Utility of Thermal Imaging in Predicting Superficial Infections in Transfemoral Osseointegrated Implants.

Autor:	Harrington CJ; From the Division of Orthopaedics, Department of Surgery, Uniformed Services University, Walter Reed National Military Medical Center, Bethesda, Md., Nelson BA; From the Division of Orthopaedics, Department of Surgery, Uniformed Services University, Walter Reed National Military Medical Center, Bethesda, Md., Lansford JL; From the Division of Orthopaedics, Department of Surgery, Uniformed Services University, Walter Reed National Military Medical Center, Bethesda, Md., Rivera JA; From the Division of Orthopaedics, Department of Surgery, Uniformed Services University, Walter Reed National Military Medical Center, Bethesda, Md.; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Md., Souza JM; Departments of Plastic and Reconstructive Surgery and Orthopedic Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio., Forsberg JA; Department of Surgery, Orthopaedic Service, Memorial Sloan Kettering Cancer Center, New York, N.Y., Potter BK; From the Division of Orthopaedics, Department of Surgery, Uniformed Services University, Walter Reed National Military Medical Center, Bethesda, Md.; Department of Surgery, Uniformed Services University, Bethesda, Md.
Jazyk:	angličtina
Zdroj:	Plastic and reconstructive surgery. Global open [Plast Reconstr Surg Glob Open] 2024 Feb 07; Vol. 12 (2), pp. e5602. Date of Electronic Publication: 2024 Feb 07 (Print Publication: 2024).
DOI:	10.1097/GOX.0000000000005602
Abstrakt:	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. Competing Interests: Dr. Forsberg reports funding from the Department of Defense, Defense Health Programs (W81XWH-17-2-0060 BA150634). All the other authors have no financial interest to declare in relation to the content of this article.
Databáze:	MEDLINE
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