Diagnostic accuracy of laser Doppler imaging in burn depth assessment: Systematic review and meta-analysis

Shin, Jin Yong; Yi, Hyung Suk

doi:10.1016/j.burns.2016.03.012

Cited by 48 publications

(32 citation statements)

References 37 publications

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“…The obvious alternative to a clinical examination is an objective method, based on a measurable physical quality which can be converted to a number or an image. Several objective methods have been suggested and tried for burn diagnostics [17,31,[33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50]. An optimal method should be easy to use, non-invasive, and quick.…”

Section: Objective Methods For Burn Depth Assessmentmentioning

confidence: 99%

Blood Flow Dynamics in Burns

Mirdell

2019

Linköping University Medical Dissertations

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Burns of intermediate thickness are hard to evaluate clinically. This often leads to unnecessary delays of up to 14 days before a surgical decision can be made. To counter this, several objective methods have been developed to determine the healing potential of the wound. Over the years, measurement of perfusion has proven to be the most successful method for evaluation of healing potential. Laser Doppler imaging (LDI) is currently the most used method and can determine surgical need 2 days after injury with an accuracy >90%. There are however emerging techniques like laser speckle contrast imaging (LSCI), which also measure perfusion. LSCI have several advantages over LDI and is easier to use. LSCI can also investigate aspects of the microcirculation, previously not possible with LDI. The aim of this thesis was to investigate LSCI's ability to evaluate surgical need in burns of indeterminate partial-thickness. The first objective was to investigate the dynamics of perfusion the first 14 days after injury. The purpose was to find the optimal time-window for perfusion measurements. The next goal was to determine the accuracy of different perfusion cutoffs. In this second study, the benefit of a subsequent measurement was also investigated. After this, interobserver variation between different profession groups was studied. Both the agreement of perfusion measurements and observer assessments were evaluated. Finally, cardiac vasomotion in combination with perfusion (pulsatility) was investigated as a method to determine surgical need <48 hours after injury. Methods:

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Section: Objective Methods For Burn Depth Assessmentmentioning

confidence: 99%

Blood Flow Dynamics in Burns

Mirdell

2019

Linköping University Medical Dissertations

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“…Other investigators have found that LSI technology becomes compelling as a tool with which to assess burn wound severity in the 48-72 h time window [29]. When comparing the accuracy of clinical observation and laser Doppler imaging techniques, time points of 24 h and 72h have been used to highlight the advantage of laser Doppler imaging over clinical assessments [3].…”

Section: Laser Speckle Imagingmentioning

confidence: 99%

Evaluating clinical observation versus Spatial Frequency Domain Imaging (SFDI), Laser Speckle Imaging (LSI) and thermal imaging for the assessment of burn depth

Ponticorvo

Rowland

Baldado

et al. 2019

Burns

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While clinical examination is needed for burn severity diagnosis, several emerging technologies aim to quantify this process for added objectivity. Accurate assessments become easier after burn progression, but earlier assessments of partial thickness burn depth could lead to earlier excision and grafting and subsequent improved healing times, reduced rates of scarring/infection, and shorter hospital stays. Spatial Frequency Domain Imaging (SFDI), Laser Speckle Imaging (LSI) and thermal imaging are three non-invasive imaging modalities that have some diagnostic ability for noninvasive assessment of burn severity, but have not been compared in a controlled experiment. Here we tested the ability of these imaging techniques to assess the severity of histologically confirmed graded burns in a swine model. Controlled, graded burn wounds, 3cm in diameter were created on the dorsum of Yorkshire pigs (n=3, 45-55kg) using a custom-made burn tool that ensures consistent pressure has been employed by various burn research groups. For each pig, a total of 16 burn wounds were created on the dorsal side. Biopsies were taken for histological analysis to verify the severity of the burn. Clinical analysis, SFDI, LSI and thermal imaging were performed at 24 and 72h after burn to assess the accuracy of each imaging technique. In terms of diagnostic accuracy, using histology as a reference, SFDI (85%) and clinical analysis (83%) performed significantly better that LSI (75%) and thermography (73%) 24h after the burn. There was no statistically significant improvement from 24 to 72h across the different imaging modalities. These data indicate that these imaging modalities, and specifically SFDI, can be added to the burn clinicians' toolbox to aid in early assessment of burn severity.

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“…We summarized all relevant and recent original and review articles on hand . Die Genauigkeit dieser Technik wurde in mehreren Studien bestätigt [3][4][5]; zudem können Kosten eingespart werden [6]. Keine der Studien hat spezifisch Handverbrennungen untersucht [7].…”

Section: Introductionunclassified

Die Verbrannte Hand – Neuheiten und aktuelle Forschung

Popp

Tapking

Branski

2019

Handchir Mikrochir plast Chir

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ZusammenfassungEine funktionierende Handmotorik ist im täglichen Leben und in der Arbeitswelt unverzichtbar. Selbst kleinere Verbrennungen können selbige entweder direkt oder durch Narbenbildung wesentlich einschränken. Erhalt und Wiederherstellung der Handfunktion sind essenziell für das körperliche und seelische Wohlbefinden von Verbrennungspatienten, zumal eine Einschränkung zu sozialer Isolation und Berufsunfähigkeit führen kann. Obwohl eine Hand nur 3 % der gesamten Körperoberfläche repräsentiert, werden Handverbrennungen als schwere Verbrennung eingestuft und zählen zu den primären Indikationen zur Behandlung in einem Verbrennungszentrum. Bei mehr als 80 % aller schweren Verbrennungen sind die Hände beteiligt und zählen somit zu den am häufigsten betroffenen Körperregionen. Unabhängig von der Schwere der gesamten Verbrennung ist den Händen höchste Priorität beizumessen.Weiterentwicklungen in der Akut- und Langzeitbehandlung von Brandverletzungen der Hand sollten zum Ziel haben, eine langfristige Verbesserung der funktionellen und ästhetischen Ergebnisse zu erlangen. Zudem soll auch bei schwerer Handverbrennung die Wiedereingliederung in Alltag und Berufsleben angestrebt werden. Der Zweck dieser Übersichtsarbeit ist es, die aktuelle Forschung auf dem Gebiet der Handverbrennung aufzuzeigen und Teilbereiche zu identifizieren, in denen in Zukunft intensivere Forschung betrieben werden sollte. Wir fassen in dieser Arbeit relevante Original- und Übersichtsarbeiten der letzten Jahre auf dem Gebiet der Handverbrennung zusammen. Neuheiten zu Akutbehandlung, Nachbehandlung, Rekonstruktion, der Verletzung durch E-Zigaretten sowie zur Funktionsbeurteilung werden vorgestellt und in Kontext zu bewährten Methoden gestellt. Die Problematik mangelnder Forschungsprojekte und potenzielle Forschungsideen werden aufgezeigt.

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Diagnostic accuracy of laser Doppler imaging in burn depth assessment: Systematic review and meta-analysis

Cited by 48 publications

References 37 publications

Blood Flow Dynamics in Burns

Blood Flow Dynamics in Burns

Evaluating clinical observation versus Spatial Frequency Domain Imaging (SFDI), Laser Speckle Imaging (LSI) and thermal imaging for the assessment of burn depth

Die Verbrannte Hand – Neuheiten und aktuelle Forschung

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