Burmeister David M, Cerna Cesario, Becerra Sandra C, Sloan Mark, Wilmink Gerald, Christy Robert J
From the *Combat Trauma and Burn Injury Research, United States Army Institute of Surgical Research, JBSA Fort Sam Houston, Texas; †General Dynamics Information Technology, JBSA Fort Sam Houston, Texas; and ‡Bioeffects Division, Radio Frequency Bioeffects Branch, Air Force Research Laboratory, Human Effectiveness Directorate, JBSA Fort Sam Houston, Texas.
J Burn Care Res. 2017 Jan/Feb;38(1):e180-e191. doi: 10.1097/BCR.0000000000000338.
Visual diagnosis of second-degree burns has proven inadequate for determining the appropriate treatment regimen. Although multiple noninvasive imaging techniques have shown promise for providing information about burn wound severity, the ideal technology to aid burn wound excision would provide real-time readouts. Herein, the authors examine a high-resolution infrared (IR) camera (thermography) and a multiprobe adapter system (MPAS-6; transepidermal evaporative water loss, colorimetry) to assess their usefulness in predicting burn severity. Contact burn wounds of increasing severity were created in a porcine model. Wounds were assessed for 4 days with an IR camera and MPAS-6. In addition, each day, the burn wounds were biopsied for histological analysis to determine burn depth for correlation with noninvasive measures. Surface temperatures decreased with increasing burn severity, which was associated with increasing transepidermal evaporative water loss. Melanin content correlated with the depth of collagen coagulation and was bimodal, with superficial and full-thickness burns having higher values than deep partial thickness wounds. Erythema content was highest in superficial burns and negatively correlated with necrosis (high-mobility group box protein 1 expression). Importantly, surface temperature taken on every single day after injury was predictive of all histologically determined measurements of burn depth (ie, collagen coagulation, apoptosis, necrosis, vascular occlusion). The results indicate that IR imaging and skin quality probes can be used to support the diagnosis of burn severity. Most importantly, IR measurements gave insight into both the zone of coagulation and the zone of stasis on every postburn day studied.
事实证明，二度烧伤的视觉诊断不足以确定合适的治疗方案。尽管多种非侵入性成像技术已显示出有望提供有关烧伤创面严重程度的信息，但有助于烧伤创面切除的理想技术应能提供实时读数。在此，作者研究了一种高分辨率红外（IR）相机（热成像）和一种多探头适配器系统（MPAS - 6；经表皮水分蒸发、比色法），以评估它们在预测烧伤严重程度方面的实用性。在猪模型中制造了严重程度不断增加的接触性烧伤创面。用IR相机和MPAS - 6对创面进行了4天的评估。此外，每天对烧伤创面进行活检以进行组织学分析，以确定烧伤深度，以便与非侵入性测量结果进行关联。随着烧伤严重程度的增加，表面温度降低，这与经表皮水分蒸发增加有关。黑色素含量与胶原凝固深度相关，呈双峰分布，浅度和全层烧伤的值高于深Ⅱ度创面。红斑含量在浅度烧伤中最高，与坏死（高迁移率族蛋白盒1表达）呈负相关。重要的是，受伤后每一天的表面温度都能预测所有组织学确定的烧伤深度测量结果（即胶原凝固、细胞凋亡、坏死、血管闭塞）。结果表明，红外成像和皮肤质量探头可用于辅助烧伤严重程度的诊断。最重要的是，在研究的每个烧伤后日子里，红外测量都能深入了解凝固区和淤血区的情况。
