Department of Bioengineering, University of Washington, Seattle, Washington, 98195.
Department of Surgery, Division of Trauma, Critical Care, and Burn, School of Medicine, University of Washington, Seattle, Washington, 98104.
Lasers Surg Med. 2021 Aug;53(6):849-860. doi: 10.1002/lsm.23367. Epub 2020 Dec 11.
There is a clinical need for an accurate, non-invasive imaging tool that can provide the objective assessment of burn wounds. The aims of this study are to demonstrate the potential of optical coherence tomography (OCT) in evaluating burn wound healing, as well as exploring the physiological basis of human wound healing.
STUDY DESIGN/MATERIALS AND METHODS: This was a retrospective study. Seven patients with severe burn wounds who were admitted to Harborview Medical Center were imaged using an in-house-built, clinical-prototype OCT system. OCT imaging was carried out at multiple scan sites on the burned skin across two time points (imaging session #1 and #2) with a field of view of ~9 × 9 mm. Due to pathological differences among burn zones, scan sites were classified into red sites (zone of hyperemia), white sites (zone of coagulation), and mixed sites. In addition to obtaining qualitative en face vascular and surface topography maps, we quantified vascular area density and surface roughness for comparative purposes.
En face vascular and surface topography maps demonstrated numerous morphological changes over both imaging sessions associated with burn injury, such as altered blood flow and loss of regular texture. Quantitative analyses revealed that during imaging session #1, vascular area density was significantly increased within the red sites compared with that of a healthy control (P = 0.0130), while vascular area density was significantly decreased within the white sites compared with that of a healthy control (P < 0.0001). During imaging session #2, vascular area density was significantly reduced to a more normal range within the red sites compared with imaging session #1 (P = 0.0215); however, vascular area density was still significantly lower within the white sites compared with that of a healthy control (P < 0.0001). Furthermore, vascular area density and surface roughness were significantly increased within the white sites during imaging session #2 compared with imaging session #1 (both P < 0.0001).
OCT is clinically feasible to monitor vascular changes and alterations in skin surface roughness during the process of burn wound healing. Variations in vascular area density and roughness measurements within the burn wounds revealed by OCT offer some key insights into the underlying pathophysiological mechanisms responsible for wound healing, which may become critical biological indicators in future clinical evaluation and monitoring of wound healing. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.
临床需要一种准确、非侵入性的成像工具，以提供对烧伤创面的客观评估。本研究的目的是展示光学相干断层扫描（OCT）在评估烧伤创面愈合中的潜力，并探索人类创面愈合的生理基础。
研究设计/材料与方法：这是一项回顾性研究。7 名严重烧伤患者在 Harborview 医疗中心接受了一种内部构建的临床原型 OCT 系统的成像。OCT 成像在两个时间点（成像会话#1 和#2）在烧伤皮肤的多个扫描部位进行，视野约为 9×9mm。由于烧伤区的病理差异，扫描部位分为红色部位（充血区）、白色部位（凝固区）和混合部位。除了获得定性的血管和表面形貌图外，我们还定量了血管面积密度和表面粗糙度以进行比较。
在两次成像过程中，获得的血管和表面形貌图显示了与烧伤损伤相关的许多形态变化，例如血流改变和纹理丧失。定量分析显示，在成像会话#1 中，与健康对照组相比，红色区域的血管面积密度显著增加（P=0.0130），而白色区域的血管面积密度显著降低（P<0.0001）。在成像会话#2 中，与成像会话#1 相比，红色区域的血管面积密度显著降低到更正常的范围（P=0.0215）；然而，与健康对照组相比，白色区域的血管面积密度仍然显著降低（P<0.0001）。此外，与成像会话#1 相比，在成像会话#2 中白色区域的血管面积密度和表面粗糙度显著增加（均 P<0.0001）。
OCT 可用于临床监测烧伤创面愈合过程中的血管变化和皮肤表面粗糙度变化。OCT 显示烧伤创面中血管面积密度和粗糙度测量值的变化为创面愈合的潜在病理生理机制提供了一些关键见解，这可能成为未来创面愈合临床评估和监测的关键生物学指标。激光外科医学。© 2020 威利父子公司。
