The effectiveness of infrared thermography in the diagnosis of necrotizing fasciitis

Abstract

The aim of this study was to investigate the effectiveness of digital infrared thermography in the early diagnosis and detection of areas of impaired perfusion and tissue necrosis in patients with necrotizing fasciitis.

Materials and methods. This scientific work is based on observations of 10 patients with suspicion of necrotizing fasciitis during 2022-2023. The patients underwent thermography using a digital infrared thermal imaging camera to obtain heat maps and thermograms, which were then analyzed for abnormal thermal patterns. The results of the thermography were compared with other signs of necrotizing fasciitis to assess the accuracy of the method.

Results. The study found that in patients with necrotizing fasciitis, there were three concentric zones with different surface temperatures around the main locus of infection. The central zone (N) had a lower temperature, the intermediate zone (F) had an increased temperature, and the outer zone (S) had a temperature close to normal for that area of the body. The results of statistical analysis indicated that there was no significant difference in temperature between the outer and intermediate zones. However, there were significant differences between the outer and central zones, as well as between the intermediate and central zones. The researchers found that the 5.72±0.23°С temperature difference between the central zone (N) with reduced thermal emission and the intermediate zone (F) with increased thermal emission, is a sign of the late stage of necrotizing fasciitis. However, at the early stage of development of necrotizing fasciitis, the "N" zone is absent, although a pronounced "F" zone is observed, which is surrounded by the "S" zone with a temperature difference of approximately 1.92±0.28°С.

Conclusions. Distinct thermal patterns observed in patients with necrotizing fasciitis provide an opportunity to improve diagnostic accuracy and assist in timely surgical intervention. Continuing the study and improvement of medical thermography can make it possible to include it in standard clinical practice in the future to improve the diagnostic and treatment process of necrotizing fasciitis.

The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the institutions indicated in the work. The informed consent of patients was obtained for participation in the study.

No conflict of interests was declared by the authors.