A systematic review of the evolution of laser Doppler techniques in burn depth assessment.

Manaf Khatib,Shehab Jabir,Bruce Philp,Edmund Fitzgerald O’Connor

doi:10.1155/2014/621792

Abstract

Aims. The introduction of laser Doppler (LD) techniques to assess burn depth has revolutionized the treatment of burns of indeterminate depth. This paper will systematically review studies related to these two techniques and trace their evolution. At the same time we hope to highlight current controversies and areas where further research is necessary with regard to LD imaging (LDI) techniques. Methods. A systematic search for relevant literature was carried out on PubMed, Medline, EMBASE, and Google Scholar. Key search terms included the following: “Laser Doppler imaging,” “laser Doppler flow,” and “burn depth.” Results. A total of 53 studies were identified. Twenty-six studies which met the inclusion/exclusion criteria were included in the review. Conclusions. The numerous advantages of LDI over those of LD flowmetry have resulted in the former technique superseding the latter one. Despite the presence of alternative burn depth assessment techniques, LDI remains the most favoured. Various newer LDI machines with increasingly sophisticated methods of assessing burn depth have been introduced throughout the years. However, factors such as cost effectiveness, scanning of topographically inconsistent areas of the body, and skewing of results due to tattoos, peripheral vascular disease, and anaemia continue to be sighted as obstacles to LDI which require further research.

Highlights

Burn wounds that heal within a 3-week window have improved aesthetic and functional outcomes with a reduced degree of scarring [1]
A literature search was carried out on PubMed, Medline, Embase, and Google Scholar and the Cochrane databases from inception to February 2014 for studies on the topic of laser Doppler in burn depth assessment
It is clear from the discussion above that many of the other alternatives to laser Doppler (LD) techniques are either more cumbersome and more expensive or more difficult to adapt to the clinical setting resulting in LD techniques coming to the vanguard

Summary

Introduction

Burn wounds that heal within a 3-week window have improved aesthetic and functional outcomes with a reduced degree of scarring [1]. Clinical assessment of burn depth when dealing with a burn of indeterminate depth has been shown to be accurate in only 65–70% of cases even when performed by an experienced burns surgeon [2]. For this reason a number of adjuncts to aid the clinician in making an accurate burn depth assessment were devised. Foremost among these techniques, and by far, the one that received unanimous approval by the burn community was laser Doppler technique to assess burn wound depth. The frequency change of the waves of laser light observed is proportional to the amount of perfusion in the tissue

Methods

Discussion

Conclusion