Introduction: Early assessment of burn depth in pediatric patients remains a clinical challenge due to the heterogeneity of burn injuries and the dynamic changes that may occur during their evolution. Clinical assessment by an experienced surgeon remains fundamental; however, infrared thermography (IRT) may provide objective and complementary radiometric information through a rapid, non-invasive, non-contact, and non-ionizing technique. Objective: To describe the thermal distribution across the entire surface of second-degree burns in two pediatric patients using high-resolution infrared thermography and to explore the use of the 10th and 90th temperature percentiles (P10 and P90) and a normalized index derived from these percentiles, termed Thermal Heterogeneity by Percentiles (THP), as a descriptor of intralesional thermal heterogeneity. Methods: Two pediatric patients with second-degree burns were evaluated using a 320 × 240-pixel radiometric infrared sensor following a standardized bedside acquisition protocol. The entire clinically visible burn surface was delineated as the Whole Burn Region of Interest (WB-ROI). All radiometric temperature values contained within each WB-ROI were included in the analysis. Minimum temperature (Tmin), maximum temperature (Tmax), mean temperature (Tmean), median temperature, standard deviation (SD), interquartile range (IQR), coefficient of variation (CV), and the P10 and P90 percentiles were calculated. For exploratory purposes, THP = (P90 − P10)/P90 was calculated as a normalized measure of the separation between the lower and upper components of the intralesional thermal distribution. Results: The two cases showed different thermal distributions. Case 1 had a Tmean of 36.06 °C, SD of 0.59 °C, IQR of 0.93 °C, and CV of 1.63%, whereas Case 2 had a lower Tmean (34.38 °C) and greater thermal dispersion, with an SD of 0.97 °C, IQR of 1.27 °C, and CV of 2.83%. In Case 1, P10 and P90 were 35.34 °C and 36.88 °C, respectively, resulting in a THP of 0.042. In Case 2, P10 and P90 were 32.96 °C and 35.64 °C, respectively, resulting in a THP of 0.075. Case 2, which showed greater thermal dispersion and a higher THP, was independently classified at the bedside by the plastic surgery team as a deep partial-thickness burn, whereas Case 1 was clinically classified as a superficial-to-intermediate partial-thickness burn. Conclusions: Radiometric analysis of the WB-ROI, together with P10 and P90, enabled quantitative characterization of intralesional thermal heterogeneity while avoiding manual selection of hot and cold regions for index calculation. THP differed between the two cases and showed descriptive consistency with other measures of thermal dispersion. However, these findings are exploratory and hypothesis-generating. THP should not currently be considered a validated marker of burn depth, healing potential, or prognosis, nor should it be used to establish diagnostic or therapeutic cutoff values. Its reproducibility and potential clinical significance should be prospectively evaluated in larger cohorts using independent clinical outcomes and established reference methods.
- Open Access
- Case Report
Exploratory Thermal Heterogeneity Patterns in Pediatric Second-Degree Burns Using High-Resolution Infrared Thermography in Uruguay
- Sergio Machado *,†,
- Beatriz Manaro †,
- Natalia Gryngras †,
- Georgina de Angelis †,
- Lizandra Gonzalez and
- Virginia Suarez
Author Information
Received: 18 April 2026 | Revised: 20 August 2026 | Accepted: 23 September 2026 | Published: 06 November 2026
Abstract
Keywords
infrared thermography | pediatric burns | thermal heterogeneity | deep partial-thickness burns
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