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de Haan J, Stoop M, van Zuijlen PPM, Pijpe A. Thermal Imaging for Burn Wound Depth Assessment: A Mixed-Methods Implementation Study. J Clin Med 2024; 13:2061. [PMID: 38610828 PMCID: PMC11012455 DOI: 10.3390/jcm13072061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Revised: 03/25/2024] [Accepted: 03/29/2024] [Indexed: 04/14/2024] Open
Abstract
Background: Implementing innovations emerging from clinical research can be challenging. Thermal imagers provide an accessible diagnostic tool to increase the accuracy of burn wound depth assessment. This mixed-methods implementation study aimed to assess the barriers and facilitators, design implementation strategies, and guide the implementation process of thermal imaging in the outpatient clinic of a burn centre. Methods: This study was conducted between September 2022 and February 2023 in Beverwijk, The Netherlands. Semi-structured interviews with burn physicians guided by the Consolidated Framework for Implementation Research (CFIR) were conducted to identify barriers and facilitators. Based on the barriers, implementation strategies were developed with the CFIR-ERIC Matching Tool, and disseminated to support the uptake of the thermal imager. Subsequently, thermal imaging was implemented in daily practice, and an iterative RE-AIM approach was used to evaluate the implementation process. Results: Common facilitators for the implementation of the thermal imager were the low complexity, the relative advantage above other diagnostic tools, and benefits for patients. Common barriers were physicians' attitude towards and perceived value of the intervention, the low compatibility with the current workflow, and a lack of knowledge about existing evidence. Six implementation strategies were developed: creating a formal implementation blueprint, promoting adaptability, developing educational materials, facilitation, conducting ongoing training, and identifying early adopters. These strategies resulted in the effective implementation of the thermal imager, reflected by a >70% reach among eligible patients, and >80% effectiveness and adoption. Throughout the implementation process, compatibility, and available resources remained barriers, resulting in low ratings on RE-AIM dimensions. Conclusions: This study developed implementation strategies based on the identified CFIR constructs that impacted the implementation of a thermal imager for burn wound assessment in our outpatient clinic. The experiences and findings of this study could be leveraged to guide the implementation of thermal imaging and other innovations in burn care.
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Affiliation(s)
- Jesse de Haan
- Burn Center, Red Cross Hospital, Vondellaan 13, 1942 LE Beverwijk, The Netherlands; (J.d.H.); or (M.S.); or (P.P.M.v.Z.)
| | - Matthea Stoop
- Burn Center, Red Cross Hospital, Vondellaan 13, 1942 LE Beverwijk, The Netherlands; (J.d.H.); or (M.S.); or (P.P.M.v.Z.)
- Plastic, Reconstructive and Hand Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
- Association of Dutch Burn Centers, 1941 AJ Beverwijk, The Netherlands
| | - Paul P. M. van Zuijlen
- Burn Center, Red Cross Hospital, Vondellaan 13, 1942 LE Beverwijk, The Netherlands; (J.d.H.); or (M.S.); or (P.P.M.v.Z.)
- Plastic, Reconstructive and Hand Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
- Paediatric Surgical Center, Emma Children’s Hospital, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
- Department of Plastic, Reconstructive and Hand Surgery, Red Cross Hospital, Vondellaan 13, 1942 LE Beverwijk, The Netherlands
- Amsterdam Movement Sciences, Tissue Function and Regeneration, 1081 HV Amsterdam, The Netherlands
| | - Anouk Pijpe
- Burn Center, Red Cross Hospital, Vondellaan 13, 1942 LE Beverwijk, The Netherlands; (J.d.H.); or (M.S.); or (P.P.M.v.Z.)
- Plastic, Reconstructive and Hand Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
- Association of Dutch Burn Centers, 1941 AJ Beverwijk, The Netherlands
- Amsterdam Movement Sciences, Tissue Function and Regeneration, 1081 HV Amsterdam, The Netherlands
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Pedrosa R, Souza Martins L, Freire RM, do Nascimento Silva RK, Ferreira JJDA, do Nascimento JA, Rodrigues de Andrade P. Accuracy of infrared thermography evaluation in burn wound healing: a systematic review and meta-analysis. J Wound Care 2024; 33:cxviii-cxxix. [PMID: 38588060 DOI: 10.12968/jowc.2024.33.sup4a.cxviii] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
OBJECTIVE Accurate assessment of burn depth and burn wound healing potential is essential to determine early treatments. Infrared thermography (IRT) is a non-invasive and objective tool to do this. This systematic review evaluated the accuracy of IRT to determine burn wound healing potential. METHOD This systematic review and meta-analysis used MEDLINE, EMBASE, CINAHL, PEDro, DiTA and CENTRAL databases. IRT data were extracted from primary studies and categorised into four cells (i.e., true positives, false positives, true negatives and false negatives). Subgroup analysis was performed according to methods used to capture thermal images. RESULTS The search strategy identified 2727 publications; however, 15 articles were selected for review and 11 for meta-analysis. In our meta-analysis, the accuracy of IRT was 84.8% (63% sensitivity and 81.9% specificity). CONCLUSION IRT is a moderately accurate tool to identify burn depth and healing potential. Thus, IRT should be used carefully for evaluating burn wounds.
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Affiliation(s)
- Rafaela Pedrosa
- Department of Physiotherapy, Graduate Program in Physiotherapy, Federal University of Paraiba, João Pessoa, Brazil
| | - Letícia Souza Martins
- Graduate Program in Physiotherapy, Federal University of Paraiba, João Pessoa, Brazil
| | | | | | | | - João Agnaldo do Nascimento
- Department of Statistics, Graduate Program in Physiotherapy, Federal University of Paraiba, João Pessoa, Brazil
| | - Palloma Rodrigues de Andrade
- Department of Physiotherapy, Graduate Program in Physiotherapy, Federal University of Paraiba, João Pessoa, Brazil
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Silva RKDN, Matias FL, Gonçalves AF, Ferreira JJDA, Andrade PRD. Skin temperature of women: A prospective longitudinal study. J Therm Biol 2023; 118:103741. [PMID: 37944300 DOI: 10.1016/j.jtherbio.2023.103741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 10/10/2023] [Accepted: 10/17/2023] [Indexed: 11/12/2023]
Abstract
INTRODUCTION The different phases of a woman's life, such as the reproductive phase and menopause, are points of great hormonal oscillation, especially estrogen and progesterone, which can interfere with skin temperature. OBJECTIVE To describe and compare skin temperatures of women during their physiological menstrual cycle, the use of exogenous hormones and menopause over a period of 28 days. METHOD This is a prospective observational study using a quantitative approach. A total of 45 volunteers participated and were equally allocated into three groups: Exogenous Hormone Group (EHG), Physiological Menstrual Cycle Group (PMCG) and Menopause Group (MG). All were submitted once a week to body composition measurements over a period of 28 days using an InBody 120 bioimpedance scale, and skin temperature using a FLIR model T-360 thermographic camera. RESULTS No significant differences were found between the mean skin temperature of women with a physiological cycle using exogenous hormones and menopause in relation to the evaluation time or between groups. However, younger women had higher temperatures in specific skin regions, such as in the breast, lower abdomen and thigh (P < 0.05) compared to menopausal women. In addition, negative correlations were observed between body fat and skin temperature of the breasts, trunk, abdomen, upper limbs and right lower limb (P < 0.05). CONCLUSION It was observed that the general skin temperature of women is not altered due to exogenous hormones, menstrual cycle phase or menopause, and that skin temperature tends to be lower in regions with an accumulation of adipose tissue.
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Affiliation(s)
| | - Francilene Lira Matias
- Postgraduate Program in Physical Therapy, Health Sciences Center, Federal University of Paraiba, João Pessoa, Brazil.
| | - Alessandra Feitosa Gonçalves
- Postgraduate Program in Physical Therapy, Health Sciences Center, Federal University of Paraiba, João Pessoa, Brazil.
| | | | - Palloma Rodrigues de Andrade
- Postgraduate Program in Physical Therapy, Health Sciences Center, Federal University of Paraiba, João Pessoa, Brazil.
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Payette J, Vaussenat F, Cloutier S. Deep learning framework for sensor array precision and accuracy enhancement. Sci Rep 2023; 13:11237. [PMID: 37433852 DOI: 10.1038/s41598-023-38290-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 07/06/2023] [Indexed: 07/13/2023] Open
Abstract
In the upcoming years, artificial intelligence is going to transform the practice of medicine in most of its specialties. Deep learning can help achieve better and earlier problem detection, while reducing errors on diagnosis. By feeding a deep neural network (DNN) with the data from a low-cost and low-accuracy sensor array, we demonstrate that it becomes possible to significantly improve the measurements' precision and accuracy. The data collection is done with an array composed of 32 temperature sensors, including 16 analog and 16 digital sensors. All sensors have accuracies between [Formula: see text]. 800 vectors are extracted, covering a range from to 30 to [Formula: see text]. In order to improve the temperature readings, we use machine learning to perform a linear regression analysis through a DNN. In an attempt to minimize the model's complexity in order to eventually run inferences locally, the network with the best results involves only three layers using the hyperbolic tangent activation function and the Adam Stochastic Gradient Descent optimizer. The model is trained with a randomly-selected dataset using 640 vectors (80% of the data) and tested with 160 vectors (20%). Using the mean squared error as a loss function between the data and the model's prediction, we achieve a loss of only 1.47x10[Formula: see text] on the training set and 1.22x10[Formula: see text] on the test set. As such, we believe this appealing approach offers a new pathway towards significantly better datasets using readily-available ultra low-cost sensors.
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Affiliation(s)
- Julie Payette
- Department of Electrical Engineering, École de technologie supérieure, Montréal, H3C 1K3, Canada
| | - Fabrice Vaussenat
- Department of Electrical Engineering, École de technologie supérieure, Montréal, H3C 1K3, Canada
| | - Sylvain Cloutier
- Department of Electrical Engineering, École de technologie supérieure, Montréal, H3C 1K3, Canada.
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Schulz T, Marotz J, Seider S, Langer S, Leuschner S, Siemers F. Burn depth assessment using hyperspectral imaging in a prospective single center study. Burns 2022; 48:1112-1119. [PMID: 34702635 DOI: 10.1016/j.burns.2021.09.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 08/10/2021] [Accepted: 09/14/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND The assessment of thermal burn depth remains challenging. Over the last decades, several optical systems were developed to determine burn depth. So far, only laser doppler imaging (LDI) has been shown to be reliable while others such as infrared thermography or spectrophotometric intracutaneous analysis have been less accurate. The aim of our study is to evaluate hyperspectral imaging (HSI) as a new optical device. METHODS Patients suffering thermal trauma treated in a burn unit in Germany between November 2019 and September 2020 were included. Inclusion criteria were age ≥18 years, 2nd or 3rd degree thermal burns, written informed consent and presentation within 24 h after injury. Clinical assessment and hyperspectral imaging were performed 24, 48 and 72 h after the injury. Patients in whom secondary wound closure was complete within 21 days (group A) were compared to patients in whom secondary wound closure took more than 21 days or where skin grafting was indicated (group B). Demographic data and the primary parameters generated by HSI were documented. A Mann Whitney-U test was performed to compare the groups. A p-value below 0.05 was considered to be statistically significant. The data generated using HSI were combined to create the HSI burn index (BI). Using a logistic regression and receiver operating characteristics curve (ROC) sensitivity and specificity of the BI were calculated. The trial was officially registered on DRKS (registration number: DRKS00022843). RESULTS Overall, 59 patients with burn wounds were eligible for inclusion. Ten patients were excluded because of a poor data quality. Group A comprised 36 patients with a mean age of 41.5 years and a mean burnt body surface area of 2.7%. In comparison, 13 patients were allocated to group B because of the need for a skin graft (n = 10) or protracted secondary wound closure lasting more than 21 days. The mean age of these patients was 46.8 years. They had a mean affected body surface area of 4.0%. 24, 48, and 72 h after trauma the BI was 1.0 ± 0.28, 1.2 ± 0.29 and 1.55 ± 0.27 in group A and 0.78 ± 0.14, 1.05 ± 0.23 and 1.23 ± 0.27 in group B. At every time point significant differences were demonstrated between the groups. At 24 h, ROC analysis demonstrated BI threshold of 0.95 (sensitivity 0.61/specificity 1.0), on the second day of 1.17 (sensitivity 0.51/specificity 0.81) and on the third day of 1.27 (sensitivity 0.92/specificity 0.71). CONCLUSION Changes in microcirculation within the first 72 h after thermal trauma were reflected by an increasing BI in both groups. After 72 h, the BI is able to predict the need for a skin graft with a sensitivity of 92% and a specificity of 71%.
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Affiliation(s)
- Torsten Schulz
- Department of Orthopedic, Trauma and Plastic Surgery, Leipzig University Hospital, Germany.
| | - Jörg Marotz
- Department for Plastic- and Reconstructive Surgery, Burns Unit, BG Kliniken Bergmannstrost, Merseburger Straße 165, D-06120 Halle (Saale), Germany
| | - Sebastian Seider
- Medical Faculty of the Martin-Luther-Universität Halle-Wittenberg, Universitätsplatz 10, D-06108 Halle (Saale), Germany
| | - Stefan Langer
- Department for Orthopedics, Trauma- and Plastic Surgery-University Hospital Leipzig, Liebigstraße 20, D-04103 Leipzig, Germany
| | - Sebastian Leuschner
- Department for Plastic- and Reconstructive Surgery, Burns Unit, BG Kliniken Bergmannstrost, Merseburger Straße 165, D-06120 Halle (Saale), Germany
| | - Frank Siemers
- Department for Plastic- and Reconstructive Surgery, Burns Unit, BG Kliniken Bergmannstrost, Merseburger Straße 165, D-06120 Halle (Saale), Germany
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Qu Y, Meng Y, Fan H, Xu RX. Low-cost thermal imaging with machine learning for non-invasive diagnosis and therapeutic monitoring of pneumonia. INFRARED PHYSICS & TECHNOLOGY 2022; 123:104201. [PMID: 35599723 PMCID: PMC9106596 DOI: 10.1016/j.infrared.2022.104201] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 05/01/2022] [Accepted: 05/01/2022] [Indexed: 06/15/2023]
Abstract
Rapid screening and early treatment of lung infection are essential for effective control of many epidemics such as Coronavirus Disease 2019 (COVID-19). Recent studies have demonstrated the potential correlation between lung infection and the change of back skin temperature distribution. Based on these findings, we propose to use low-cost, portable and rapid thermal imaging in combination with image-processing algorithms and machine learning analysis for non-invasive and safe detection of pneumonia. The proposed method was tested in 69 subjects (30 normal adults, 11 cases of fever without pneumonia, 19 cases of general pneumonia and 9 cases of COVID-19) where both RGB and thermal images were acquired from the back of each subject. The acquired images were processed automatically in order to extract multiple location and shape features that distinguish normal subjects from pneumonia patients at a high accuracy of 93 % . Furthermore, daily assessment of two pneumonia patients by the proposed method accurately predicted the clinical outcomes, coincident with those of laboratory tests. Our pilot study demonstrated the technical feasibility of portable and intelligent thermal imaging for screening and therapeutic assessment of pneumonia. The method can be potentially implemented in under-resourced regions for more effective control of respiratory epidemics.
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Affiliation(s)
- Yingjie Qu
- Department of Intelligence Science and Technology, Anhui Polytechnic University, Wuhu, Anhui 241000, China
| | - Yuquan Meng
- Department of Mechanical Science and Engineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Hua Fan
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of University of Science and Technology of China, Hefei, Anhui 230036, China
| | - Ronald X Xu
- Suzhou Institute for Advanced Research, University of Science and Technology of China, Suzhou, Jiangshu 215009, China
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Miskovic V, Malafronte E, Minetti C, Machrafi H, Varon C, Iorio CS. Thermotropic Liquid Crystals for Temperature Mapping. Front Bioeng Biotechnol 2022; 10:806362. [PMID: 35646874 PMCID: PMC9133408 DOI: 10.3389/fbioe.2022.806362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 03/24/2022] [Indexed: 11/13/2022] Open
Abstract
Wound management in Space is an important factor to be considered in future Human Space Exploration. It demands the development of reliable wound monitoring systems that will facilitate the assessment and proper care of wounds in isolated environments, such as Space. One possible system could be developed using liquid crystal films, which have been a promising solution for real-time in-situ temperature monitoring in healthcare, but they are not yet implemented in clinical practice. To progress in the latter, the goal of this study is twofold. First, it provides a full characterization of a sensing element composed of thermotropic liquid crystals arrays embedded between two elastomer layers, and second, it discusses how such a system compares against non-local infrared measurements. The sensing element evaluated here has an operating temperature range of 34–38°C, and a quick response time of approximately 0.25 s. The temperature distribution of surfaces obtained using this system was compared to the one obtained using the infrared thermography, a technique commonly used to measure temperature distributions at the wound site. This comparison was done on a mimicked wound, and results indicate that the proposed sensing element can reproduce the temperature distributions, similar to the ones obtained using infrared imaging. Although there is a long way to go before implementing the liquid crystal sensing element into clinical practice, the results of this work demonstrate that such sensors can be suitable for future wound monitoring systems.
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Affiliation(s)
- Vanja Miskovic
- Service Chimie-Physique, Université Libre de Bruxelles, Brussels, Belgium
- *Correspondence: Vanja Miskovic,
| | - Elena Malafronte
- Service Chimie-Physique, Université Libre de Bruxelles, Brussels, Belgium
| | - Christophe Minetti
- Service Chimie-Physique, Université Libre de Bruxelles, Brussels, Belgium
| | - Hatim Machrafi
- Service Chimie-Physique, Université Libre de Bruxelles, Brussels, Belgium
- GIGA-In Silico Medicine, Université de Liége, Liège, Belgium
| | - Carolina Varon
- Service Chimie-Physique, Université Libre de Bruxelles, Brussels, Belgium
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Nischwitz SP, Luze H, Schellnegger M, Gatterer SJ, Tuca AC, Winter R, Kamolz LP. Thermal, Hyperspectral, and Laser Doppler Imaging: Non-Invasive Tools for Detection of The Deep Inferior Epigastric Artery Perforators-A Prospective Comparison Study. J Pers Med 2021; 11:jpm11101005. [PMID: 34683146 PMCID: PMC8538291 DOI: 10.3390/jpm11101005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 10/02/2021] [Accepted: 10/04/2021] [Indexed: 11/16/2022] Open
Abstract
Perforator flaps have become one of the leading procedures in microsurgical tissue transfer. Individual defects require a tailored approach to guarantee the most effective treatment. A thorough understanding of the individual vascular anatomy and the location of prominent perforators is of utmost importance and usually requires invasive angiography or at least acoustic Doppler exploration. In this study, we aimed at evaluating different non-invasive imaging modalities as possible alternatives for perforator location detection. After a cooling phase, we performed thermal, hyperspectral and Laser Doppler imaging and visually evaluated a possible detection of the perforator for a period of five minutes with an image taken every minute. We identified the most prominent perforator of the deep inferior epigastric artery by handheld acoustic Doppler in 18 patients. The detected perforator locations were then correlated. Eighteen participants were assessed with six images each per imaging method. We could show a positive match for 94.44%, 38.89%, and 0% of patients and 92.59%, 25.93%, and 0% of images for the methods respectively compared to the handheld acoustic Doppler. Sex, age, abdominal girth, and BMI showed no correlation with a possible visual detection of the perforator in the images. Therefore, thermal imaging can yield valuable supporting data in the individualized procedure planning. Future larger cohort studies are required to better assess the full potential of modern handheld thermal imaging devices.
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Affiliation(s)
- Sebastian P. Nischwitz
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria; (H.L.); (A.-C.T.); (R.W.); (L.-P.K.)
- COREMED—Cooperative Centre for Regenerative Medicine, JOANNEUM RESEARCH Forschungsgesellschaft mbH, 8010 Graz, Austria;
- Correspondence:
| | - Hanna Luze
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria; (H.L.); (A.-C.T.); (R.W.); (L.-P.K.)
- COREMED—Cooperative Centre for Regenerative Medicine, JOANNEUM RESEARCH Forschungsgesellschaft mbH, 8010 Graz, Austria;
| | - Marlies Schellnegger
- COREMED—Cooperative Centre for Regenerative Medicine, JOANNEUM RESEARCH Forschungsgesellschaft mbH, 8010 Graz, Austria;
- Division of Macroscopic and Clinical Anatomy, Medical University of Graz, 8036 Graz, Austria
| | | | - Alexandru-Cristian Tuca
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria; (H.L.); (A.-C.T.); (R.W.); (L.-P.K.)
| | - Raimund Winter
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria; (H.L.); (A.-C.T.); (R.W.); (L.-P.K.)
| | - Lars-Peter Kamolz
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria; (H.L.); (A.-C.T.); (R.W.); (L.-P.K.)
- COREMED—Cooperative Centre for Regenerative Medicine, JOANNEUM RESEARCH Forschungsgesellschaft mbH, 8010 Graz, Austria;
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Dang J, Lin M, Tan C, Pham CH, Huang S, Hulsebos IF, Yenikomshian H, Gillenwater J. Use of Infrared Thermography for Assessment of Burn Depth and Healing Potential: A Systematic Review. J Burn Care Res 2021; 42:irab108. [PMID: 34120173 DOI: 10.1093/jbcr/irab108] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Burn wound depth assessments are an important component of determining patient prognosis and making appropriate management decisions. Clinical appraisal of the burn wound by an experienced burn surgeon is standard of care but has limitations. IR thermography is a technology in burn care that can provide a non-invasive, quantitative method of evaluating burn wound depth. IR thermography utilizes a specialized camera that can capture the infrared emissivity of the skin, and the resulting images can be analyzed to determine burn depth and healing potential of a burn wound. Though IR thermography has great potential for burn wound assessment, its use for this has not been well documented. Thus, we have conducted a systematic review of the current use of IR thermography to assess burn depth and healing potential. METHODS A systematic review and meta-analysis of the literature was performed on PubMed and Google Scholar between June 2020-December 2020 using the following keywords: FLIR, FLIR ONE, thermography, forward looking infrared, thermal imaging + burn*, burn wound assessment, burn depth, burn wound depth, burn depth assessment, healing potential, burn healing potential. A meta-analysis was performed on the mean sensitivity and specificity of the ability of IR thermography for predicting healing potential. Inclusion criteria were articles investigating the use of IR thermography for burn wound assessments in adults and pediatric patients. Reviews and non-English articles were excluded. RESULTS A total of 19 articles were included in the final review. Statistically significant correlations were found between IR thermography and laser doppler imaging (LDI) in 4/4 clinical studies. A case report of a single patient found that IR thermography was more accurate than LDI for assessing burn depth. Five articles investigated the ability of IR thermography to predict healing time, with four reporting statistically significant results. Temperature differences between burnt and unburnt skin were found in 2/2 articles. IR thermography was compared to clinical assessment in five articles, with varying results regarding accuracy of clinical assessment compared to thermography. Mean sensitivity and specificity of the ability of IR thermography to determine healing potential <15 days was 44.5 and 98.8 respectively. Mean sensitivity and specificity of the ability of FLIR to determine healing potential <21 days was 51.2 and 77.9 respectively. CONCLUSION IR thermography is an accurate, simple, and cost-effective method of burn wound assessment. FLIR has been demonstrated to have significant correlations with other methods of assessing burns such as LDI and can be utilized to accurately assess burn depth and healing potential.
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Affiliation(s)
- Justin Dang
- Los Angeles County + University of Southern California (LAC+USC) Medical Center, Los Angeles, CA
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA
| | - Matthew Lin
- Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Calvin Tan
- Division of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Christopher H Pham
- Division of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Samantha Huang
- Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Ian F Hulsebos
- Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Haig Yenikomshian
- Division of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Justin Gillenwater
- Division of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA
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Thermal imaging via FLIR One – A promising tool in clinical burn care and research. Burns 2020; 46:988-989. [DOI: 10.1016/j.burns.2020.02.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 02/28/2020] [Indexed: 11/23/2022]
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