Division of Plastic Surgery, University of Massachusetts Medical School, Worcester, USA.
J Burn Care Res. 2021 Aug 4;42(4):825-828. doi: 10.1093/jbcr/irab003.
Burn depth is a critical factor in determining the healing potential of a burn as the extent of injury ultimately guides overall treatment. Visible-Light Hyperspectral Imaging is an FDA-approved, noninvasive, and noncontrast imaging technology that uses light waves within the visible spectrum to evaluate skin and superficial soft tissue perfusion. In this case report, visible-light hyperspectral imaging was used to evaluate a 37-year-old male who presented to the Emergency Department with a thermal burn of the trunk, back, and right upper extremity. Images were taken at initial evaluation, 6 hours postinjury, and again during daily dressing changes until hospital day 5 when the patient underwent surgical debridement. In this patient, operative treatment was postponed until 89.7 hours postinjury, at which point the clinical examination showed clear visual demarcation in regions of irreversible damage. Comparatively, visible-light hyperspectral imaging analysis of the permanently injured tissue demonstrated acute but varying changes in both oxygenated hemoglobin and deoxygenated hemoglobin at the time of initial evaluation. The most dramatic change in tissue oxygenation occurred between 6.5 and 39.3 hours, demonstrating visible-light hyperspectral imaging's ability to detect significant differences in oxygenation values between areas of second-degree superficial burns and areas of second-degree deep and third-degree burns in the acute period. The data suggest that the utilization of visible-light hyperspectral imaging in this 6.5- to 39.3-hour window may help predict final burn depth before clinical assessment, potentially allowing for surgical intervention within the first 48 hours following injury.
烧伤深度是决定烧伤愈合潜力的关键因素,因为损伤程度最终指导整体治疗。可见光-高光谱成像技术是一种获得 FDA 批准的、非侵入性的、非对比成像技术,它利用可见光范围内的光波来评估皮肤和浅层软组织的灌注。在本病例报告中,使用可见光-高光谱成像技术评估了一名 37 岁男性,他因躯干、背部和右上臂热烧伤到急诊科就诊。在初始评估、受伤后 6 小时以及每日换药时拍摄图像,直到入院第 5 天,患者接受手术清创。在该患者中,手术治疗推迟到受伤后 89.7 小时,此时临床检查显示不可逆损伤区域有明确的视觉分界。相比之下,可见光-高光谱成像分析显示,永久性损伤组织中的含氧血红蛋白和去氧血红蛋白在初始评估时均表现出急性但不同的变化。组织氧合的最大变化发生在 6.5 至 39.3 小时之间,表明可见光-高光谱成像技术能够在急性期间检测到二度浅度烧伤和二度深部及三度烧伤区域之间氧合值的显著差异。数据表明,在 6.5 至 39.3 小时的时间窗口内使用可见光-高光谱成像技术可能有助于在临床评估之前预测最终的烧伤深度,从而可能在受伤后 48 小时内进行手术干预。