Kim Lawrence H C, Ward Diane, Lam Lawrence, Holland Andrew J A
Children's Hospital Burns Research Institute and Burns Unit, Department of Surgery, New South Wales, Australia.
J Burn Care Res. 2010 Mar-Apr;31(2):328-32. doi: 10.1097/BCR.0b013e3181d0f572.
Early definitive treatment of burns facilitates optimal results by reducing the risk of subsequent hypertrophic scarring. Laser Doppler imaging (LDI) has been shown to assist in predicting burn wound healing potential. This study sought to determine whether use of LDI in pediatric burn patients has led to earlier decision making for grafting. The study cohort were patients who underwent a skin grafting procedure for a burn wound at a single institution, a state referral center for all major pediatric burns, between June 2006 and December 2007. Patients were divided into two groups: those who underwent LDI scanning and those who were only assessed clinically. Time of burn injury to time of decision making for the grafting procedure was calculated in days. Forty-nine percent of 196 patients underwent LDI. The mean time from the date of injury to decision making for graft procedure was 8.9 days in those patients who had an LDI scan vs 11.6 days in the group assessed by clinical observation alone. This trend for earlier decision for grafting procedure in the LDI group was statistically significant (P = .01). There was no significant difference between those patients who were scanned and those only assessed clinically in relation to gender, age, mechanism of injury, percentage BSA burnt, and wound culture results. There was a significant reduction in time to grafting decision in the LDI group. This would potentially lead to reduced length of stay, reduced number of hospital visits, and streamlined care for the patient and their family.
早期对烧伤进行确定性治疗可通过降低后续肥厚性瘢痕形成的风险来促进获得最佳治疗效果。激光多普勒成像（LDI）已被证明有助于预测烧伤创面的愈合潜力。本研究旨在确定在小儿烧伤患者中使用LDI是否能促使更早做出植皮决策。研究队列是2006年6月至2007年12月期间在一家单一机构（一家主要小儿烧伤的州转诊中心）因烧伤创面接受皮肤移植手术的患者。患者分为两组：接受LDI扫描的患者和仅接受临床评估的患者。计算从烧伤受伤时间到做出植皮手术决策的时间（以天为单位）。196例患者中有49%接受了LDI检查。接受LDI扫描患者从受伤日期到做出植皮手术决策的平均时间为8.9天，而仅通过临床观察评估的组为11.6天。LDI组中更早做出植皮手术决策的这一趋势具有统计学意义（P = 0.01）。在接受扫描的患者与仅接受临床评估的患者之间，在性别、年龄、受伤机制、烧伤体表面积百分比和创面培养结果方面没有显著差异。LDI组做出植皮决策的时间显著缩短。这可能会缩短住院时间，减少医院就诊次数，并简化对患者及其家属的护理。
