The Northeastern Society of Plastic Surgeons

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Use of FLIR ONE Smartphone Thermography in Burn Wound Assessment
Erica Y. Xue, M.S., Laurel S. Karian, M.D., Jonathan D. Keith, M.D..
Rutgers New Jersey Medical School, Newark, NJ, USA.

BACKGROUND Forward-looking infrared (FLIR) thermography technology utilizes a handheld camera that measures skin infrared emissivity, captures photographs, and can be analyzed through specialized software. FLIR images can be used to analyze and correlate burn wound temperature with burn depth, burn progression, as well as the number of days needed for healing. FLIR ONE is a miniature, smartphone-compatible thermal imaging camera that has been used to assess inflammation in diabetic foot ulcers as well as locating perforators in flap surgery. However, FLIR ONE's reliability in burn wound assessment has not been evaluated. This case series investigates the accuracy of FLIR ONE in comparison to the widely used indocyanine green (ICG) angiography in assessing burn wounds.
METHODS Five acute third-degree burn wounds were assessed using SPY System (ICG angiography) and FLIR ONE imaging (infrared thermography) to determine burn extent prior to surgical intervention. Patients were taken to the OR within 24 hours of presentation; FLIR ONE images were captured approximately 35 to 45 cm above the wound surface. Margins of unsalvageable tissue as determined by ICG and FLIR ONE were marked and compared.
RESULTS The area of unsalvageable tissue as determined by FLIR ONE closely corresponded to the area determined by ICG. FLIR ONE overestimated unsalvageable tissue margins by about 1 to 2 cm. The area estimated by ICG consistently overlapped with over 90 percent of the area estimated by FLIR ONE.
CONCLUSIONS There is a strong correlation between FLIR ONE and ICG when assessing salvageable tissue in third degree burn wounds. FLIR ONE maximizes the convenience and cost effectiveness of infrared thermography technology, but may overestimate unsalvageable tissue area. FLIR ONE is promising as an adjunct to current imaging modalities such as ICG, but requires further study for comparison.


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