Utility of Thermal Imaging in Predicting Superficial Infections in Transfemoral Osseointegrated Implants
Background:. Superficial infection is a common minor complication of transcutaneous implants that can be challenging to predict or diagnose. Although it remains unclear whether superficial infections progress to deep infections (which may require implant removal), predicting and treating any infecti...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2024-02-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005602 |
| _version_ | 1797292738401533952 |
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| author | Colin J. Harrington, MD Benjamin A. Nelson, MD Jefferson L. Lansford, MD Julio A. Rivera, PhD Jason M. Souza, MD Jonathan A. Forsberg, MD, PhD Benjamin K. Potter, MD, FACS |
| author_facet | Colin J. Harrington, MD Benjamin A. Nelson, MD Jefferson L. Lansford, MD Julio A. Rivera, PhD Jason M. Souza, MD Jonathan A. Forsberg, MD, PhD Benjamin K. Potter, MD, FACS |
| author_sort | Colin J. Harrington, MD |
| collection | DOAJ |
| description | Background:. Superficial infection is a common minor complication of transcutaneous implants that can be challenging to predict or diagnose. Although it remains unclear whether superficial infections progress to deep infections (which may require implant removal), predicting and treating any infection in these patients is important. Given that flap thinning during stage II surgery requires compromising vascularity for stability of the skin penetration aperture, we hypothesized that early skin temperature changes predict long-term superficial infection risk.
Methods:. We obtained standardized thermal imaging and recorded surface temperatures of the aperture and overlying flaps 2 weeks postoperatively for the first 34 patients (46 limbs) treated with the Osseointegrated Prosthesis for the Rehabilitation of Amputees transfemoral implant system. We used two-sided t tests to compare temperatures surrounding the aperture and adjacent soft tissues in patients with and without subsequent infection.
Results:. During median follow-up of 3 years, 14 limbs (30.4%) developed 23 superficial infections. At patients’ initial 2-week visit, mean skin temperature surrounding the aperture was 36.3ºC in limbs that later developed superficial infections and 36.7ºC in uninfected limbs (P = 0.35). In four patients with bilateral implants who later developed superficial infection in one limb, average temperature was 1.5ºC colder in the infected limb (P = 0.12).
Conclusions:. Superficial infections remain a frequent complication of transfemoral osseointegration surgery. We did not find differences in early heat signatures between limbs subsequently complicated and those not complicated by superficial infection. Further research should explore more objective measures to predict, diagnose, and prevent infections after osseointegration surgery. |
| first_indexed | 2024-03-07T20:01:47Z |
| format | Article |
| id | doaj.art-15b9301430af4018b4899014cc416fde |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-03-07T20:01:47Z |
| publishDate | 2024-02-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-15b9301430af4018b4899014cc416fde2024-02-28T06:48:00ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742024-02-01122e560210.1097/GOX.0000000000005602202402000-00032Utility of Thermal Imaging in Predicting Superficial Infections in Transfemoral Osseointegrated ImplantsColin J. Harrington, MD0Benjamin A. Nelson, MD1Jefferson L. Lansford, MD2Julio A. Rivera, PhD3Jason M. Souza, MD4Jonathan A. Forsberg, MD, PhD5Benjamin K. Potter, MD, FACS6From the * Division of Orthopaedics, Department of Surgery, Uniformed Services University, Walter Reed National Military Medical Center, Bethesda, Md.From the * Division of Orthopaedics, Department of Surgery, Uniformed Services University, Walter Reed National Military Medical Center, Bethesda, Md.From the * Division of Orthopaedics, Department of Surgery, Uniformed Services University, Walter Reed National Military Medical Center, Bethesda, Md.From the * Division of Orthopaedics, Department of Surgery, Uniformed Services University, Walter Reed National Military Medical Center, Bethesda, Md.‡ Departments of Plastic and Reconstructive Surgery and Orthopedic Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio§ Department of Surgery, Orthopaedic Service, Memorial Sloan Kettering Cancer Center, New York, N.Y.From the * Division of Orthopaedics, Department of Surgery, Uniformed Services University, Walter Reed National Military Medical Center, Bethesda, Md.Background:. Superficial infection is a common minor complication of transcutaneous implants that can be challenging to predict or diagnose. Although it remains unclear whether superficial infections progress to deep infections (which may require implant removal), predicting and treating any infection in these patients is important. Given that flap thinning during stage II surgery requires compromising vascularity for stability of the skin penetration aperture, we hypothesized that early skin temperature changes predict long-term superficial infection risk. Methods:. We obtained standardized thermal imaging and recorded surface temperatures of the aperture and overlying flaps 2 weeks postoperatively for the first 34 patients (46 limbs) treated with the Osseointegrated Prosthesis for the Rehabilitation of Amputees transfemoral implant system. We used two-sided t tests to compare temperatures surrounding the aperture and adjacent soft tissues in patients with and without subsequent infection. Results:. During median follow-up of 3 years, 14 limbs (30.4%) developed 23 superficial infections. At patients’ initial 2-week visit, mean skin temperature surrounding the aperture was 36.3ºC in limbs that later developed superficial infections and 36.7ºC in uninfected limbs (P = 0.35). In four patients with bilateral implants who later developed superficial infection in one limb, average temperature was 1.5ºC colder in the infected limb (P = 0.12). Conclusions:. Superficial infections remain a frequent complication of transfemoral osseointegration surgery. We did not find differences in early heat signatures between limbs subsequently complicated and those not complicated by superficial infection. Further research should explore more objective measures to predict, diagnose, and prevent infections after osseointegration surgery.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005602 |
| spellingShingle | Colin J. Harrington, MD Benjamin A. Nelson, MD Jefferson L. Lansford, MD Julio A. Rivera, PhD Jason M. Souza, MD Jonathan A. Forsberg, MD, PhD Benjamin K. Potter, MD, FACS Utility of Thermal Imaging in Predicting Superficial Infections in Transfemoral Osseointegrated Implants Plastic and Reconstructive Surgery, Global Open |
| title | Utility of Thermal Imaging in Predicting Superficial Infections in Transfemoral Osseointegrated Implants |
| title_full | Utility of Thermal Imaging in Predicting Superficial Infections in Transfemoral Osseointegrated Implants |
| title_fullStr | Utility of Thermal Imaging in Predicting Superficial Infections in Transfemoral Osseointegrated Implants |
| title_full_unstemmed | Utility of Thermal Imaging in Predicting Superficial Infections in Transfemoral Osseointegrated Implants |
| title_short | Utility of Thermal Imaging in Predicting Superficial Infections in Transfemoral Osseointegrated Implants |
| title_sort | utility of thermal imaging in predicting superficial infections in transfemoral osseointegrated implants |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005602 |
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