Prospective Evaluation of Thermographic Imaging for Early Detection of Pressure Injuries: A Follow-Up Study

Pressure injuries are a major source of morbidity in critically ill patients, and early recognition is particularly difficult in patients with darker skin tones where erythema may be missed. This prospective study evaluated thermographic imaging with the Wound Scout in 32 patients (40 wound encounters) admitted to the ICU. Abnormal temperature, defined as > ±1.1°C, was significantly associated with deep tissue pressure injury (DTPI) diagnosis, with an odds ratio of 6.1 (95% CI 1.2-36.6), sensitivity of 83% and positive predictive value of 74%. Wound Scout changed the diagnosis in 25% of encounters, most often in sacral wounds where visual inspection is limited. Performance was consistent across Fitzpatrick skin types, supporting its utility in skin of colour. Longitudinal data from a small subset (n = 10) did not show predictive value for progression. Thermography offers an objective, equitable adjunct to clinical assessment that may improve early detection of pressure injuries.