Thermal territories of the abdomen after caesarean section birth: infrared thermography and analysis
Thermal territories of the abdomen after caesarean section birth: infrared thermography and analysis
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DOI：
10.12968/jowc.2016.25.9.499
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发表时间：
2016-09-01
影响因子：
1.9
通讯作者：
Farrell, T.
中科院分区：
文献类型：
--
作者：
Childs, C.;Siraj, M. R.;Farrell, T.
目的：发展和完善定性制图和定量分析技术，以确定产后腹部、剖宫产部位和感染手术伤口的“热区域”。此外，探讨妇女的观点，热成像和可接受性作为一种方法的感染筛查。方法：在英国谢菲尔德某大型大学教学医院进行前瞻性可行性研究。择期剖宫产术后头两天床边对腹部进行红外热成像。目标招募：三种身体质量指数（BMI）类别各6名女性(正常，18.5-24.9 kg/m(2)；超重25-29.9 kg/m(2)；肥胖>= 30 kg/m(2))。此外，因伤口感染而到病房就诊的妇女也符合纳入研究的条件。我们还通过半结构化访谈探讨了热成像技术的应用及其实用性，并利用主题内容分析对其进行了分析。结果：我们招募了20名接受过剖腹产手术的女性。从预定的身体质量指数来看，8名女性肥胖（包括两名伤口感染的女性），7名女性超重，5名女性的身体质量指数正常。温度（摄氏度）分析和像素聚类分割（基于分层聚类的分割，HCS）揭示了疤痕和邻近区域之间的热区域特征。健康疤痕和感染疤痕的热强度分布存在差异；具有潜在的伤口监测功能。在已发生伤口感染的妇女中，健康皮肤和伤口部位之间的最大温差（δ T）超过2摄氏度。第2天，两名妇女的疤痕热像图具有感染伤口热像图的特征。结论：剖宫产后早期和后期热成像是可行和可接受的。女性报告了该技术对未来伤口感染筛查的潜在益处。疤痕和邻近健康皮肤之间像素簇差异的热强度谱分析和HCS有可能成为开发针对剖宫产后妇女早期感染监测技术的一种方法。
Objective: To develop and refine qualitative mapping and quantitative analysis techniques to define 'thermal territories' of the post-partum abdomen, the caesarean section site and the infected surgical wound. In addition, to explore women's perspectives on thermal imaging and acceptability as a method for infection screening.Method: Prospective feasibility study undertaken at a large University teaching hospital, Sheffield UK. Infrared thermal imaging of the abdomen was undertaken at the bedside on the first two days after elective caesarean section. Target recruitment: six women in each of three body mass index (BMI) categories (normal, 18.5-24.9 kg/m(2); overweight 25-29.9 kg/m(2); obese >= 30 kg/m(2)). Additionally, women presenting to the ward with wound infection were eligible for inclusion in the study. Perspectives on the use of thermal imaging and its practicality were also explored via semi-structured interviews and analysed using thematic content analysis.Results: We recruited 20 women who had all undergone caesarean section. From the booking BMI, eight women were obese (including two women with infected wounds), seven women were overweight and five women had a normal BMI. Temperature (degrees C) profiling and pixel clustering segmentation (hierarchical clustering-based segmentation, HCS) revealed characteristic features of thermal territories between scar and adjacent regions. Differences in scar thermal intensity profiles exist between healthy scars and infected wounds; features that have potential for wound surveillance. The maximum temperature differences (Delta T) between healthy skin and the wound site exceed 2 degrees C in women with established wound infection. At day two, two women had a scar thermogram with features observed in the 'infected' wound thermogram.Conclusion: Thermal imaging at early and later times after caesarean birth is feasible and acceptable. Women reported potential benefits of the technique for future wound infection screening. Thermal intensity profiling and HCS for pixel cluster dissimilarity between scar and adjacent healthy skin has potential as a method for the development of techniques targeted to early infection surveillance in women after caesarean section.