Skin graft monitoring using forward-looking infrared thermal imaging

This study examined the feasibility of non-invasive infrared thermography to monitor skin graft viability. Sixty-three patients with skin defects attending a single institution from May 2022 to August 2023 were included. Patients underwent full-thickness or split-thickness skin grafts based on clinical indication. Infrared thermal images were obtained on postoperative days 0, 2, 4, 6 and 8. The temperature difference between the skin graft and surrounding normal skin was assessed using image analysis software. All 33 patients with full-thickness skin grafts showed successful healing. Among the 30 patients with split-thickness skin grafts, 7 experienced failure. The groups with successful full-thickness and split-thickness skin grafts exhibited a gradual increase in graft temperature, peaking on postoperative day 6 and decreasing on postoperative day 8. Temporal temperature changes were significant in each patient group (p < 0.001), and the differences in temperature change patterns between the two groups with successful grafts and the group with graft failure were also significant (p < 0.001). On postoperative day 6, the temperature difference was highest in the full-thickness skin graft group (0.197 ± 0.335°C), followed by the successful split-thickness skin graft group (0.426 ± 0.428°C), and the split-thickness skin graft group with graft failure (−2.100 ± 0.361°C). In conclusion, infrared thermal imaging can provide a non-invasive real-time assessment of graft status and predict graft success or failure.