Computed tomography of pressure sores

Firooznia, Hossein; Rafii, Mahvash; Golimbu, Cornelia; Sokolow, Jack

doi:10.1016/0149-936x(83)90060-7

Cited by 7 publications

(4 citation statements)

References 14 publications

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“…Early detection and intervention of deep tissue injury are therefore an essential step in preventing injury deterioration. Current tools for early detection of deep tissue injury include ultrasonography, computed tomography and magnetic resonance imaging, which are also appropriate for the evaluation of pressure ulcers .…”

Section: Discussionmentioning

confidence: 99%

Combination of thermographic and ultrasonographic assessments for early detection of deep tissue injury

Higashino

Nakagami

Kadono

et al. 2012

International Wound Journal

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Early detection and intervention of deep tissue injury are important to lead good outcome. Although the efficiency of ultrasonographic assessment of deep tissue injury has been reported previously, it requires a certain level of skill for accurate assessment. In this study, we present an investigation of the combination of thermographic and ultrasonographic assessments for early detection of deep tissue injury. We retrospectively reviewed 28 early-stage pressure ulcers (21 patients) presenting at the University of Tokyo Hospital between April 2009 and February 2010, surveying the associated thermographic and ultrasonographic findings. The wound temperature patterns were divided into low, even and high compared with the surrounding skin. Ultrasonographic findings were classified into unclear layer structure, hypoechoic lesion, discontinuous fascia and heterogeneous hypoechoic area. All 13 ulcers that were associated with low temperature showed good outcome; three ulcers had even temperatures and 12 ulcers showed high temperature on thermographic assessment. The two deep tissue injuries were rated high on thermographic assessment and showed heterogeneous hypoechoic area findings on ultrasonographic assessment. No non-deep tissue injury lesion was associated with these two findings simultaneously. The combination of thermographic and ultrasonographic assessments is expected to increase the accuracy of the early detection of deep tissue injuries.

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Section: Discussionmentioning

confidence: 99%

Combination of thermographic and ultrasonographic assessments for early detection of deep tissue injury

Higashino

Nakagami

Kadono

et al. 2012

International Wound Journal

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“…Imaging technologies can be used for detecting abscess and cavity formation under the skin around the wound. Magnetic resonance imaging and computed tomography are commonly used to identify such abnormalities underneath the periwound skin . However, these modalities are costly and may not be available in certain care settings, which hinders their timely and routine use.…”

Section: Introductionmentioning

confidence: 99%

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

Kanazawa

Kitamura

Nakagami

et al. 2015

International Wound Journal

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Undermined pressure ulcers (PUs) are troublesome complications that are likely to delay wound healing. Early skin incision and debridement can prevent the deterioration of undermined PUs, thus it is necessary to identify devitalised tissue areas to determine the appropriate timing for such interventions. This retrospective cohort study evaluated whether a lower temperature at the wound edge than the wound bed and periwound skin, detected by thermography, can predict undermining development in PUs 1 week after the assessment. Twenty-two participants with category III, IV, or unstageable PUs who were examined by interdisciplinary PU team and were followed up for at least two consecutive weeks were analysed. We found 9/11 PUs without a lower temperature at the wound edge did not develop undermining development, whereas 8/11 PUs with the lower temperature did develop undermining. The relative risk of undermining development after 1 week in PUs with the lower temperature was 4·00 (95% confidence intervals: 1·08-14·7). The sensitivity, specificity, positive predictive value and negative predictive value were 0·80, 0·75, 0·73 and 0·81, respectively. A thermal imaging assessment focusing on a lower temperature pattern at the wound edge may provide sufficient information to predict undermining development.

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“…A study using CT in the diagnosis of PI was conducted by Firooznia et al 41 in the 1980s. In this study, CT scans provided a more accurate diagnosis than pelvic film, bone scan, gallium scan, and sonography in the diagnosis of PIs, abscess, osteomyelitis, and myositis ossificans 41 . However, MRI, which came to the fore after CT, is known to be superior to CT in terms of soft tissue evaluation.…”

Section: Discussionmentioning

confidence: 99%

“…In this study, CT scans provided a more accurate diagnosis than pelvic film, bone scan, gallium scan, and sonography in the diagnosis of PIs, abscess, osteomyelitis, and myositis ossificans. 41 However, MRI, which came to the fore after CT, is known to be superior to CT in terms of soft tissue evaluation. This is highlighted by studies that involve the observation of muscle swelling and edematous changes via MRI following deformation caused by force applied to the soft tissue.…”

Section: Discussionmentioning

confidence: 99%

Volumetric Evaluation of Dead Space in Ischial Pressure Injuries Using Magnetic Resonance Imaging: A Case Series

Kim¹,

Park²,

Nam³

et al. 2021

Adv Skin Wound Care

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OBJECTIVE To establish a preoperative evaluation procedure by measuring the volume of dead space using MRI in patients with ischial pressure injuries. METHODS Patients with spinal cord injury and ischial pressure injuries who underwent treatment between August 2016 and November 2019 were included in the study. Preoperative MRI scan was conducted on all patients. The volume estimation and three-dimensional (3D) reconstruction were performed based on MRI data using a 3D Slicer. Based on the resulting volume, a muscle flap that could fit the dead space was selected. Surgery was performed with the selected muscle flap, and a fasciocutaneous flap was added, if necessary. RESULTS A total of eight patients with ischial pressure injuries were included in the study. The mean patient age was 59.0 ± 11.0 years. The mean body mass index was 26.62 ± 3.89 kg/m2. The mean volume of dead space was 104.75 ± 81.05 cm3. The gracilis muscle was the most selected muscle flap and was used in four patients. In five of eight cases, a fasciocutaneous flap was used as well. The mean follow-up period was 16 months, and by that point, none of the patients evinced complications that required surgery. CONCLUSIONS To the authors’ knowledge, this is the first report on volumetric evaluation of dead space in ischial pressure injuries. The authors believe that the 3D reconstruction process would enable adequate dead space obliteration in ischial pressure injuries. The authors propose that preoperative MRI scans in patients with ischial pressure injury should become an essential part of the process.

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Computed tomography of pressure sores

Cited by 7 publications

References 14 publications

Combination of thermographic and ultrasonographic assessments for early detection of deep tissue injury

Combination of thermographic and ultrasonographic assessments for early detection of deep tissue injury

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

Volumetric Evaluation of Dead Space in Ischial Pressure Injuries Using Magnetic Resonance Imaging: A Case Series

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