Van-Buendia Lan B, Allely Rebekah R, Lassiter Ronald, Weinand Christian, Jordan Marion H, Jeng James C
Burn Center, Washington Hospital Center, Washington DC 20010, USA.
J Burn Care Res. 2010 May-Jun;31(3):441-7. doi: 10.1097/BCR.0b013e3181db5250.
Clinically, the initial blanching in burn scar seen on transparent plastic face mask application seems to diminish with time and movement requiring mask alteration. To date, studies quantifying perfusion with prolonged mask use do not exist. This study used laser Doppler imaging (LDI) to assess perfusion through the transparent face mask and movement in subjects with and without burn over time. Five subjects fitted with transparent face masks were scanned with the LDI on four occasions. The four subjects without burn were scanned in the following manner: 1) no mask, 2) mask on while at rest, 3) mask on with alternating intervals of sustained facial expression and rest, and 4) after mask removal. Images were acquired every 3 minutes throughout the 85-minute study period. The subject with burn underwent a shortened scanning protocol to increase comfort. Each face was divided into five regions of interest for analysis. Compared with baseline, mask application decreased perfusion significantly in all subjects (P < .0001). Perfusion did not change during the rest period. There were no significant differences with changing facial expression in any of the regions of interest. On mask removal, all regions of the face demonstrated a hyperemic effect with the chin (P = .05) and each cheek (P < .0001) reaching statistical significance. Perfusion levels did not return to baseline in the chin and cheeks after 30 minutes of mask removal. Perfusions remain constantly low while wearing the face mask, despite changing facial expressions. Changing facial expressions with the mask on did not alter perfusion. Hyperemic response occurs on removal of the mask. This study exposed methodology and statistical issues worth considering when conducting future research with the face, pressure therapy, and with LDI technology.
临床上，在应用透明塑料面罩时，烧伤瘢痕最初出现的皮肤变白现象似乎会随着时间推移和因活动需要调整面罩而逐渐减轻。迄今为止，尚无关于长时间使用面罩时定量评估灌注情况的研究。本研究使用激光多普勒成像（LDI）来评估有烧伤和无烧伤受试者在佩戴透明面罩时随时间变化的灌注情况及面部活动情况。五名佩戴透明面罩的受试者接受了四次LDI扫描。四名无烧伤的受试者按以下方式进行扫描：1）不戴面罩；2）静息时佩戴面罩；3）佩戴面罩并交替进行持续面部表情和静息状态；4）摘除面罩后。在整个85分钟的研究期间，每3分钟采集一次图像。有烧伤的受试者采用了缩短的扫描方案以提高舒适度。将每张脸分为五个感兴趣区域进行分析。与基线相比，佩戴面罩使所有受试者的灌注均显著降低（P < .0001）。静息期间灌注无变化。在任何感兴趣区域，面部表情变化均无显著差异。摘除面罩后，面部所有区域均出现充血效应，其中下巴（P = .05）和双侧脸颊（P < .0001）达到统计学显著水平。摘除面罩30分钟后，下巴和脸颊的灌注水平未恢复至基线。尽管面部表情发生变化，但佩戴面罩时灌注水平持续较低。佩戴面罩时面部表情的变化并未改变灌注情况。摘除面罩时会出现充血反应。本研究揭示了在未来使用面部、压力疗法和LDI技术进行研究时值得考虑的方法学和统计学问题。
