Thermographic mapping of the abdomen in healthy subjects and patients after enterostoma
Thermographic mapping of the abdomen in healthy subjects and patients after enterostoma
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DOI：
10.12968/jowc.2015.24.3.112
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发表时间：
2015-03-01
影响因子：
1.9
通讯作者：
Childs, C.
中科院分区：
文献类型：
--
作者：
Siah, C. J. R.;Childs, C.
目的：在伤口评估标准中，发热是手术伤口感染的体征和症状，但目前在临床实践中没有用于评估手术伤口皮肤温度的诊断工具。使用热成像，本研究的目的是绘制愈合的手术伤口的温度，并提供以下验证数据：a）距离皮肤温度目标视场（FOV）的最佳IR成像距离B）身体成分对腹部皮肤表面温度读数的影响c）造口关闭后感染与非感染伤口的热成像特征。在一个小的（240 cm x 320 cm）临床室中，在受控的环境条件下测量健康、无发热受试者的腹部皮肤表面温度。受试者站立位置距离红外摄像机30 cm、60 cm和100 cm。腹部皮肤表面温度和热成像地图在人口的外科手术患者之前和之后关闭enterostoma.Results：主题（30）年龄19-52（中位数=29）岁被招募。在100厘米的距离，9个解剖区域的每一个都显示出随着BMI的增加，平均温度降低。BMI >25的受试者平均腹部温度较低。观察到右下腹（p=0.022）、左腰区（p=0.009）、右腰区（p=0.010）和脐区（p=0.021）存在统计学显著性差异。一半的患者（5/10）发生手术伤口infection.Conclusion：在调查的操作距离内，没有观察到腹部温度读数的显着影响。随着BMI的增加，注意到下腹部温度。腹部手术伤口的热模式揭示了愈合和感染伤口之间的一些差异。愈合的伤口显示了热“地图”的变化;术后第一天温度升高，随后五天“变暖”。“冷点”出现在手术伤口的热谱图上，随后被证明是感染的。在临床环境的设置中，100 cm的距离不会显著改变FOV内的皮肤温度读数。有一个建议，身体成分影响皮肤温度。感染的手术伤口比愈合的伤口看起来“更冷”。
Objective: Heat is a sign and symptom of surgical wound infection in wound assessment criteria but there is currently no diagnostic tool being used in clinical practice to assess the skin temperature of surgical wounds. Using thermal imaging, the objective of this study was to map the temperature of the healing surgical wound and to provide confirmatory data of: a) optimum IR imaging distance from skin temperature target field of view (FOV) b) body composition effects on abdominal skin surface temperature readings c) thermal mapping characteristics of infected versus non-infected wounds post stoma-closure.Method: The abdominal skin surface temperature of healthy, afebrile subjects was measured under controlled, ambient conditions in a small (240cm x 320cm) clinical room. Subject standing positions were 30cm, 60cm and 100cnn from the IR camera. Abdominal skin surface temperature and thermal imaging maps were acquired in a population of surgical patients before and after closure of enterostoma.Results: Subjects (30) aged 19-52 (median=29) years were recruited. At a distance of 100cm, each of nine anatomical regions showed a decrease in mean temperature as BMI increased. Subjects with BMI >25 had lower mean abdominal temperatures. Statistically significant differences were observed for right hypochondrium (p=0.022), left lumbar region (p=0.009), right lumbar region (p=0.010) and the umbilical region (p=0.021). Half of patients (5/10) developed surgical wound infection.Conclusion: Within the operating distances investigated, no significant effect on abdominal temperature readings was observed. With increasing BMI, lower abdominal temperatures were noted. The thermal pattern of abdominal surgical wounds reveals some differences between the healing and infected wound. Healing wounds showed changes in the thermal 'map'; an increase in temperature on the first post-operative day, and 'warming' over the subsequent five days. 'Cold spots' emerged on the thermogram of the surgical wounds which subsequently were shown to be infected. Within the setting of a clinical environment, distances up to 100cm did not significantly alter skin temperature readings within the FOV. There is a suggestion that body composition influences skin temperature. Infected surgical wounds appear 'colder' than healing wounds.