Farrar E, Pujji O, Jeffery S
Burns & Plastic Surgery, Queen Elizabeth Hospital Birmingham, United Kingdom.
University of Birmingham Medical School, United Kingdom.
Burns. 2017 Dec;43(8):1736-1741. doi: 10.1016/j.burns.2017.05.015. Epub 2017 Aug 8.
New technologies in the field of burn wound and scar assessment are continually being evaluated. Accurate estimation of total body surface area (TBSA) burn wound is of paramount importance in fluid resuscitation to prevent complications which are associated with morbidity and mortality. Estimating the TBSA is performed by a multitude of different methods, however a gold standard would be ideal. The aim of this study was to compare the estimation of burned TBSA% between 3D photography by Panasonic FZ-M1 Toughpad in conjunction with WoundCare Lite software and expert opinion volunteered by burns doctors.
Two life sized mannequins were used to simulate burns; an adult and a child. The burn was drawn to mimic real life burn patterns. Burns were measured prior to specialist assessment on the 3D camera. Burns doctors were asked to estimate the TBSA% of the burn. 10 burn sizes were assessed on the adult mannequin, and 8 on the child.
Wound size as estimated from the camera varied from 0.42% to 18.23%, with a mean of 5.246%. Each burn was assessed by a median of 3 assessors (ranging from 2 to 8). Burn TBSA assessments from the 3D camera and specialist assessment (compared using ICC) showed excellent agreement, 0.985 (95% CI 0.905, 0.996).
This study has demonstrated that the wound mapping software WoundCare Lite in conjunction with the Panasonic FZ-M1 Toughpad 3D camera compares well with expert opinion in determining burn surface area on a mannequin. Further research is needed to establish whether this is the case in burns on patients in an acute setting.
烧伤创面和瘢痕评估领域的新技术不断得到评估。准确估计烧伤的总体表面积(TBSA)对于液体复苏至关重要,以预防与发病率和死亡率相关的并发症。估计TBSA有多种不同方法,然而理想的是有一个金标准。本研究的目的是比较松下FZ-M1 Toughpad 3D摄影结合WoundCare Lite软件估计的烧伤TBSA百分比与烧伤科医生的专家意见。
使用两个真人大小的人体模型模拟烧伤,一个成人模型和一个儿童模型。绘制烧伤以模拟真实生活中的烧伤模式。在3D相机进行专科评估之前测量烧伤情况。要求烧伤科医生估计烧伤的TBSA百分比。对成人模型评估了10种烧伤大小,对儿童模型评估了8种。
相机估计的伤口大小从0.42%到18.23%不等,平均为5.246%。每次烧伤由中位数为3名评估者(范围为2至8名)进行评估。3D相机和专科评估的烧伤TBSA评估结果(使用ICC进行比较)显示出极好的一致性,为0.985(95%CI 0.905,0.996)。
本研究表明,伤口测绘软件WoundCare Lite结合松下FZ-M1 Toughpad 3D相机在确定人体模型上的烧伤表面积方面与专家意见相当。需要进一步研究以确定在急性环境下患者烧伤的情况是否如此。