Clinical utilization of near‐infrared spectroscopy devices for burn depth assessment

Abstract

The diagnosis of burn depth is based on a visual assessment and can be subjective. Near-infrared (NIR) spectroscopic devices were used preclinically with positive results. The purpose of this study was to test the devices in a clinical setting using easily identifiable burn wounds. Adult patients with acute superficial and full-thickness burns were enrolled. NIR point spectroscopy and imaging devices were used to collect hemodynamic data from the burn site and an adjacent unburned control site. Oxy-hemoglobin and deoxy-hemoglobin concentrations were extracted from spectroscopic data and reported as oxygen saturation and total hemoglobin. Sixteen patients (n=16) were included in the study with equal numbers in both burn wound groups. Point spectroscopy data showed an increase in oxygen saturation (p<0.0095) and total hemoglobin (<0.0001) in comparison with the respective control areas for superficial burn wounds. The opposite was true for full-thickness burns, which showed a decrease in oxygenation (p<0.0001) and total hemoglobin (p<0.0147) in comparison with control areas. NIR imaging technology provides an estimate of hemodynamic parameters and could easily distinguish superficial and full-thickness burn wounds. These results confirm that NIR devices can successfully distinguish superficial and full-thickness burn injuries.

Tissue Accumulation of Cephalothin in Burns: a Comparative Study by Microdialysis of Subcutaneous Interstitial Fluid Cephalothin Concentrations in Burn Patients and Healthy Volunteers

“…3). The longer delay between unbound cephalothin concentration equivalence in the plasma and interstitium observed for burn patients than for healthy volunteers is consistent with reports of impaired full-thickness burn tissue vascular perfusion (3). The similar increases in the area under the curve for unbound interstitial levels in patient nonburnt and burnt tissue sites probably arose in part from bound cephalothin (plasma protein binding in burn patients, 58% Ϯ 9%) being carried into the tissues with the albumin that undergoes extravasation, as reported for patients with severe edema (11).…”

Assessment of burn depth and burn wound healing potential

“…Some of these techniques could become clinically useful as technology improves but others, including the 'gold standard' of biopsy/histology, are never likely to attain clinical usefulness because they are restricted to single or multiple small areas and are not practical for mapping large areas of the wound. Near infrared spectroscopic (NIRS) techniques have been assessed experimentally by Sowa et al [59] and clinically by Cross et al [60] in 16 patients. These spectroscopic techniques provide information on oxygen saturation and total haemoglobin when used in point mode; relative differences in oxygenation were obtained when used in the imaging mode.…”

Quantitative assessment of graded burn wounds in a porcine model using spatial frequency domain imaging (SFDI) and laser speckle imaging (LSI)

“…Finally, both traditional diffuse reflectance spectroscopy (DRS) and imaging have been investigated within the context of burn wounds by various groups [16][17][18][19]. Visible and near infrared (NIR) polarized light is used to illuminate the tissue and the remitted cross-polarized light is captured with a camera or fiber to isolate subsurface features in tissue.…”