Medical thermography in the diagnosis of pressure ulcers: a narrative review

What is it about?

Background: Pressure ulcers are a common complication in healthcare, with a global prevalence of approximately 12.8%. Traditional risk assessment methods (Norton, Braden, and Waterlow scales) show limited predictive accuracy (sensitivity 46.8–82.4%, specificity 27.4–67.5%). There is a need to complement them with more objective diagnostic methods such as infrared thermography (IRT). Aim: A review of potential applications of infrared thermography in the early diagnosis and monitoring of pressure ulcers. Methods: A selective search of PubMed, Scopus, and Web of Science databases was conducted, focusing mainly on English and Polish articles from 2015 to 2025, using the terms “thermography”, “infrared imaging”, “pressure ulcers”, “diagnosis” and “wound monitoring.” Findings: IRT enables non-invasive assessment of skin temperature distribution, detecting functional changes before visible symptoms appear. Temperature drops (ΔT ≤ -0.1°C) in at-risk areas predict pressure ulcer development more accurately than traditional scales. Hypothermic areas of non-blanching erythema are 31.8 times more likely to undergo necrosis. IRT also identifies deep tissue damage, predicts undermining, and assesses healing potential. AI algorithms enhance the diagnostic accuracy of IRT (overall accuracy ~84.6%). Conclusions: IRT is a valuable complement to traditional pressure ulcer assessment methods, allowing early detection of subcutaneous changes regardless of skin color. Implications for clinical practice: Implementation of IRT is recommended upon admission of high-risk patients, interpreting temperature differences relative to adjacent skin areas, and immediate intervention upon detection of thermal anomalies.

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