558 Use of Forward-Looking Infrared (FLIR) Technology to Assess Burn Depth and Healing Potential: A Systematic Review and Meta-Analysis

Abstract

Abstract Introduction Burn wound depth assessments are an important component of determining patient prognosis and making appropriate management decisions. Clinical appraisal of the burn wound by an experienced burn surgeon is standard of care but has limitations. Forward-looking Infrared (FLIR) is a new technology in burn care that can provide a non-invasive, quantitative method of evaluating burn wound depth. FLIR utilizes a specialized camera that can capture the infrared emissivity of the skin, and the resulting images can be analyzed to determine burn depth and healing potential of a burn wound. Though FLIR has great potential for burn wound assessment, its use for this has not been well documented. Thus, we have conducted a systematic review and meta-analysis of the current use of FLIR technology to assess burn depth and healing potential. Methods A systematic review of the literature was performed on PubMed and Google Scholar between June 2020-August 2020 using the following keywords: thermal imaging, FLIR, forward looking infrared, burn, burn depth. Meta-analysis was performed on the mean sensitivity and specificity of the ability of FLIR to predict healing potential. Inclusion criteria were articles investigating the use of FLIR for burn wound assessments in adults, pediatric patients and animal models. Reviews and non-English articles were excluded. Results A total of 11 articles were included in the final review. Statistically significant correlations were found between FLIR and laser doppler imaging (LDI) in 3/3 clinical studies. A case report of a single patient found that FLIR was more accurate than LDI for assessing burn depth. Three articles investigated the ability of FLIR to predict healing potential, with all three reporting statistically significant results. Significant temperature differences between burnt and unburnt skin were found in 2/2 articles. FLIR was compared to clinical assessment by burn surgeons in two articles; one article found that FLIR was more accurate for assessing burn depth, while the other article found that clinical assessment was more accurate for predicting healing potential < 21 days. Mean sensitivity and specificity of the ability of FLIR to determine healing potential < 15 days was 44.5 and 98.8 respectively. Mean sensitivity and specificity of the ability of FLIR to determine healing potential < 21 days was 44.0 and 77.4 respectively. Conclusions FLIR is an accurate, simple, and cost-effective method of burn wound assessment. FLIR has been demonstrated to have significant correlations with other methods of assessing burns such as LDI and can be utilized to accurately assess burn depth and healing potential.