Thermal Infrared Camera Imaging to Aid Necrotizing Soft Tissue Infections of the Genitalia Management

OBJECTIVE To determine if imaging with a thermal infrared camera might aid clinicians with diagnosis of equivocal necrotizing soft tissue infections of the genitalia (NSTIG) cases and help surgeons when determining appropriate surgical resection margins.MATERIALS/ METHODS For 12 months at a single tertiary academic hospital, sequential patients already undergoing explo-ration for acute scrotum had preoperative photography with an infrared camera (FLIR C5). We compared infrared and standard preoperative photography with operative reports and postopera-tive photography to investigate if infrared photography corresponded with operative findings in severe scrotal infections-specifically the viability of the skin and the ultimate surgical resection margins. RESULTS A total of 16 patients were included. The pre-operative infrared photos directly correlated with resection margins in 13 of 16 (81%) patients. Notably, areas with a relatively lower (cooler) infra-red intensity corresponded well to both visibly necrotic tissue when discrete and areas with large underlying fluid collections. Diffuse warm signal relative to surrounding skin correlated with cellu-litis and viable skin.CONCLUSION In this observational study, infrared photography corresponded well with physical exam and opera-tive findings. There may be a role for augmented temperature photography in the diagnosis and tri -age of scrotal infections. More research with standardized temperature gating of infrared signal and controls with normal or nonacute scrotums are needed to elucidate the clinical utility for infrared photograph.UROLOGY 175: 202-208, 2023. Published by Elsevier Inc.