Green H A, Bua D, Anderson R R, Nishioka N S
Harvard Medical School, Department of Dermatology, Massachusetts General Hospital, Boston 02114.
Arch Dermatol. 1992 Jan;128(1):43-9.
Expedient primary excision of deep dermal and full-thickness burn wounds with subsequent skin grafting is the standard of care in most burn institutions, but differentiating full-thickness from partial-thickness burns is often difficult. Because accurate early assessment of burn depth may improve care, a variety of technical methods have attempted to measure burn depth but these methods have had limited success. We describe a new technique to determine burn depth that uses infrared (840- to 850-nm) fluorescence emission from intravenously administered indocyanine green following excitation with infrared (780 nm) and UV light (369 nm). Full-thickness and partial-thickness burns in hairless rat skin were distinguished based on the infrared-induced and UV-induced fluorescence intensity ratios relative to normal, unburned skin immediately after the burn and on post-burn days 1 through 3 and 7. Dual-wavelength excitation of indocyanine green infrared fluorescence can delineate full-thickness from partial-thickness burns at an early date, allowing prognosis, surgical planning, and early primary excision and grafting.
对深度真皮和全层烧伤创面进行及时的一期切除并随后进行皮肤移植，是大多数烧伤治疗机构的标准治疗方法，但区分全层烧伤和部分厚度烧伤往往很困难。由于准确的烧伤深度早期评估可能改善治疗效果，人们尝试了多种技术方法来测量烧伤深度，但这些方法取得的成功有限。我们描述了一种确定烧伤深度的新技术，该技术利用静脉注射吲哚菁绿后，在红外光（780 nm）和紫外光（369 nm）激发下产生的红外（840至850 nm）荧光发射。根据烧伤后即刻以及烧伤后第1天至第3天和第7天相对于正常未烧伤皮肤的红外诱导和紫外诱导荧光强度比，区分无毛大鼠皮肤的全层烧伤和部分厚度烧伤。吲哚菁绿红外荧光的双波长激发可以早期区分全层烧伤和部分厚度烧伤，从而有助于预后判断、手术规划以及早期一期切除和移植。
