Thermography, tissue oxygenation, temperature-difference analysis, and wound imaging in this author's SAWC Spring study helped inform prognosis, treatment decisions, and management.

Key Takeaways

• Wound care imaging: Assessment combined thermography, tissue oxygenation, temperature-difference analysis, and wound imaging across different patient populations; these modalities helped inform prognosis, treatment decisions, and management.
• Clinical applications: In patients with normal perfusion/ankle-brachial index, temperature differences helped identify potential infectious or inflammatory processes; in pyoderma gangrenosum, imaging findings correlated with inflammatory changes.
• Perfusion assessment: Tissue oxygenation imaging identified areas with reduced perfusion and necrosis, with changes observed after appropriate debridement. The speaker noted that integrating multiple noninvasive measures can provide a broader clinical assessment and guide next-step care decisions.

Please note: This content is a direct transcript, capturing the authentic conversation without edits. Some language may reflect the flow of live discussion rather than polished text. 

Transcript 

My name is Alicia Oropallo. I am a professor of surgery at Northwell Health and the School of Medicine, Zucker School of Medicine, at Northwell Health. I also am a professor of the Feinstein Institutes for Medical Research and the director of the Comprehensive Wood Healing Center at Northwell Health. 

I think it's really important to, when you assess patients, that you use as many different modalities, especially non-invasive modalities, to really get a full comprehensive understanding of that patient. And in this case, we used different type of patient populations, but we looked at different types of imaging modalities. In other words, we looked at thermography, we looked at tissue oxygenation, and we looked at temperature difference, and just, of course, the wound image itself over those serial different types of patients and their outcomes. And we could see that all of those features made a significant difference in helping the clinician make the appropriate decision on not only the prognosis, but also helping with the treatment and management. 

Our first case was a patient that actually didn't have, we controlled the oxygenation. So the perfusion itself was consistent with normal. So that was a normal ankle brachial index. But we were looking at different temperature differences, and we could assess that in different clinical scenarios with different temperature differences, we can tell if they actually have an infectious component or not. And in a patient that had what we had, pyoderma gangrenosum, we looked to see if there was a difference in inflammation. So we could see that there were changes in the inflammation that was consistent with the overall condition of the patient that needed to be addressed. And then when we look at tissue oxygenation itself, we could assess in our patient that there were areas that were necrotic. And so we could see that there was less perfusion to those areas until they were appropriately debrided. 

I think one of the challenges is really—the driving force is whether the clinician wants to adopt these. Because once they do these different modalities, it can be so helpful in determining the patient's clinical performance. In other words, when you assess a patient, you can only visualize what they might have. But having those indirect insights—in other words, knowing that they may have an inflammatory process that you may need to be dealing with. Or maybe you're uncertain whether they might have an infectious ideology. Or perhaps maybe you're uncertain whether you can obtain the proper imaging to determine whether they have perfusion deficiencies. This now in one device can give you all of that spectrum of information and give you a clear outline and algorithm of the next best approach to their care.