Background: Scores and prediction models, such as the MESS score for trauma and the Wifi classification for diabetic foot ulcers, help in the decision-making process of amputation. However, they can be subjective as they depend on the experience of the medical staff applying them. Objective: Assess the impact of temperature measurement using infrared thermal imaging in extremities salvage. Methods: We included 29 patients who sought a second opinion after an amputation recommendation. Infrared thermographic images were acquired to measure the temperature differences (ΔT) between the injured and uninjured limbs. For the salvaged limbs, we provided clinical follow-up until 12 weeks. Results: Of the patients enrolled in the study, 27 limbs were salvaged. Thermographic images allowed the discrimination of two groups: the first group of 18 patients with negative deltas, ΔT -3.6°C ± 1.99, and a second group of 9 patients with positive deltas, ΔT of 3.36°C ±2.71. None of the groups had progression to enlargement of their delta in the first 5 days, and at the twelfth week, ΔT approached 0°C at wound closure. For the two patients who required amputation, one patient showed an initial negative ΔT of -4.3°C, which worsened to -5°C by the fifth day, and the other patient showed an initial negative of -4.5°C, which worsened to -5.8°C by the fifth day. Conclusions: Digital infrared thermography is a tool that can help guide limb salvage in patients with uncertain clinical diagnoses. This imaging modality allows visualization of thermal differences and patterns derived from thermal changes in patients at risk of limb amputation.

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