Laser Doppler Imaging Determines Need for Excision and Grafting in Advance of Clinical Judgment: A Prospective Blinded Trial

Burn Wound Infections

“…A total of 23 burn patients and 41 wounds were analyzed by both methods. LDI and the surgeon agreed on determination of wound depth only 56% of the time (P ϭ 0.031) (224). LDI agreed with wound biopsy confirmation when the scan indicated a need for excision.…”

“…Laser Doppler imaging (LDI) has recently been shown to provide a more objective measurement on which to base the decision to operate (25,199,224). A recent prospective blinded trial compared the clinical outcome of using LDI versus clinical judgment to assess injury depth.…”

Assessment of burn depth and burn wound healing potential

“…After scanning a burned area, LDI devices generate a color coded perfusion map that corresponds to varying burn depths. LDI is a highly valid measure for burn wound depth and its accuracy has been reported at up to 99% if infected wounds are excluded [52]. Indeed, the most recent studies addressing the critical interface between superficial and deep partial thickness burns suggest that LDI reliably predicts the level that distinguishes between burns that will or will not heal by re-epithalialisation by 3 weeks [9,53].…”

“…These findings were supported by those of Hoeksema et al [54] who reported LDI accuracy of 95% and 97% for LDI scans performed on day 3 and day 5 after burn, respectively compared to 52.5% and 71.4% for clinical evaluation. Jeng et al [52] reported that use of LDI to assess burn depth enabled earlier and more objective determination of the need to excise and graft burns [55], and showed that use of LDI helped to avoid unnecessary surgery and resulted in a reduction of both costs and workload. For paediatric patients treated surgically, Petrie et al [56] found that the length of hospital stay fell to 9.8 days after the introduction of routine LDI assessments compared with 15.1 days before its introduction.…”

Burn Depth Assessment in Thermal Skin Burns: Review

“…8 LDI yanık yara derinliğinde oldukça geçerli bir ölçüm metodudur ve eğer yanık yarası enfeksiyondan arındırılmışsa kesinliği %99'un üstündedir. 39 Yapılan bir çalışmada, LDI'nın klinik değerlendirme yöntemine olan üstünlüğünün yanık sonrası üç ve beşinci günlerde yapılan derinlik değerlendirme-sinde anlamlı olduğu belirtilmiştir. 40 Parsiyel yanık-lar ile yüzeysel yanıklar arasında kritik bir ara birim olduğunu belirten birçok yeni çalışma, LDI'nın üç haftaya kadar epitelizasyonla iyileşecek ya da iyileş-meyecek yanıklar arasında karşılaştırmalı olarak gü-venilir bir şekilde değerlendirme yapabildiğini ortaya koymuştur.…”