A clinical investigation into the relationship between increased periwound skin temperature and localized wound infection

Marjorie Fierheller, RN, BScN, Ms(c); Dr. Michael Clark; Dr. RG Sibbald, Chronic Wound Healing Clinic, Mississauga, Ontario

Many studies relate the presence of chronic wound infection to reduced strength of healing tissue and delayed healing. Although failure to heal may be the result of many coexisting factors, infection is often found to be a significant contributor.
Increased local temperature is a classic sign of wound infection and its accurate measurement may have the potential to aid in diagnosis of chronic wound infection at the “bedside.” Although infrared thermometry is currently utilized for this purpose in some chronic wound care practice settings, research evidence to support such use is very limited.
An experimental, cross-sectional clinical research study was conducted to investigate the relationship between increased periwound skin temperature and localized wound infection in patients with chronic leg ulcers of non-arterial etiology as a thesis for the Masters in Wound Healing and Tissue Repair, Cardiff University, Cardiff UK.
Participants were enrolled from within the population of a chronic wound healing clinic. Data collected from non-wounded participants (n = 20) using a test-retest method supports reliability of the infrared thermometer utilized for this study (Pearson's Correlation r = .939). Analysis of data collected from participants with chronic, non-arterial, leg ulcers (n = 40) is supportive of a statistically significant relationship between increased periwound skin temperatures and wound infection (P = 0.000).

Does infrared light therapy improve sensation in diabetics?

Lawrence A. Lavery; Douglas P. Murdoch; Jayme Williams; David C. Lavery, Scott & White Memorial Hospital

Objective: To determine the efficacy of Monochromatic Infrared Photo Energy (Anodyne) in-home treatments over a 90-day period to improve peripheral sensation and self-reported quality of life in persons with diabetes mellitus.
Methods: This was a double blind, randomized, sham-controlled clinical trail. We randomized 69 diabetics with sensory neuropathy demonstrated by vibration perception threshold between 20–45 V on the great toe and fifth metatarsal head on both feet into 2 treatment groups. Sixty patients (120 limbs) completed the study. Patients were randomly assigned to an active or sham treatment groups. Anodyne units were used at home every day for 40 minutes for 90 days. We evaluated nerve conduction velocities, vibration perception threshold, Semmes Weinstein Monofilaments (SWM) (4-, 10-, 26-, and 60-g monofilaments), the Michigan Neuropathy Screening Instrument (MNSI), 10-cm visual analog pain scale, and the Neuropathy Quality of Life Instrument.
Results: Sixty-nine subjects were enrolled, and 60 subjects completed the study. There were no differences in measures for quality of life, Neuropathy Disability Score, Michigan Neuropathy Screening Instrument, VPT, SWM, or NCV's in active or sham treatment groups (P > 0.05).
Summary: Anodyne therapy was no more effective than sham therapy in the treatment of sensory neuropathy in persons with diabetes.

Effects in diabetic midfoot Charcot deformity with wounds after posterior tibial tendon reconstruction using acellular regenerative tissue matrix

Daniel Lee, DPM; Gerit Mulder, DPM, MS, University of California, San Diego