Chin Michael S, Babchenko Oksana, Lujan-Hernandez Jorge, Nobel Lisa, Ignotz Ronald, Lalikos Janice F
Department of Radiation Oncology and Division of Plastic Surgery, University of Massachusetts Medical School, Worcester, Mass.
Plast Reconstr Surg Glob Open. 2016 Jan 7;3(12):e591. doi: 10.1097/GOX.0000000000000558. eCollection 2015 Dec.
Differentiating between superficial and deep-dermal (DD) burns remains challenging. Superficial-dermal burns heal with conservative treatment; DD burns often require excision and skin grafting. Decision of surgical treatment is often delayed until burn depth is definitively identified. This study's aim is to assess the ability of hyperspectral imaging (HSI) to differentiate burn depth.
Thermal injury of graded severity was generated on the dorsum of hairless mice with a heated brass rod. Perfusion and oxygenation parameters of injured skin were measured with HSI, a noninvasive method of diffuse reflectance spectroscopy, at 2 minutes, 1, 24, 48 and 72 hours after wounding. Burn depth was measured histologically in 12 mice from each burn group (n = 72) at 72 hours.
Three levels of burn depth were verified histologically: intermediate-dermal (ID), DD, and full-thickness. At 24 hours post injury, total hemoglobin (tHb) increased by 67% and 16% in ID and DD burns, respectively. In contrast, tHb decreased to 36% of its original levels in full-thickness burns. Differences in deoxygenated and tHb among all groups were significant (P < 0.001) at 24 hours post injury.
HSI was able to differentiate among 3 discrete levels of burn injury. This is likely because of its correlation with skin perfusion: superficial burn injury causes an inflammatory response and increased perfusion to the burn site, whereas deeper burns destroy the dermal microvasculature and a decrease in perfusion follows. This study supports further investigation of HSI in early burn depth assessment.
区分浅度和深度真皮(DD)烧伤仍然具有挑战性。浅度真皮烧伤通过保守治疗即可愈合;深度真皮烧伤通常需要切除并植皮。手术治疗的决定往往会推迟到烧伤深度被明确确定之后。本研究的目的是评估高光谱成像(HSI)区分烧伤深度的能力。
用加热的黄铜棒在无毛小鼠背部造成不同严重程度的热损伤。在受伤后2分钟、1小时、24小时、48小时和72小时,使用高光谱成像(一种非侵入性的漫反射光谱法)测量受伤皮肤的灌注和氧合参数。在72小时时,对每个烧伤组的12只小鼠(n = 72)进行组织学测量烧伤深度。
通过组织学验证了三种烧伤深度水平:中度真皮(ID)、深度真皮(DD)和全层。在受伤后24小时,中度真皮和深度真皮烧伤的总血红蛋白(tHb)分别增加了67%和16%。相比之下,全层烧伤的tHb降至其原始水平的36%。在受伤后24小时,所有组之间的脱氧血红蛋白和总血红蛋白差异均具有统计学意义(P < 0.001)。
高光谱成像能够区分三种不同程度的烧伤损伤。这可能是因为它与皮肤灌注相关:浅度烧伤损伤会引起炎症反应并增加烧伤部位的灌注,而深度烧伤会破坏真皮微血管,随后灌注减少。本研究支持进一步研究高光谱成像在早期烧伤深度评估中的应用。