New Application for the Early Detection of Wound Infections Using a Near-Infrared Fluorescence Device and Forward-Looking Thermal Camera

Abstract

Background: Timely and accurate identification of wound infections is essential for effective management, yet remains clinically challenging. This study evaluated the utility of a near-infrared autofluorescence imaging system (Fluobeam®, Fluoptics, Grenoble, France) and a thermal imaging system (FLIR®, Teledyne LLC, Thousand Oaks, CA, USA) for detecting bacterial and fungal infections in chronic wounds. Fluobeam® enables real-time visualization of microbial autofluorescence without exogenous contrast agents, whereas FLIR® detects localized thermal changes associated with infection-related inflammation. Methods: This retrospective clinical study included 33 patients with suspected wound infections. All patients underwent autofluorescence imaging using Fluobeam® and concurrent thermal imaging with FLIR®. Imaging findings were compared with microbiological culture results, clinical signs of infection, and semi-quantitative microbial burdens. Results: Fluobeam® achieved a sensitivity of 78.3% and specificity of 80.0% in detecting culture-positive infections. Fluorescence signal intensity correlated strongly with microbial burden (r = 0.76, p < 0.01) and clinical indicators, such as exudate, swelling, and malodor. Pathogens with high metabolic fluorescence, including Pseudomonas aeruginosa and Candida spp., were consistently identified. Representative cases demonstrate the utility of fluorescence imaging in guiding targeted debridement and enhancing intraoperative decision-making. Conclusions: Near-infrared autofluorescence imaging with Fluobeam® and thermal imaging with FLIR® offer complementary, noninvasive diagnostic insights into microbial burden and host inflammatory response. The combined use of these modalities may improve infection detection, support clinical decision-making, and enhance wound care outcomes