Clinical use of multimodal imaging (thermal and fluorescence) in wound care: Case series using the MolecuLightDX+

Aim: To evaluate the clinical utility of combined thermal and fluorescence imaging for the assessment and management of chronic wounds. Methods: This observational case series included patients with chronic wounds of varying etiologies. Each wound was imaged using the MolecuLightDX+ device, which captures standard images, thermal infrared images for skin-surface temperature mapping, and fluorescence images for bacterial load detection at point-of-care. Key metrics included temperature differentials (ΔT °C) between the wound and contralateral limb, periwound or unaffected tissue and presence or absence of fluorescence signals indicating bacterial loads >104 CFU/g. Imaging results were correlated with clinical findings to guide wound management decisions. Results: Thermal imaging identified regions indicative of perfusion or inflammatory abnormalities (ΔT ranged 1.7°C–8.8°C) in all cases, including potential regions of ischemia, tunnelling or undermining not visible on clinical inspection. Some cases with fluorescence imaging showed fluorescence signals consistent with elevated bacterial burden within wound or periwound regions, which were confirmed with microbiological analysis, a clinically important finding associated with increased infection risk and delayed healing. Combined imaging guided clinical decision-making, such as prompting vascular evaluation, targeted debridement, or antimicrobial therapy. Conclusions: Thermal and fluorescence imaging, whether used independently or together, provided real-time and complementary information about the wound environment, supporting diagnostic decision making and treatment planning for complex chronic wounds.