Long term monitoring of a pressure ulcer risk patient using thermal images

Abstract

Patients in an immobile state are susceptible to pressure ulcers, which are localized injuries to the skin and/or underlying tissues due to prolonged pressure. This paper builds upon a body of work examining in-hospital older adult patients at-risk of developing pedal pressure ulcers by examining thermal images of one patient, who was reporting pain in her right foot, over 112 days of a hospital stay. Thermal images of the patient's left and right heels and malleoli were subjected to image processing to remove noise and enhance contrast, region selection and feature extraction to observe changes in temperature over time. Mean intensity within each ROI was extracted, and the difference in temperature between the left and right heels was calculated over time. The resulting temperature pattern was consistent with the physical phenomenon related to ulcer development, intervention and recovery; the right heel was similar in temperature when starting the study and at the end of the study, but was drastically warmer when experiencing erythema and drastically colder when experiencing ischaemia. These results suggest that consistent thermal imaging, in conjunction with image processing may be able to detect the formation of pressure ulcers faster than can be visually observed. Early detection of pressure ulcers is critical in the prevention of pressure ulcers, and is of great importance to any hospital or nursing home.

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

“…Based on the formation mechanism of PI, many scholars have proposed that the development of PI begins with muscle tissue damage, penetrating from the deep to surface within 48 h (Bennett et al, 2017; Judy et al, 2011; Mayrovitz et al, 2018; Moore et al, 2017). When the pressure goes beyond tissue resistance threshold, tissue damage starts immediately, which often precedes visual recognition (Bennett et al, 2017; Judy et al, 2011; Mayrovitz et al, 2018; Moore et al, 2017). Therefore, how to identify potential damage within 48 h before visual recognition provides a possibility to reduce the incidence of PI to some extent.…”

“…Therefore, we used portable infrared thermal imager as the research tool. First, with the characteristics of simple operation, portability and easy access, it was superior to the devices used in previous studies with complicated operation, large volume and high price (Bennett et al, 2017; Kanazawa et al, 2016). It was feasible for equipment acquisition and promotion in clinical setting.…”

Pressure Injury Link to Entropy of Abdominal Temperature

“…It may be worth noting that our approach based on evaluation of the irregularity of abdominal skin temperature as a proxy measure of skin thermoregulation is not to be confused with approaches that monitor skin temperature localized to the most commonly anticipated wound locations, such as the sacrum. Relative differences in skin temperature between zones can give an early indication of a developing pressure injury [ 59 , 60 , 61 , 62 ]. Localized approaches can result in early detection of pressure injuries, but they require clinicians or nursing facility staff to frequently scan several suspect areas for thermal imaging, which can be labor intensive.…”

Pressure Injury Link to Entropy of Abdominal Temperature

“…It may be worth noting that our approach based on evaluation of the complexity of abdominal skin temperature as a proxy measure of skin thermoregulation is not to be confused with approaches that monitor skin temperature localized to the most commonly anticipated wound locations, such as the sacrum. Relative differences in skin temperature between zones can give an early indication of a developing pressure injury [45][46][47][48]. Localized approaches can result in early detection of pressure injuries, but they require clinicians or nursing facility staff to frequently scan several suspect areas for thermal imaging, which can be labor intensive.…”