Proposed Topic (Most preferred): :
Research and Innovations (new projects / technology / innovations / service models)
Proposed Topic (Second preferred): :
Clinical Safety and Quality Service II (Projects aiming to enhance clinical safety and outcomes, clinical governance / risk management)
Authors (including presenting author) :
Koo SC, Wong HH, Szeto SL
Affiliation :
Department of Orthopaedics and Traumatology, Alice Ho Miu Ling Nethersole Hospital
Introduction :
Missing a case of vascular injuries can have great impact on both patient and surgeon as delayed treatment can lead to finger necrosis that necessities finger amputation which has medicolegal implications.
Current assessment of finger vascular injuries often requires surgeon's experience and is subjective. Injuries to the finger’s arteries shut down the blood supply of distal finger segment and hence decrease the temperature of the affected segment. Infrared thermography camera captures infrared radiation and convert them to images in which temperature values are proportional to pixel values. The obtained image can be taken as a marker for finger blood flow. No research has been done to use handheld infrared thermography camera in the identification of finger injuries that necessities revascularization surgery to save the finger.
Objectives :
To assess the accuracy of handheld infrared thermography camera as an adjunct to standard clinical methods in assessing the severity of vascular injury in finger and determining the need for urgent revascularization surgery.
Methodology :
During clinical assessment of patients with traumatic finger injury, a digital thermal photo was taken using the handheld infrared thermography camera. The condition of the digital artery was assessed during subsequent surgical exploration for surgical repair of finger injury. The results of the digital thermal photo and the surgical exploration finding were compared to determine the accuracy of handheld infrared thermography camera detecting vascular injury in finger that required urgent revascularization surgery.
Result & Outcome :
From 1st December 2022 to 31st December 2023, there were 45 patients having traumatic finger injury attended Alice Ho Miu Ling Nethersole Hospital recruited, with mean age of 42, and male-to-female ratio of 8:1. 4 patients had artery injury that required revasularization, and all were correctly detected by infrared thermography camera. There were in total 4 true positive, 40 true negative, 1 false positive and 0 false negative. The handheld infrared thermography camera had 100% sensitivity and 97.6% specificity. The positive predictive value was 80% and negative predictive value was 100%. It had 97.8% diagnostic accuracy.
Conclusion:
Using handheld infrared thermography camera is an accurate, objective, low-cost, user-friendly, and non-invasive method that helps surgeons assess severe vascular injury in fingers and differentiate which patient requires urgent revascularization surgery.
