Wearn Christopher, Lee Kwang Chear, Hardwicke Joseph, Allouni Ammar, Bamford Amy, Nightingale Peter, Moiemen Naiem
Scar Free Foundation Centre for Burns Research, University Hospital Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK; University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
Scar Free Foundation Centre for Burns Research, University Hospital Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK.
Burns. 2018 Feb;44(1):124-133. doi: 10.1016/j.burns.2017.08.004. Epub 2017 Oct 9.
The accurate assessment of burn depth is challenging but crucial for surgical excision and tissue preservation. Laser Doppler Imaging (LDI) has gained increasing acceptance as a tool to aid depth assessment but its adoption is hampered by high costs, long scan times and limited portability. Thermal imaging is touted as a suitable alternative however few comparison studies have been done.
Sixteen burn patients with 52 regions of interests were analysed. Burn depth was determined using four methods LDI, thermal imaging, photographic and real-time clinical evaluation at day 1 and day 3. LDI flux and Delta T values were used for the prediction of outcomes (wound closure in <21 days). Photographic clinical evaluation of burn depth was performed by 4 blinded burn surgeons.
Accuracy of assessment methods were greater on post burn day 3 compared to day 0. Accuracies of LDI on post burn day 0 and 3 were 80.8% and 92.3% compared to 55.8% and 71.2% for thermal imaging and 62.5% and 71.6% for photographic clinical assessment. Real-time clinical examination had an accuracy of 88.5%. Thermal imaging scan times were significantly faster compared to LDI.
LDI outperforms thermal imaging in terms of diagnostic accuracy of burn depth likely due to the susceptibility of thermal imaging to environmental factors.
准确评估烧伤深度具有挑战性，但对于手术切除和组织保存至关重要。激光多普勒成像（LDI）作为辅助深度评估的工具越来越受到认可，但其应用受到高成本、长扫描时间和有限便携性的阻碍。热成像被吹捧为一种合适的替代方法，然而很少有比较研究。
分析了16名烧伤患者的52个感兴趣区域。在第1天和第3天使用四种方法确定烧伤深度，即LDI、热成像、摄影和实时临床评估。LDI通量和ΔT值用于预测结果（伤口在<21天内闭合）。由4名不知情的烧伤外科医生对烧伤深度进行摄影临床评估。
与第0天相比，烧伤后第3天评估方法的准确性更高。烧伤后第0天和第3天LDI的准确率分别为80.8%和92.3%，热成像分别为55.8%和71.2%，摄影临床评估分别为62.5%和71.6%。实时临床检查的准确率为88.5%。与LDI相比，热成像扫描时间明显更快。
在烧伤深度的诊断准确性方面，LDI优于热成像，这可能是由于热成像对环境因素敏感。
