Allely Rebekah R, Van-Buendia Lan B, Jeng James C, White Patricia, Wu Jingshu, Niszczak Jonathan, Jordan Marion H
Division of Burn Rehabilitation, Burn Center, Washington Hospital Center, Washington, DC, USA.
J Burn Care Res. 2008 Jan-Feb;29(1):42-8. doi: 10.1097/BCR.0b013e31815f6eeb.
A paradigm shift in management of postburn facial scarring is lurking "just beneath the waves" with the widespread availability of two recent technologies: precise three-dimensional scanning/digitizing of complex surfaces and computer-controlled rapid prototyping three-dimensional "printers". Laser Doppler imaging may be the sensible method to track the scar hyperemia that should form the basis of assessing progress and directing incremental changes in the digitized topographical face mask "prescription". The purpose of this study was to establish feasibility of detecting perfusion through transparent face masks using the Laser Doppler Imaging scanner. Laser Doppler images of perfusion were obtained at multiple facial regions on five uninjured staff members. Images were obtained without a mask, followed by images with a loose fitting mask with and without a silicone liner, and then with a tight fitting mask with and without a silicone liner. Right and left oblique images, in addition to the frontal images, were used to overcome unobtainable measurements at the extremes of face mask curvature. General linear model, mixed model, and t tests were used for data analysis. Three hundred seventy-five measurements were used for analysis, with a mean perfusion unit of 299 and pixel validity of 97%. The effect of face mask pressure with and without the silicone liner was readily quantified with significant changes in mean cutaneous blood flow (P < .5). High valid pixel rate laser Doppler imager flow data can be obtained through transparent face masks. Perfusion decreases with the application of pressure and with silicone. Every participant measured differently in perfusion units; however, consistent perfusion patterns in the face were observed.
随着两项最新技术的广泛应用,烧伤后面部瘢痕管理的范式转变正“潜藏于水面之下”:复杂表面的精确三维扫描/数字化以及计算机控制的快速成型三维“打印机”。激光多普勒成像可能是追踪瘢痕充血的合理方法,瘢痕充血应作为评估进展和指导数字化面部地形面罩“处方”渐进性变化的基础。本研究的目的是确定使用激光多普勒成像扫描仪通过透明面罩检测灌注的可行性。在五名未受伤的工作人员的多个面部区域获取灌注的激光多普勒图像。在不戴面罩的情况下获取图像,然后分别在佩戴有和没有硅胶衬里的宽松面罩以及佩戴有和没有硅胶衬里的紧密面罩的情况下获取图像。除了正面图像外,还使用左右斜位图像来克服面罩曲率极端处无法测量的问题。使用一般线性模型、混合模型和t检验进行数据分析。共375次测量用于分析,平均灌注单位为299,像素有效性为97%。有无硅胶衬里的面罩压力的影响很容易量化,平均皮肤血流量有显著变化(P < .5)。通过透明面罩可以获得高有效像素率的激光多普勒成像仪血流数据。施加压力和使用硅胶会使灌注降低。每个参与者的灌注单位测量结果不同;然而,面部的灌注模式是一致的。