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

<b>Background:</b> 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. <b>Methods:</b> 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. <b>Results:</b> 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, <i>p</i> < 0.01) and clinical indicators, such as exudate, swelling, and malodor. Pathogens with high metabolic fluorescence, including <i>Pseudomonas aeruginosa</i> and <i>Candida</i> spp., were consistently identified. Representative cases demonstrate the utility of fluorescence imaging in guiding targeted debridement and enhancing intraoperative decision-making. <b>Conclusions:</b> 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.