The New Age of Wound Care: Leveraging the Synergy of Multi-modal Fluorescence and Thermal Imaging

Introduction: Many factors perpetuate the chronicity of non-healing wounds. Bacteria, impaired blood flow, and poor oxygenation play a significant role. Thermal imaging, serving as a proxy for skin temperature and blood flow, provides clinical insights into the diverse pathophysiological events taking place under the skin. Fluorescence imaging* is a well-known and accurate regional bacterial locator, also capable of differentiating Pseudomonas. This case series examines the real-world utility of a combined device integrating both technologies in a multi-center setting.Methods: Patients attending advanced wound care centers were imaged with the multi-modal platform. The handheld device* facilitated: [1] real-time mapping of bacterial load/location (fluorescence imaging), [2] real-time thermography (thermal imaging), [3] co-registered standard images, and [4] digital wound measurement. The impact of multi-modal imaging on diagnosis, treatment planning, and workflow was documented.Results:25 patients underwent multi-modal imaging at Northwell Health, NY or Madigan Army Medical Center, WA. 32% (8/25) had an isolated positive fluorescence finding, 16% (4/25) had an isolated abnormal thermal finding, and 8% (2/25) had abnormal/positive findings for thermal and bacterial fluorescence. We present a compilation of the most relevant sample cases illustrating the benefits of multi-modal imaging in informing diagnosis and guiding treatment.Discussion: Multi-modal imaging findings proved complementary and synergistic, enhancing clinical workflow. Thermal imaging identified tunneling, undermining, sinus tracts, and areas of increased pressure, facilitating informed intervention. Meanwhile, fluorescence imaging enabled targeted hygiene and debridement for proactive bacterial infection management. When combined, these modalities supported infection diagnoses, including cellulitis. Consolidating these technologies into a single device allows for seamless utilization without disrupting workflow, offering a higher level of diagnostic insight at the bedside. Moreover, the integration of these imaging modalities holds promise in identifying pressure and preventing infection and its complications, facilitating proactive management of chronic wounds.References: