and pressure-wound healing. We examined patients with grades 2–4 pressure ulcers from a medical center in southern Taiwan and recorded the temperatures of the wound bed, periwound, and normal skin using infrared thermographic cameras. A total of 50 pressure ulcers and 248 infrared-thermography temperature records were analyzed. Normal skin temperature was not related to pressure ulcer wound healing. In a multivariate analysis, higher malnutrition universal-screening-tool scores were associated with poor wound-healing (p = 0.020), and higher periwound-temperature values were associated with better wound-healing (p = 0.028). In patients who had higher periwound-skin temperature than that of the wound bed, that r...
Monitoring neuropathic ulcer healing with infrared dermal thermometry
The Journal of Foot and Ankle Surgery, 1996
The purpose of this study is to prospectively evaluate skin temperatures at the site of neuropathic ulceration before, during, and after wound healing using the contralateral extremity as a physiologic control and to evaluate variables that may influence skin temperature gradients. We studied 17 male and 8 female diabetics with mean age and duration of diabetes of 52.4 ± 11.6 years and 13.8 ± 7.8 years with grade I (Meggitt-Wagner) plantar ulcers. All patients received weekly cast changes with wound and skin temperature assessments. After healing, all patients were fitted with prescription shoe gear. Temperatures on the ulcerated foot were higher than those on the contralateral foot on initial presentation (91.1 vs. 84.2°F, t = 8.9, P < 0.0001,95% C15.3 to 8.5), but the same following healing. Patients with vibration perception thresholds greater than 45 V had wider skin temperature gradients than those with lesser degrees of sensory neuropathy (8.8 ± 4.1 vs. 4.9 ± 2.5°F, P = 0.007). Additionally, subjects with toe brachial indices below 0.60 had greater skin temperature gradients at the site of ulceration than those with higher indices (9.4 ± 4.0 vs, 5.8 ± 3.4°F, P = 0.01). There was not a significant difference in initial skin temperature gradients by duration of wound prior to treatment, duration of wound healing, sex, maximum plantar pressure, or hemoglobin A 1C level.
Self-monitoring of leg skin temperature for venous ulcer prevention
Background: For intervention studies that require the use of participant self-reports, the quality and accuracy of recorded data and variability in participant adherence rates to the treatment can cause significant outcome bias. Read this original research and sign up to receive Patient Preference and Adherence journal here: https://www.dovepress.com/articles.php?article\_id=24987
Treatment of pressure ulcers with noncontact normothermic wound therapy: Healing and warming effects
Journal of Wound Ostomy and Continence Nursing, 2001
This study compared healing rates in stage III and IV pressure ulcers treated with noncontact normothermic wound therapy or moist dressings. Periwound temperature changes with noncontact normothermic wound therapy were evaluated. Design: This 8-week, prospective, randomized clinical trial evaluated linear rate of healing of the wound edge and periwound temperature changes during the 1-hour warming treatment and for 15 minutes after warming. Setting and subjects: Forty subjects referred from primary care providers, home care providers, acute care facilities, and long-term care facilities were enrolled in the study. Twenty-nine subjects completed the trial (14 received standard care, and 15 received noncontact normothermic wound therapy). Instruments: Ulcers were measured with acetate tracings, digital and Polaroid photography, and Pressure Sore Status Tool evaluations. The linear rate of healing was determined with use of computerized planimetry. Periwound temperatures were recorded with use of a Cole Parmer thermometer YSI 400 series. Methods: Subjects were evaluated weekly. Subjects randomly assigned to noncontact normothermic wound therapy received 3 treatments daily, during which the dressing was warmed to 38°C for 1 hour. Subjects in the standard care group were treated with dressings that were moisture retentive and provided absorption as needed. Results: The two groups were statistically similar with regard to baseline and wound characteristics. The linear rate of healing was significantly faster in the group treated with noncontact normothermic wound therapy (Mann-Whitney U test = 47, P = .01). On average, periwound temperatures increased 2.4°C at the end of warming (1 hour), a significant increase above baseline values (P = .001). Conclusions: The healing rate was significantly increased with noncontact normothermic wound therapy treatment. Periwound temperature increased significantly after 1 hour of warming, achieving levels approximating normothermia. Healing effects associated with noncontact normothermic wound therapy may be related to several mechanisms, including improvements in perfusion, oxygen supply, and cellular activity in response to warming. (J WOCN 2001;28:244-52.) *Frequency or mean (± SD).
2016
Cancer CRP C-reactive Protein CSV Comma-separated Values xix Thermography Imaging the temperatures in a material, or in the body or an organ. Imaging is based on self-emanating infrared radiation (heat waves), or on changes in properties of the material or tissue that vary with temperature, such as elasticity; magnetic field; or luminescence [MeSH term] Wound healing Restoration of integrity to traumatized tissue [MeSH term] xx PUBLICATIONS AND PRESENTATIONS Publications Journal of Wound Care (JWC)-submitted and published Siah, C. J., & Childs, C. (2015). Thermographic mapping of the abdomen in healthy subjects and patients after enterostoma.
Skin temperature monitoring reduces the risk for diabetic foot ulceration in high-risk patients
American Journal of Medicine, 2007
To evaluate the effectiveness of home temperature monitoring to reduce the incidence of foot ulcers in high-risk patients with diabetes.In this physician-blinded, 18-month randomized controlled trial, 225 subjects with diabetes at high risk for ulceration were assigned to standard therapy (Standard Therapy Group) or dermal thermometry (Dermal Thermometry Group) groups. Both groups received therapeutic footwear, diabetic foot education, regular foot care, and performed a structured foot inspection daily. Dermal Thermometry Group subjects used an infrared skin thermometer to measure temperatures on 6 foot sites twice daily. Temperature differences >4°F between left and right corresponding sites triggered patients to contact the study nurse and reduce activity until temperatures normalized.A total of 8.4% (n = 19) subjects ulcerated over the study period. Subjects were one third as likely to ulcerate in the Dermal Thermometry Group compared with the Standard Therapy Group (12.2% vs 4.7%, odds ratio 3.0, 95% confidence interval, 1.0 to 8.5, P = .038). Proportional hazards regression analysis suggested that thermometry intervention was associated with a significantly longer time to ulceration (P = .04), adjusted for elevated foot ulcer classification (International Working Group Risk Factor 3), age, and minority status. Patients that ulcerated had a temperature difference that was 4.8 times greater at the site of ulceration in the week before ulceration than did a random 7 consecutive-day sample of 50 other subjects that did not ulcerate (3.50 ± 1.0 vs 0.74 ± 0.05, P = .001).High temperature gradients between feet may predict the onset of neuropathic ulceration and self-monitoring may reduce the risk of ulceration.
Journal of diabetes science and technology, 2018
In clinical practice, both area and temperature of the ulcer have been shown to be effective in tracking the healing status of diabetes-related foot ulcer (DRFU). However, traditionally, the area of the DRFU is measured regardless of the temperature distribution. The current prospective, observational study used thermal imaging, as a more accurate tool, to measure both the area and the temperature of DRFU. We aimed to predict healing of DRFU using thermal imaging within the first 4 weeks of ulceration. A pilot study was conducted where thermal and color images of 26 neuropathic DRFUs (11 healing vs 15 nonhealing) from individuals with type 1 or 2 diabetes were taken at the initial clinic visit (baseline), at week 2, and at week 4. The thermal images were segmented into isothermal patches to identify the wound boundary and area corresponding to temperature distribution. Five parameters were obtained: temperature of the wound bed, area of the isothermal patch of the wound bed, area of...