A Comprehensive Scoping Review on the Use of Point‐Of‐Care Infrared Thermography Devices for Assessing Various Wound Types

ABSTRACT

This scoping review investigates the use of point‐of‐care infrared thermography devices for assessing various wound types. A comprehensive search across four databases yielded 76 studies published between 2010 and 2024 that met the inclusion criteria. The review highlights thermography applications in burns, surgical wounds, diabetic foot ulcers, pressure injuries, and other lower limb wounds. Key findings indicate its effectiveness in detecting early signs of inflammation and healing delays, facilitating timely interventions. The technology shows promise in accurately predicting wound healing trajectories and assessing treatment outcomes. Recent advancements have made thermographic devices more affordable and user‐friendly, expanding their clinical potential. However, challenges persist, including reimbursement, training requirements, and integration with electronic medical records (EMRs), with EMR integration identified as a critical barrier to widespread adoption. While preliminary findings are promising, the current evidence base is constrained by small sample sizes, retrospective study designs, and limited consideration of skin tone variability. Large, prospective studies are essential to validate the clinical utility of thermography in wound care and to inform the development of standardised protocols that support equitable, bias‐reduced assessment across diverse populations. Addressing these gaps is critical for advancing research, enhancing clinician training, and improving patient outcomes in wound care. Overall, point‐of‐care thermography demonstrates significant potential to enhance wound assessment and monitoring, thereby elevating care quality and patient outcomes.

Summary.

• Point‐of‐care thermography is a non‐invasive imaging technique that can detect early signs of inflammation and healing delays in various wound types, including burns, surgical wounds, diabetic foot ulcers, and pressure injuries.

• This scoping review analysed 76 studies published between 2010 and 2024 from four databases to examine the applications of point‐of‐care infrared thermography devices in wound assessment.

• Recent advancements have made thermographic devices more affordable and user‐friendly, expanding their clinical use in wound care.

• Point‐of‐care thermography has shown promise in predicting wound healing outcomes and guiding treatment decisions across different wound types, including burns, surgical wounds, diabetic foot ulcers, and pressure injuries.

• Current research on thermography in wound care lacks focus on racial equity and skin tone variability, highlighting the need for future studies to address this gap and develop standardised protocols for equitable wound assessment.

• Integration with electronic medical records (EMRs) remains a critical challenge for broader adoption, along with reimbursement and training requirements.

1. Introduction

Over the past decades, significant advancements in technology have revolutionised wound management. Thermography, a non‐contact imaging technique, has emerged as a promising tool in wound care by visualising skin surface temperatures through the detection of infrared radiation emitted by the skin, creating a real‐time thermal profile of the area (Figure 1). This method measures skin surface temperature at the bedside, providing indirect information on blood flow and tissue viability [1].

FIGURE 1.

Wound images from a patient with darker skin tone. The top image shows an ulcer of mixed aetiology, while the bottom image depicts an arterial ulcer. Photographs were taken with both white light and thermography (absolute temperature and temperature gradient). Images were collected and are presented with patient consent.

Temperature variation is a clinically significant marker in wound healing, providing valuable, objective information about the physiological status of wounds and their surrounding tissue. Quantitative temperature assessment—particularly through non‐invasive methods—has emerged as a powerful adjunct to traditional visual and tactile wound assessment, offering clinicians early and actionable insights into the wound healing trajectory [2, 3]. Upon wound formation, local temperature typically rises during the initial inflammatory phase, peaking within the first 3–4 days, and then gradually returns to baseline as healing progresses. A steady decline in wound temperature after the first week generally indicates favourable healing, while persistently elevated temperatures are often associated with excessive inflammation, signalling the need for urgent clinical intervention [3, 4]. Conversely, abnormally low wound temperatures can impair cellular activity, reduce collagen deposition, and delay healing, particularly if temperatures fall below critical thresholds such as 33°C, which is necessary for optimal neutrophil, fibroblast, and keratinocyte function [3].

Peer‐reviewed studies have demonstrated that temperature differences between the wound bed, periwound, and contralateral healthy skin can predict healing outcomes across a range of wound types, including surgical wounds, burns, diabetic foot ulcers (DFUs), and pressure injuries. A decrease in wound temperature during the second week post‐injury is associated with positive healing trajectories, while sustained or rising temperatures may indicate delayed healing or complications [5, 6, 7]. In burns and DFUs, a temperature difference greater than 1°C between the wound and adjacent or contralateral skin has been shown to predict impaired healing, guiding clinicians in early intervention and personalised care planning [2, 8] (Figure 2).

FIGURE 2.

Wound images from a patient with lighter skin tone. The top image shows an arterial ulcer, while the bottom image depicts a diabetic foot ulcer. Photographs were taken with both white light and thermography (absolute temperature and temperature gradient). Images were collected and are presented with patient consent.

Recent advances have made thermal imaging cameras more affordable, portable, and user‐friendly, enabling the development of point‐of‐care thermal imaging devices that are practical for clinical settings [2, 9]. This increased accessibility has expanded the potential of thermography in wound assessment and monitoring. Moreover, with the integration of artificial intelligence software, the applications of thermography in wound management continue to rapidly evolve [10].

Trained clinicians now use these point‐of‐care devices to capture real‐time thermal images of wounds and peri‐wound areas, which can be uploaded to the patient's chart, providing a more objective and precise approach to wound monitoring [11]. In addition to visually assessing and measuring the wound bed, thermography offers insights that are not visible to the naked eye, revealing crucial details about wound temperature, temperature patterns, and underlying tissue changes [11]. Thermograms detect minute temperature variations that can signal healing progress, the onset of inflammation, or new tissue necrosis, often before clinical symptoms appear, allowing for earlier interventions and more effective wound care management [12, 13].

The use of thermography in wound care is becoming increasingly recognised across various healthcare disciplines and is now utilised in settings ranging from long‐term care homes to acute care hospitals and multidisciplinary outpatient clinics [11, 13, 14, 15, 16]. Thermography has been adopted for a wide range of patient populations and wound types, including pressure injuries, surgical wounds, burns, and DFUs [11, 15, 16, 17].

Despite its growing potential, the integration of thermography in wound care and clinical practice faces several challenges, limiting its role in wound management to a generally experimental one. Financial constraints related to device acquisition, technological infrastructure, and staff training remain barriers to broader adoption. Additionally, the need for secure electronic medical record (EMR) systems that support image uploading and ensure clinician proficiency in device use are critical for effective implementation [11].

Considering these advancements and challenges, this scoping review focuses specifically on point‐of‐care thermal imaging devices and synthesises evidence across a broad range of wound types. By mapping out the existing literature, assessing current technological and clinical factors, and identifying research gaps, we aim to provide a comprehensive overview of how point‐of‐care thermography is being applied in wound care and to explore its potential for improving clinical outcomes and advancing equitable healthcare delivery.

2. Methods

2.1. Protocol and Registration

This scoping review was conducted in accordance with the Arksey and O'Malley framework for scoping reviews [18]. Reporting was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis extension for Scoping Reviews (PRISMA‐ScR) (Figure 3 and Table S1) [19, 20]. The protocol was published prior to starting the review process on Open Science Framework (OSF); additional material was later updated in accordance with the iterative nature of a scoping review method [20].

FIGURE 3.

PRISMA‐ScR flowchart illustrates search results and study selection process.

All studies evaluating the assessment of wounds in humans using point‐of‐care infrared thermography have been considered. The population is human studies. The concept is clinical studies investigating the use of point‐of‐care infrared thermography devices for assessing wound healing. The context was clinical, ambulatory, or pre‐clinical sites.

2.2. Database Search and Eligibility Criteria

The databases searched were Medline, Embase, CINAHL, and Cochrane Library. The first author conducted the literature search of each database in collaboration with an experienced librarian (June 29, 2023). The reference list of all included sources of evidence was screened for missed additional relevant studies. Based on the Medline search strategy in Table 1, the searches in the other databases were adapted. When suitable, we used controlled vocabulary terms (e.g., Medical Subject Headings (MeSH)) and free text words, combined with Boolean operators and truncations. Only studies involving human subjects, written in English, and published within 15 years of the search date were included.

TABLE 1.

Search strategy in Medline.

Search step	Search string	Results
1	exp Thermography/or thermograph*.mp.	10 911
2	infrared imag*.mp.	3324
3	heat imag*.mp.	11
4	thermal imag*.mp.	2660
5	multispectral imag*.mp.	1579
6	1 or 2 or 3 or 4 or 5	16 919
7	wound*.mp. or exp surgical wound/or exp wound healing/or exp surgical wound Infection/or exp surgical wound Dehiscence/or exp wound infection/	469 190
8	burn.mp. or exp burns/	75 579
9	burns.mp.	69 686
10	pressure injur*.mp.	1835
11	pressure sore*.mp.	3265
12	bed sore*.mp.	243
13	7 or 8 or 9 or 10 or 11 or 12	535 796
14	6 and 13	552
15	Animals/	7 182 855
16	Humans/	20 818 421
17	15 not (15 and 16)	5 022 897
18	14 not 17	613

The inclusion criteria for study selection were primary sources, peer‐reviewed literature, English language, participants being human, published within 15 years of the search date, and studies evaluating wounds using point‐of‐care non‐contact infrared thermography. The exclusion criteria were: studies published > 15 years before the search date (due to the rapid advancement of the technology, these were deemed less relevant to clinical applications today), grey literature, secondary sources, studies investigating conditions other than wounds, studies that are wound‐adjacent, or studies that are preventative and do not include actual wounds.

Primary sources with all study designs were included, such as experimental studies, pilot studies, randomised controlled trials, non‐randomised controlled trials, case control studies, cohort studies, and case series.

2.3. Screening Process and Data Extraction

All references were transferred and stored into Zotero (Center for History and New Media, George Mason University, Fairfax, VA, USA), and duplicates were removed using the built‐in software. The title‐abstract screening process was done using Covidence. Three authors (SR, TO, DO) screened these papers using the eligibility criteria from the protocol. Conflicts were resolved by a researcher (RF). Full texts were obtained from the remaining references, and these were reviewed by four participating researchers (SR, TO, DO, JT) following the same procedure, with RF again resolving conflicts. The process is presented in Figure 3 as Preferred Reporting Items for Systematic Reviews and Meta‐analyses extension for scoping review (PRISMA‐ScR) flow diagram.

Data was extracted into a pre‐designed and pre‐tested spreadsheet by three researchers (SR, DO, TO) and reviewed by a fourth researcher (RF). The electronic laboratory notebook platform was not used. Data items that were extracted included: author(s), title, journal, year of publication, country of publication, purpose, information on study design and participants, sample size, thermography device used, intervention (if applicable), comparator, outcomes, key findings, and limitations. A meta‐analysis was not performed because the objective was to identify, map, and summarise the current knowledge and evidence. Additionally, a quality assessment was not conducted, as it would be inconsistent with the scoping review methodology.

The data was summarised and presented in a tabular and narrative format in the results section. The studies were divided according to characteristics including publication year, continent, wound type, participant type, and care setting. The studies were also mapped according to wound type, study description, and outcomes relevant for clinical applications of thermography.

3. Results

3.1. Overview of Included Studies

A total of 76 studies were included in the analysis. The studies covered various applications of thermography, including burns (21.1%, 16/76), surgical wounds (21.1%, 16/76), DFUs (17.1%, 13/76), pressure injuries (13.2%, 10/76), multiple wound types (9.2%, 7/76), other lower limb wounds (15.8%, 12/76), and other wound types (2.6%, 2/76) (Table 2). Additional details on study characteristics, including publication year, geographic location, participant types, and care settings, are provided in Tables 3, 4, 5.

TABLE 2.

Study characteristics.

Characteristic	Number of studies
Publication year interval
2008–2010	1
2011–2013	12
2014–2016	13
2017–2019	20
2020–2022	27
2023–2025	3
Continents
Africa	1
Asia	14
Europe	35
North America	20
South America	1
Oceania	5
Wound type
Burns	16
Foot wounds in patients with diabetes	13
Other lower limb wounds	12
Pressure injuries	10
Surgical wounds	16
Multiple wound types	7
Other wound types	2
Participant type
Patients or wound images from patients	69
Clinicians alone or together with patients	6
Simulated cases or wound models	1
Care settings
Acute care settings including outpatient clinics	56
Acute care and community settings	2
Burn unit	9
Simulated context for research	4
Long‐term care settings (nursing home/facilities)	5

TABLE 3.

Summary of study characteristics and key findings for clinical applications of thermography in wound care.

Wound type	Number of studies	Median sample size (range)	Studies with control group n/N (%)	Main outcomes evaluated	Key findings summary
Burns	16	34 (5–50)	10/16 (63%)	Burn depth assessment, Healing time prediction	Thermography predicts burn depth and healing time with good sensitivity and specificity; machine learning models improve prediction.
Diabetic foot ulcers (DFUs)	13	24 (1–100)	7/13 (54%)	Healing prediction, Infection risk assessment	3°F (~1.67°C) temperature difference predicts wound‐related infection; 3D thermography and machine learning improve early detection and classification.
Pressure injuries	10	50 (28–308)	7/10 (70%)	Early detection of pressure injuries, healing prediction	Higher wound bed temperatures predict better healing; thermography identifies deep tissue injuries before visible signs.
Surgical wounds	16	53 (18–530)	12/16 (75%)	SSI detection, wound healing monitoring	Temperature gradients predict surgical site infections; early ‘cold spot’ detection correlated with infection risk.
Other lower limb wounds	12	56 (12–124)	8/12 (66%)	Ulcer healing prediction, treatment monitoring	Temperature patterns differentiate healing versus non‐healing ulcers; AI and thermal imaging predict healing trajectories.
Mixed wound etiologies	7	30 (6–142)	4/7 (55%)	Inflammation detection, wound healing assessment	Thermography detects temperature variations linked to wound infection, inflammation, and healing, with improved precision using overlay systems.
Other wounds	2	17 (9–17)	1/2 (50%)	Ischemia detection, healing monitoring	Thermography and LDI complement each other in monitoring ischemia and ulcer healing; effective for small sample studies in digital ulcers.

Note: This table presents the distribution of studies by wound type, sample sizes, control group usage, main clinical outcomes evaluated, and summarises the key findings relevant for clinical applications.

TABLE 4.

Summary of key temperature differences and associated wound healing outcomes.

Article	Wound type	Temperature difference	Clinical interpretation
Carrière et al. [21]	Burns	ΔT cutoff 0.6°C (healing < 14 days)	Predicts faster healing
Ganon et al. [22]	Burns	ΔT 1.2°C at days 8–10	Deep burns healing > 15 days
Hardwicke et al. [23]	Burns	Wound cooler by 2.3°C vs normal skin	Indicates full‐thickness burn
Jaspers et al. [24]	Burns	ΔT of 0.07°C between burn and healthy skin	Predicts need for surgical intervention
Jaspers et al. [25].	Burns	ΔT cutoff 1.15°C (healing < 21 days)	Predicts faster healing
Singer et al. [23]	Burns	Persistently elevated temperature post‐burn	Indicates deep burns needing surgery
Simmons et al. [26]	Burns	Slower rewarming after cooling	Predicts need for grafting
Heyboer et al. [27].	DFU	Post‐HBO2 therapy increased temperature	Predicts positive response to HBO2 therapy
Chanmugam et al. [28]	Mixed Wound Types	1.1°C–1.2°C increase	Normal healing pattern
Chanmugam et al. [28]	Mixed Wound Types	1.5°C–2.3°C increase	Associated with inflammation
Chanmugam et al. [28]	Mixed Wound Types	4°C–5°C increase	Associated with infection
Chang et al. [29]	Other lower Limb Wounds	Temperature difference > 1.3°C post‐endovascular therapy	Predicts freedom from major amputation
Oohashi et al. [30]	Pressure Injuries	Higher temperature at healed site compared to periwound area	Predicts pressure injury recurrence within 2 weeks
Childs et al. [31]	Surgical Wounds	Temperature drop > 2°C at surgical incision site	May predict surgical site infection
Luze et al. [32]	Surgical Wounds	Intraoperative temperature < 26°C	Strongly associated with an increased risk of wound‐healing disorders and mastectomy‐skin‐flap necrosis

Abbreviations: CLI, critical limb ischemia; DFU, diabetic foot ulcer; HBO₂, hyperbaric oxygen therapy.

TABLE 5.

Summary of individual study details and clinical outcomes, organised by wound type.

Study	Wound type	Device used	Sample size	Control group	Key temperature findings	Study description	Outcomes
Burke‐Smith et al. [33]	Burns	moorLDI2‐BI‐VR, FLIR E60, Scanoskin	20	No	Not specified quantitatively	20 patients with burn wounds were assessed using IRT, LDI, and SIA to evaluate burn severity and healing.	Thermography was effective in predicting healing outcomes and could distinguish between burns healing in under 14 days versus those requiring longer healing or grafting.
Carrière et al. [21]	Burns	FLIR ONE Pro	43	No	ΔT = 0.6°C (< 14 days), −2.3°C (> 21 days)	Assessed 43 burn wounds using a handheld thermal imager and compared results to LDI as a reference.	Strong correlation with LDI; thermal imaging showed 95% specificity in both thresholds, proving valid and accessible.
Ganon et al. [22]	Burns	FLIR ONE	40	No	1.2°C threshold (day 8–10)	Pediatric burn patients were imaged to distinguish between different burn depths based on ΔT with healthy skin.	1.2°C threshold allowed 100% specificity for deep burns after 8 days, supporting early diagnosis.
Goel et al. [34]	Burns	FLIR ONE	45	No	Smartphone imager: sensitivity 66.7%, specificity 76.7%	Patients underwent thermal and Doppler imaging to assess burn depth and predict healing.	Smartphone thermal imaging had good predictive value, offering a practical tool in clinical settings.
Hardwicke et al. [35]	Burns	FLIR SC660	11	No	Full‐thickness: 2.3°C cooler; Deep partial: 1.2°C; Superficial: 0.1°C cooler	Thermal imaging was performed to quantify temperature differences for varying burn depths.	Provided a reliable, non‐invasive method to evaluate burn severity based on thermal gradients.
Janicki et al. [36]	Burns	FLIRm P660	Not specified	No	Temperature change correlated with burn depth	Infrared images were analyzed alongside histopathology to define burn depth using ΔT.	Established that skin temperature drop correlates with burn severity, enabling objective depth prediction.
Jaspers et al. [24]	Burns	Xenics Gobi‐384	50	Yes (LDI)	ΔT = −0.07°C (sensitivity and specificity 80%)	Reliability and validity of thermal imaging were tested against LDI as the gold standard.	ΔT thresholds effectively differentiated surgical vs. conservative treatment needs.
Jaspers et al. [25]	Burns	FLIR ONE thermal imager	50	No	1.15°C cut‐off (moderate validity)	Two observers assessed burns at different time points to evaluate consistency and healing.	FLIR ONE had high inter‐rater reliability but only moderate validity for predicting healing time.
Klama‐Baryła et al. [37]	Burns	Not specified	21	No	Temperature increase during normal graft healing	Infrared thermal imaging was used to evaluate burn depth and skin graft healing over time.	Demonstrated utility of thermal imaging in graft monitoring, confirmed by CTA.
Martínez‐Jiménez et al. [8]	Burns	Not specified	56	No	Algorithm accuracy 85.35%, κ = 90%	Developed a prediction algorithm using temperature differences for treatment needs (e.g., grafting, amputation).	Prediction model accurately classified healing outcomes, supporting clinical decision‐making.
Mazurek et al. [38]	Burns	Handheld thermal camera	32	No	Healed burns significantly warmer	Minimal and average temperatures were measured for healing vs. non‐healing wounds.	Thermography effectively predicted healing potential with strong inverse correlation to healing time.
Medina‐Preciado et al. [39]	Burns	Digital infrared thermal camera	13	No	Deep vs superficial burns show significant ΔT	Pediatric burns were compared with contralateral healthy skin and histopathology to validate burn depth assessment.	Accurately differentiated between burn depths; helped estimate grafting needs.
Simmons et al. [26]	Burns	Far infrared time‐lapse thermography	16	No	Slower rewarming in graft‐needed burns	Thermal imaging measured rewarming rates post‐cooling.	Successfully predicted graft requirement based on slower thermal recovery in deep burns.
Singer et al. [23]	Burns	Not specifies	39	No	ΔT trends on days 1–2 differentiate burn depth	Imaging within 48 h was used to classify burns and predict healing.	IRTI outperformed clinical assessment in early depth estimation; increasing temps = healing, decreasing = excision.
Wearn et al. [40]	Burns	Not specified	16	Yes (LDI)	LDI more accurate, but thermal faster and patient‐preferred	Assessed accuracy and preference between thermal imaging and LDI in early burns.	Thermal imaging showed promise for point‐of‐care depth assessment, despite lower accuracy than LDI.
Xue et al. [41]	Burns	Smartphone‐compatible thermal imager	5	Yes (ICG)	Correlated with ICG; overestimated by 1–2 cm	Compared thermal imaging with ICG angiography to identify viable tissue.	Smartphone thermal camera offered a strong proxy for more complex imaging, aiding surgical planning.
Aliahmad et al. [42]	DFU	Infrared thermal camera (unspecified)	26	No	Isothermal area ratio predicted healing	Segmented isothermal patches on thermal and color images at baseline, week 2, and week 4 to monitor DFU healing.	Isothermal area ratio was a strong predictor of 4‐week healing outcome, outperforming other measures.
Cassar et al. [43]	DFU	FLIR e‐series	20	Yes (pre‐ and post‐)	Post‐revascularization temp ↑	Assessed response to endovascular therapy in ischemic DFUs using thermal imaging.	Significant limb temperature rise post‐revascularization confirmed perfusion improvement.
De Souza Borges et al. [44].	DFU	Infrared thermography (unspecified)	30	No	Ulcer side +2.58°C vs. contralateral foot	Measured plantar skin temperature and vascular indices in DFU patients.	DFU side showed significantly higher temperature despite no vascular alterations via ABI.
Gatt et al. [45]	DFU	FLIR SC7200	57	Yes	Higher temps in neuroischemic feet	Compared thermographic differences in healthy, neuroischemic non‐ulcerated, and ulcerated toes.	Thermography differentiated DFU types but not ulcerated vs. non‐ulcerated toes of the same foot.
Heyboer et al. [27]	DFU	Long‐wave infrared thermography (LWIT)	24	Yes (TCOM)	Temp changes correlated with TCOM post‐HBO2	Investigated LWIT correlation with TCOM in patients undergoing HBO2 therapy.	LWIT temperature differentials matched TCOM readings and improved with HBO2 therapy.
Maddah and Beigzadeh [46]	DFU	FLIR ONE	7	No	Thermal conductivity varied by DFU subtype	Classified DFUs into three subtypes (inflammatory, vascular, metabolic) based on tissue thermal response.	Thermography distinguished DFU categories, showing early detection potential.
Sharma et al. [47]	DFU	Infrared camera (unspecified)	71 diabetic, 33 healthy	Yes	Accurate ulcer prediction using ML/CNN	Used ML and CNN models to assess DFU severity from thermal images.	Provided reliable, non‐invasive method for DFU severity classification.
Chanmugam et al. [28]	Mixed wound types	Scout System	6	Yes (healing vs. infected/inflamed)	Infection: ΔT 4°C–5°C; inflammation: 1.5°C–2.3°C	Small cohort evaluated for heat patterns of infection, inflammation, and healing.	Thermography clearly differentiated healing trajectories and complications.
Glik et al. [48]	Mixed wound types	FLIR E60	142	Yes (pre‐post HBOT)	Ulcer temp and area ↓ with HBOT	Thermography used alongside planimetry to monitor hyperbaric oxygen therapy.	Confirmed reduced ulcer size and surface temperature after treatment.
Keenan et al. [49]	Mixed wound types	FLIR A325	11	Yes	Emissivity adjustment changed ΔT by ~0.83%	Examined how wound emissivity variations affect temp accuracy.	Emissivity correction increased measurement precision; critical for chronic wounds.
Langemo and Spahn [50]	Mixed wound types	Scout System	40 image pairs	Yes (reader comparison)	High consistency in wound edge mapping	Readers overlaid visual wound borders onto thermal images using the Scout system.	High precision and reproducibility confirmed device reliability for temp and wound size.
Langemo and Spahn [9]	Mixed wound types	Scout System	102 images	Yes (reader agreement)	Consistent temp readings across readers	Investigated intra‐ and inter‐reader reliability in thermal wound analysis.	Reliable temperature detection and wound monitoring confirmed with low variability.
Marina et al. [51]	Mixed wound types	FLIR E50 and FLIR ONE	12	No	Temp changes aided surgical planning	Used thermography pre‐ and post‐operatively to assess lacerations, burns, and DFUs.	Helped assess bone involvement and detect infection or ischemia during recovery.
Mendonça et al. [52]	Mixed wound types	FLIR T300	122	Yes (ulcer type comparison)	Distinct ΔT by ulcer type and size	Five ulcer types assessed with thermal, ABI, ROM, and pain data.	Lower temps noted in larger pressure ulcers; thermal profile varied by ulcer etiology.
Chang et al. [29]	Other lower limb wounds	Spectrum 9000‐MB Series	124	Yes	DIFF2 cutoff −1.30°C predicted healing	Used plantar temps to predict healing in critical limb ischemia post endovascular therapy.	Thermographic DIFF2 significantly associated with wound healing and limb salvage.
Cwajda‐Białasik et al. [53]	Other lower limb wounds	FLIR T650	53	Yes (regions of interest)	Periwound skin temp correlated with infection	Thermal patterns in ulcer, periwound, and control areas assessed for vascular and infectious status.	ΔT helped predict healing and early infection signs in chronic venous ulcers.
Dahlmanns et al. [54]	Other lower limb wounds	VarioCAM HD head 800	36	Yes (CVD staging)	Localized temp patterns matched disease stage	Examined leg temp patterns in chronic venous disease with and without ulcers.	Temp variations within small distances corresponded to ulcer status and disease progression.
Delaney et al. [55]	Other lower limb wounds	Not specified	12	Yes	Higher temp in ulcer centers	Compared blood flow and temps between ulcerated and non‐ulcerated areas in sickle cell patients.	Ulcer centers had highest perfusion and temp; periwound warmer than remote tissue.
Dini et al. [56]	Other lower limb wounds	FLIR T620	18	Yes (WBS correlation)	Higher wound bed temps correlated with WBS	Assessed venous ulcers using wound bed scores (WBS) and thermal readings.	Found a positive correlation between wound temp and WBS, supporting thermal monitoring.
Englisz‐Jurgielewicz et al. [57]	Other lower limb wounds	FLIR E60	60	Yes (HBOT treatment cycles)	Periwound temp ↓ with treatment cycles	Monitored venous ulcer temp changes across HBOT sessions.	Temperature decreased with HBOT, suggesting improved healing and inflammation resolution.
Hashmi et al. [58]	Other lower limb wounds	FLIR SC620	30	Yes (contact thermometry)	Friction blisters showed increased skin temps	Evaluated thermography's ability to detect early changes during blister formation due to load application.	Thermography quantified skin temp changes as a surrogate for inflammation, supporting its remote‐use potential.
Monshipouri et al. [59]	Other lower limb wounds	ULIRVISION TI160	72	Yes (healing outcome)	Texture patterns at week 2 predicted non‐healing	Used textural thermal features to classify wound healing trajectories in venous leg ulcers.	Texture analysis enabled early prediction of wounds unlikely to heal.
Ngo et al. [60]	Other lower limb wounds	ULIRVISION TI160	56	Yes (3‐week vs week 0 prediction)	AI model predicted healing earlier than clinical signs	Developed AI model to predict venous ulcer healing using baseline thermal images.	Week 0 prediction model outperformed standard 3‐week clinical assessments.
Ogrin et al. [61]	Other lower limb wounds	Fluke‐TiR1	78	Yes	No predictive temp pattern found	Thermal imaging was used over 12 weeks to assess venous leg ulcer progression.	Thermography was not predictive of healing progression in VLUs.
Taradaj et al. [62]	Other lower limb wounds	MobIR 3	106	Yes (physical therapies compared)	Compression therapy increased ulcer temps	Measured temps after compression, high‐voltage stim, and laser therapy.	Compression improved microcirculation; others had no significant thermal impact.
Bilska et al. [63]	Pressure injuries	VIGOcam v50	43	Yes (LLLT vs control)	Greater healing in LLLT group with temp pattern shifts	Compared temperature distribution in stage III/IV ulcers with vs without laser therapy.	LLLT led to more effective healing with distinct thermographic changes.
Farid et al. [64]	Pressure injuries	FLIR i7	85	Yes (PRIDAS warm vs cool)	Cool PRIDAS sites associated with necrosis	Analyzed blanching, skin temp, and necrosis development in pressure areas.	Warm sites had 0% necrosis, while 65% of cool, non‐blanching sites developed necrosis.
Higashino et al. [65]	Pressure injuries	Thermotracer TH5108ME	28	Yes	High temps with hypoechoic areas = deep injury	Retrospective analysis of early‐stage pressure ulcers using two imaging modalities.	Co‐detection of elevated temp and ultrasound hypoechogenicity predicted deep tissue injury.
Kanazawa et al. [66]	Pressure injuries	Thermotracer TH7800N	22	Yes (ulcer development)	Lower edge temps predicted undermining (RR = 4.0)	Investigated if wound edge temps could forecast undermining in pressure ulcers.	Cooler edge temps significantly associated with future undermining development.
Koerner et al. [67]	Pressure injuries	Scout System	308	Yes (pre/post‐intervention)	Early temp anomalies reduced HAPIs by 60%	ICU patients were assessed for temperature anomalies to prevent hospital‐acquired pressure injuries (HAPIs).	Thermography enabled early detection of deep tissue injuries and reduced HAPIs significantly.
Lin et al. [68]	Pressure injuries	FLIR C3	50	Yes (healing vs non‐healing)	Higher periwound temps linked to better healing	Studied temperature of wound bed, periwound, and normal skin in grades 2–4 pressure ulcers.	Higher periwound‐to‐wound bed temp ratio was predictive of better healing outcomes.
Nakagami et al. [69]	Pressure injuries	Thermotracer TH5108ME	35	Yes (3‐week healing outcome)	Ulcer temps predictive of 3‐week healing status	Evaluated temp‐based ulcer classification for prognosticating healing.	Thermographic classification correlated with healing outcomes, even before visual differences appeared.
Nakagami et al. [70]	Pressure injuries	Not specified	37	Yes	High temp + unclear ultrasound structure = delayed healing	Investigated combined thermographic and sonographic predictors of pressure ulcer healing.	Combo of temp increase and unclear layered structure was useful in predicting delayed healing.
Oohashi et al. [30]	Pressure injuries	Thermo Shot F30	30	Yes (2‐week recurrence)	Higher temps at healed sites predicted recurrence	Studied healed pressure injuries to detect thermographic predictors of recurrence.	Healed areas with higher temps were more likely to show recurrence within 2 weeks.
Simman and Angel [71]	Pressure injuries	Scout System	70	Yes (visual vs temp detection)	LWIT detected temp changes pre‐visual signs	Longitudinal thermal imaging of sacrum and heels for early detection of deep‐tissue pressure injuries.	Thermography identified anomalies before visual signs, aiding early intervention.
Batinjan et al. [72]	Surgical wounds	FLIR T335	40	Yes (aPDT vs no aPDT)	aPDT group had significantly lower wound temps	Assessed laser‐treated vs untreated third molar surgery sites.	aPDT group showed reduced inflammation and improved healing on day 3.
Childs et al. [31]	Surgical wounds	FLIR T450sc	20	Yes (infected vs uninfected)	Cold spots > 2°C linked to SSI	Investigated thermal patterns post‐cesarean delivery to detect surgical site infections.	Cold spot presence by day 2 was associated with later SSI diagnosis.
Childs et al. [73]	Surgical wounds	FLIR T450sc	53	Yes (day 2, 7 outcome)	Low abdominal temps predicted SSI (77% day 2, 70% day 7)	Explored thermographic mapping to predict SSI post‐cesarean section.	Temperature mapping enabled early identification of women at risk, especially obese women.
Fletcher et al. [74]	Surgical wounds	SEEK Thermal Compact	530	Yes	AUC = 0.90, Sens = 95%, Spec = 84%	Evaluated algorithm trained on smartphone thermal images to detect surgical site infections.	High accuracy and predictive value for SSI detection using smartphone imaging + ML.
Li et al. [75]	Surgical wounds	T3Pro	40	Yes (post‐op progression)	Detected temp changes indicating healing or complications	Assessed thoracic surgical incisions post‐op using thermal imaging.	Thermography identified early temperature changes reflective of healing trajectory and possible complications.
Luze et al. [32]	Surgical wounds	FLIR ONE	15	Yes (complication vs no)	Temps < 26°C linked to necrosis risk	Used intraoperative thermal imaging during mastectomy and reconstruction to assess perfusion risk.	Intraoperative low temps were associated with increased risk of wound‐healing complications and necrosis.
Naji et al. [76]	Surgical wounds	FLIR A65 and FLIR E95	18	Yes	Enabled spatiotemporal monitoring intraorally	Evaluated post‐orthodontic intraoral wound healing.	Thermography provided non‐contact, quantitative visualization of intraoral healing over time.
Nergård et al. [77]	Surgical wounds	FLIR thermacam S65 HS	17	Yes (pre/post)	Changes in skin perfusion linked to wound healing	Assessed abdominal skin perfusion during flap breast reconstruction.	Internal mammary artery use affected perfusion and potentially wound healing.
Phillips et al. [78]	Surgical wounds	FLIR ONE	19	Yes (flow compromised vs normal)	Temp drops indicated microvascular compromise	Explored mobile thermal imaging for assessing DIEAP flap perfusion.	Thermography served as surrogate for blood flow and early indicator of micro‐anastomotic compromise.
Prey et al. [79]	Surgical wounds	FLIR ONE	177	Yes (infection vs no)	Could stratify incision types, not infections	Attempted ML detection of SSI from surgical thermal images.	Low infection rate limited SSI model, but algorithm classified surgical incisions effectively.
Rabbani et al. [80]	Surgical wounds	FLIR ONE	84	Yes (flaps with/without vascular insult)	Failed to detect vascular insult before clinical signs	Thermal imaging was used adjunctively to detect vascular issues in surgical flaps.	Clinical signs outperformed thermography in early detection, though thermography was still useful as an adjunct.
Rahbek et al. [81]	Surgical wounds	FLIR C3	231 pin sites	No	ICC for intra‐rater reliability: 0.85	231 pin sites from orthopedic patients with external fixators were assessed to explore the capability and intra‐rater reliability of digital thermography in detecting pin site infections.	Digital thermography with a hand‐held FLIR C3 camera reliably detected pin site infections, with intra‐rater agreement measured by ICC at 0.85.
Romanò et al. [82]	Surgical wounds	NEC‐Avio Thermo Shot F30S	80 (40 hip, 40 knee)	No	Peak temperature difference at 3 days, normalizing by day 90	40 patients undergoing total hip replacements and 40 patients undergoing total knee replacements were evaluated to assess telethermographic patterns of surgical site healing.	Similar telethermographic patterns were found in the healing of surgical sites for both total hip and knee replacements, with peak temperature differences observed three days postoperatively, gradually normalizing by 90 days.
Romanò et al. [83]	Surgical wounds	NEC‐Avio Thermo Shot F30S	55 (40 no infection, 15 infected)	Yes	Persistent elevated temperatures in infected patients	40 patients without infection and 15 patients with postsurgical periprosthetic infection were compared to establish reference telethermographic patterns for wound healing after total knee replacement (TKR).	A reproducible telethermographic pattern was found in uncomplicated TKR patients, with a significant increase in temperature postoperatively that normalized within 90 days, whereas patients with septic complications showed a persistent elevated mean differential temperature.
Siah and Childs [84]	Surgical wounds	FLIR T640	40	Yes (30 healthy)	‘Cold spots’ seen in infected wounds; warming trend in non‐infected wounds	40 patients (30 healthy and 10 post‐enterostoma closure) were assessed using thermal imaging to map abdominal skin temperatures and identify thermal characteristics of infected versus non‐infected wounds.	Infected surgical wounds exhibited 'cold spots' on the thermal maps, while non‐infected wounds showed a progressive 'warming' pattern, suggesting that thermography can differentiate between infected and non‐infected wounds.
Siah et al. [17]	Surgical wounds	Not specified	60	No	Lower temperature in infected wounds vs. non‐infected; partial warming around incision	60 patients after enterostoma closure were analyzed for infrared thermal patterns and surface temperature readings of surgical wounds to detect delayed wound healing within four days post‐surgery.	Infected surgical wounds exhibited significantly lower temperatures than non‐infected wounds, with partial warming of the skin surrounding the incision, suggesting delayed healing could be identified within the first four days post‐surgery.
Murray et al. [85]	Other wound types	Agema Thermavision 570	17	No	Perfusion improved with ulcer healing; thermography confirmed ischemia	17 patients with systemic sclerosis and digital ulcers were assessed using laser Doppler imaging and thermography to identify ischemic components in both fingertip and extensor surface ulcers and to evaluate ulcer healing.	LDI and thermography were effective in monitoring ischemia, which reduced with ulcer healing, although laser Doppler imaging was better suited to monitoring changes in perfusion with healing due to better imaging resolution.
Saito et al. [86]	Other wound types	Thermo Shot F30	9	No	Thermal patterns supported healing observation	9 patients with systemic sclerosis and digital ulcers were evaluated to assess the efficacy of extracorporeal shockwave therapy for promoting ulcer healing.	Thermography was useful in aiding the assessment of digital ulcer healing.

Although screening efforts for publications on thermography in wound care began in 2008, the first article meeting the inclusion criteria was published in 2010. Consequently, the data in Figures 4 and 5 start from 2010, reflecting the first relevant publication. Figure 4 shows a noticeable increase in the number of articles from the interval 2010–2012 to 2019–2021, with a peak of 28 articles in the latter period. However, there is a decline in the number of publications in the most recent interval (2022–2024), which could indicate a recent slowdown or a delay in publication trends. Figure 5 separates the number of publications by year intervals for each wound type, highlighting the most significant growth trends over time in publications related to DFUs, burns and surgical wounds.

FIGURE 4.

Number of publications on point‐of‐care thermography in wound care in the scoping review, using intervals of 2 years. Screening for relevant publications began in 2008; however, the first selected article appeared in 2010, as reflected in the graph.

FIGURE 5.

Number of publications on point‐of‐care thermography for each wound type in the scoping review, using 2‐year intervals. Screening for relevant publications began in 2008; however, the first selected article appeared in 2010, as reflected in the graph.

A summary of the key temperature thresholds and differences reported across studies, along with their clinical interpretations by wound type, is presented in Table 4. This table consolidates findings to highlight how variations in wound temperature are associated with specific wound healing outcomes and infection risks.

3.2. Burns

Burn injuries result from trauma caused by heat, friction, radiation, cold, chemical, or electrical sources. Thermography has been applied to burn injuries in 16 studies, focusing on predicting wound healing, classifying burn depth, and guiding management (Table 3).

Goel et al. demonstrated that a handheld thermal imager had a sensitivity of 66.7% and specificity of 76.7% in predicting burn healing within 21 days, compared to laser Doppler imaging (LDI), which had a sensitivity of 93.3% and specificity of 40.0% [16]. Burns healing within 21 days showed a mean temperature difference of 1°C from normal skin, consistent with findings by previous researchers [25, 34].

Hardwicke et al. found full‐thickness burns were 2.3°C cooler than non‐burnt skin, while deep partial thickness and superficial burns were 1.2°C and 0.1°C cooler, respectively [35]. Although thermography was less accurate than LDI in assessing burn depth, it provided significantly faster scanning times and was preferred by patients [40].

Jaspers et al. established a 0.07°C temperature difference as a reliable threshold (sensitivity 80%, specificity 80%) for distinguishing between burn injuries that could be treated conservatively or required surgical intervention (e.g., excision, grafting) [24].

3.3. DFUs

Patients with diabetes are prone to foot ulcers due to neurological and/or vascular complications. Thermography has been used in 13 studies to predict wound healing, identify at‐risk areas, and monitor treatment efficacy (Table 3).

Aliahmad et al. demonstrated that changes around DFUs visualised by thermography from week 1 to week 2 could predict the healing trajectory (p = 0.036) [42].

Van Doremalen et al. used 3D thermography to detect inflammation and predict ulceration risk; Cassar et al. showed that thermography could detect temperature increases in limbs treated with endovascular revascularisation, indicating treatment success [43, 87].

3.4. Pressure Injuries

Pressure injuries are localised tissue damage typically occurring over bony prominences due to prolonged pressure, with additional influences from shear and frictional forces. Thermography has been used in 10 studies to predict wound healing, detect early development, and prevent pressure injuries (Table 3).

Nakagami et al. found that pressure injuries with higher temperatures in the wound bed compared to periwound skin had a 2.25‐fold relative risk for delayed healing [69]. Nakagami et al., in another study, combined ultrasonography and thermography to assess pressure ulcers, finding that ulcers with increased temperature and unclear layered structure had a 6.85‐fold increased risk of delayed healing or deterioration [70].

Simman et al. showed that long‐wave infrared thermography could detect temperature changes in intact skin before visible pressure ulcer development [71]. Oohashi et al. determined that increased temperature at a healed site was associated with ulcer recurrence (odds ratio 101), with sensitivity and specificity of 84% and 90%, respectively, for recurrence within 2 weeks [30].

Koerner et al. demonstrated that providing wound prevention protocols based on thermal anomalies over bony prominences led to a 60% reduction in hospital‐acquired pressure injuries [88].

3.5. Surgical Wounds

Surgical wounds result from surgical procedures and can develop complications such as infection and delayed healing depending on bacterial load. Thermography has been applied in 16 studies to predict wound infection and healing disorders (Table 3).

Childs et al. found that a 1°C decrease in mean abdominal temperature was associated with a threefold increase in the risk of surgical site infection in post‐caesarean section patients [73]. Siah et al. observed that infected surgical wounds were cooler compared to non‐infected wounds, and ‘cold’ spots at the incision site as early as postoperative day 2 were associated with infection and delayed healing [17]. Rahbek et al. used thermography to predict orthopaedic pin site infection with a 34°C threshold, achieving 73% sensitivity and 67% specificity [81]. Luze et al. found that intraoperative temperatures < 26°C were associated with mastectomy skin flap necrosis [32].

3.6. Other Lower Limb Wounds

Thermography has also been applied to venous leg ulcers, ischaemic ulcers, and sickle cell disease leg ulcers in 12 studies, focusing on predicting wound healing and monitoring treatment efficacy (Table 3).

Chang et al. showed that a post‐endovascular therapy temperature difference threshold of 1.3°C predicted freedom from major amputation in patients with critical limb ischemia [29]. Cwajda‐Białasik et al. found that a 0.04°C decrease in temperature difference between ulcer and periwound skin was associated with a 1 cm² reduction in ulcer area [53]. Englisz et al. reported that decreasing temperature differences between ulcer and periwound skin with hyperbaric oxygen therapy sessions was associated with healing in venous leg ulcers [57].

3.7. Mixed Wound Etiologies

Thermography has been applied to wounds of mixed etiologies in seven studies, including chronic venous insufficiency ulcers, diabetic foot syndrome, and traumatic wounds, focusing on detecting inflammation, monitoring healing and enhancing diagnostic precision (Table 3).

Chanmugam et al. demonstrated that long‐wave infrared thermography could reliably differentiate between normal healing, inflammation, and infection based on distinct temperature differentials [28].

3.8. Other Wound Types

Murray et al. compared thermography and LDI for detecting ischemia in digital ulcers in systemic sclerosis patients [85]. Thermography identified 66% of ulcers as ischemic, with a median temperature difference of 0.98°C. While LDI showed higher sensitivity, thermography effectively monitored ulcer status and healing.

Saito et al. used thermography to evaluate the effect of extracorporeal shock wave therapy (ESWT) on digital ulcers, showing a significant reduction in ulcer size from a mean diameter of 10.9 mm to 2.5 mm after 20 weeks [86]. Thermography was effective in tracking healing and assessing ESWT's impact.

4. Discussion

4.1. Objectives of Research

This scoping review explored thermography's role in wound management, assessing its applications, technological advancements, and research gaps across 76 studies, including burns, surgical wounds, DFUs, pressure injuries, and other lower limb wounds. Key findings highlight its effectiveness in detecting early wound complications before clinical symptoms, enabling earlier interventions. Thermography also shows promise in predicting healing trajectories and assessing treatment outcomes with increasing accuracy. Despite its growing adoption and more affordable devices, challenges such as costs, training needs, and integrating EMR remain barriers to broader implementation.

4.2. Interpretation of Findings

Medical applications of thermography began emerging in the late 1960s, primarily to detect conditions such as breast cancer and vascular diseases by capturing thermal patterns indicative of abnormal blood flow or inflammation. Over the decades, thermography has evolved significantly, with wide applications within wound care to assess healing and monitor inflammation [72]. The technology has proven effective in predicting wound healing by measuring temperature variations in wound areas non‐invasively [42]. Thermography has been particularly valuable in managing acute DFUs and postoperative wounds, detecting early thermal changes before visible symptoms or complications appear [72]. Research has highlighted thermography's role in identifying chronic temperature increases that are associated with infection risk in DFUs, aiding timely clinical decision‐making [89, 90]. Additionally, it has shown promise in monitoring progression in pressure injuries, burns, and surgical wounds, facilitating early intervention and improving patient outcomes [90].

4.3. Comparison to Existing Techniques

Thermography has proven to be highly effective when compared to various imaging and non‐imaging techniques used in wound assessment. Traditional methods, such as bacterial swabbing and visual inspection, often fall short in detecting subclinical infections and can result in delayed diagnoses due to the several days required to obtain bacterial culture results. In contrast, thermography provides immediate feedback, allowing for quicker clinical decision‐making and early detection of wound deterioration, particularly in sensitive cases such as DFUs and pressure injuries [42, 89].

When compared to conventional imaging methods such as wound photography, thermography offers distinct advantages by providing real‐time physiological insights into inflammation. Studies show that thermography can detect temperature variations indicative of underlying infections, even when wounds appear visually improved; thus enhancing the thoroughness of wound evaluations [91].

Furthermore, thermography compares favourably with advanced imaging techniques such as spectrophotometric intracutaneous analysis and LDI. While LDI excels in assessing blood flow, thermography is more adept at identifying early‐stage infections [92]. Additionally, the non‐invasive nature of thermography reduces the risk of wound contamination, providing an advantage over more intrusive methods.

4.4. New Developments and Advancements

Recent advancements have significantly expanded the clinical applications of thermography, particularly with the integration of machine learning and temperature pattern recognition algorithms. Contemporary research highlights the ability of machine learning algorithms to analyse large datasets of thermographic images, improving the accuracy of wound outcome predictions. These algorithms enable the automated detection of atypical thermal patterns, enhancing clinicians' ability to make timely and informed decisions regarding wound management [21, 42, 91].

Improvements in temperature pattern recognition algorithms have further refined the identification of distinct thermal signatures associated with delayed healing. This automation has reduced variability in thermographic interpretation, making the technology more accessible to clinicians [92]. The development of portable and handheld thermography devices has increased their usability across various clinical settings, including home care and telemedicine [90].

Ongoing validation of these devices remains crucial. Researchers stress the importance of rigorous validation processes to ensure accuracy across diverse care environments and wound types, and drive broader adoption in clinical practice [90].

4.5. Clinical Applications

Thermography has proven effective in practical applications due to its non‐invasive nature and seamless integration into existing clinical workflows. In acute care settings, it supports continuous temperature monitoring during wound evaluations, enabling healthcare professionals to make timely adjustments to treatment plans and is particularly valuable for managing chronic wounds as regular monitoring is essential to prevent complications [90].

The technology's portability enhances its utility in home care and telemedicine. Portable thermographic devices enable remote wound monitoring, reducing the need for frequent clinic visits and allowing clinicians to obtain real‐time data from patients' homes [90]. This may be beneficial for maintaining care for elderly or less mobile patients, limiting travel and delays in referral to specialist appointments.

This minimises the risk of wound contamination and allows for earlier intervention. Early detection can improve patient outcomes and reduce overall healthcare costs [93].

4.6. Strengths and Limitations

The foremost advantage of thermography lies in its ability to provide immediate, non‐invasive insights into wound temperature, providing objective physiologic data. This capability provides insight for the early detection of infections, inflammation, and healing delays, giving clinicians critical information to address issues before they escalate into serious complications [89]. Thermography proves particularly effective in managing chronic wounds, where prompt intervention can prevent severe outcomes, such as amputations [90].

However, several challenges remain despite these benefits. The cost of thermographic devices, though decreasing, still represents a significant investment for smaller clinics and community health centers [90]. Accessibility remains an issue, particularly in rural areas where advanced medical technologies are less available.

Although thermography offers a promising, non‐invasive approach to wound assessment, the current clinical evidence base remains limited in several important respects. Most published studies are small, observational, or pilot in nature, with considerable heterogeneity in study design, patient populations, wound types, and outcome measures [94]. There is a notable lack of large, well‐controlled randomised trials directly comparing thermography to standard assessment methods or demonstrating improvements in patient outcomes.

Additionally, there is no universally accepted protocol for thermographic imaging in wound care, and variations in device calibration, imaging technique, and environmental conditions can affect results and limit comparability between studies [59, 94]. Many studies do not adequately control for confounding factors such as comorbidities or care setting, and some have methodological weaknesses that could introduce bias [59]. While thermography can reliably detect temperature anomalies associated with infection and delayed healing, firm evidence supporting its use for infection surveillance or as a standalone diagnostic tool is limited [94]. Thermography can produce false positives due to inflammation and benign conditions (e.g., post‐surgical hyperemia, physical activity), which can also elevate skin temperature and may mimic pathological findings [90]. Accurate readings also depend on precise calibration and stable environmental conditions, which can be challenging in certain care settings [92]. Without accurate clinical assessment, such false positives may result in unnecessary interventions, including empirical antibiotic use or premature surgical consultation.

Given this potential susceptibility to false positives, emerging evidence shows potential in combining thermal imaging with other adjunct modalities, such as bacterial fluorescence imaging or tissue oxygenation measurement. Bacterial fluorescence devices can highlight bacterial load in real time, and non‐invasive oxygenation assessment tools (e.g., near‐infrared spectroscopy or hyperspectral imaging) can offer critical data about perfusion and tissue viability. Integrating these modalities may enhance diagnostic accuracy, reduce diagnostic uncertainty, and guide more precise wound management decisions.

Another important consideration is the learning curve associated with the effective use of thermographic devices. Accurate image acquisition requires proper positioning, consistent distance, and awareness of environmental factors such as room temperature and lighting. Additionally, interpreting thermal images demands specific training and clinical experience. Without adequate education, even high‐resolution thermography can be misinterpreted, reducing diagnostic accuracy and contributing to both false positives and false negatives. Structured training programmes, clinical decision support tools, and standardized imaging protocols may help reduce inter‐operator variability and enhance clinical adoption.

However, one of the notable advantages of thermography is its potential to improve wound assessment across a range of provider experience levels. While expert users may extract more nuanced insights, even less experienced clinicians can benefit from thermography's ability to provide objective, quantifiable temperature data. This can help reduce the subjectivity inherent in traditional visual and tactile assessments, promoting more consistent evaluations. With appropriate onboarding and guided interpretation, thermography may serve as a valuable tool to elevate care quality and support clinical decision‐making even in settings with limited wound care specialisation.

This review highlights the integration of thermography into EMRs as a critical area for enhancing clinical adoption. While research and training are essential, the lack of seamless EMR integration limits data continuity and real‐time monitoring, hindering the effective use of thermographic information in patient care and clinical decision‐making. Clinicians require easy access to both historical and real‐time thermographic data to track wound progression and adjust treatments accordingly. Integrating thermography into EMRs would facilitate broader applications across healthcare settings, extending beyond acute care to home care and long‐term care. This integration would also support procedural tracking and appropriate billing, further influencing clinical adoption. Additionally, improved data sharing for telemedicine could enhance collaboration among healthcare providers, particularly in remote or underserved areas, allowing for timely interventions.

Equity can impact wound care outcomes, including delayed wound healing and adverse events such as higher rates of amputation. Advanced imaging modalities (e.g., bacterial fluorescence, thermography, tissue oxygenation) may augment bias introduced by skin tone that contributes to disparities in racial outcomes. Thermography benefits by providing objective temperature‐related data, which may help remove bias from traditional assessment alone. The current research on thermography in wound care lacks focus on racial equity and skin tone variability, with limited evidence on its impact on health disparities. Future studies should prioritise diverse populations, explore the influence of skin tone on thermographic accuracy, and develop protocols to potentially improve equity in wound assessment.

These limitations underscore the need for larger studies with standardised protocols and clinically relevant endpoints to establish the role of thermography in routine wound care and to assess its clinical and cost‐effectiveness. Despite these limitations, with appropriate training and integration into clinical practices, thermography has substantial potential to enhance wound care management.

5. Conclusion

This scoping review highlights the significant potential of point‐of‐care infrared thermography in enhancing wound assessment across various wound types, including burns, DFUs, pressure injuries, surgical wounds, and other lower limb wounds. Thermography offers a non‐invasive, objective method for detecting inflammation and delayed healing, facilitating timely clinical interventions. While recent technological advancements have improved device accessibility and the integration of machine learning has enhanced diagnostic capabilities, barriers such as cost, training, and integration with EMRs persist. Additionally, the lack of standardised protocols and limited consideration of racial and skin tone variability indicate important areas for future research. Addressing these gaps is crucial to realising the full potential of thermography in clinical practice and ensuring equitable wound care delivery.

Ethics Statement

No ethics approval or patient consent was obtained before commencing this review, since this review includes only publicly published and peer reviewed sources.

Conflicts of Interest

R.D.J.F. is employed by Swift Medical as Vice President of Clinical Innovation, and S.R. was previously a summer employee at Swift Medical. All other authors declare no conflicts of interest.

Rahman S., Ogilvie T., Okonski D., et al., “A Comprehensive Scoping Review on the Use of Point‐Of‐Care Infrared Thermography Devices for Assessing Various Wound Types,” International Wound Journal 22, no. 8 (2025): e70741, 10.1111/iwj.70741.

Data Availability Statement

Data sharing is not applicable to this article as no new data were created or analyzed in this study.