Early Diagnosis of Acute wound Infection in Orthopaedic Trauma using CRP and Serial Periwound Skin Temperature Monitoring by Infrared Thermoradiography

Abstract

Background: Infrared imaging allows non-contact, non-radiating, non-invasive investigation of biological systems, both in preclinical research settings and in the clinical assessment of patients. Quantitative measurement of periwound skin temperature using a reliable infrared camera can assist the wound care practitioner with early identification of deep or spreading infection, allow for timely intervention, and help to monitor ongoing treatment response. Aim: To assess the wound healing in orthopaedic trauma using infrared camera as an adjunct in clinical practice. Methods: Prospective observation study of 40 patients with acute wound managed in a tertiary centre from December 2018 to October 2019. Infrared camera used as an adjunct along with other routine blood investigations to assess the healing of these wounds during the course of hospital stay. All skin temperatures were documented using a handheld infrared camera under consistent environmental conditions on the day of dressing. Wound infection was identified using the combination of a serial CRP value and clinical judgement. Results: Out of 40 patients, 28 cases were post operative wounds and none of them developed any complications. The remaining 12 cases were post traumatic, in which 4 developed infections. These cases were identified by infrared camera in correlation with CRP and other clinical parameters. Conclusion: Infrared thermography can act as an adjunct in acute post traumatic and post-surgical wound to monitor healing. It cannot replace an experienced clinician’s assessment and judgement based on individual patient and wound factors.