INDIKACE K OPERAČNÍ LÉČBĚ POPÁLENIN PŘI VYUŽITÍ METODY LASERDOPPLER IMAGING

Abstract

The clinical assessment of depth of burns misdiagnosed in up to 35% of cases, especially in the early stages of thermal trauma to the 5th postoperative day. The correct determination of the depth of burns is crucial for planning the adequate therapeutic approach, ie, conservative or surgical treatment of burn wounds. Four basic grades of burn depth are distinguished cliniccaly. Grade I, IIa, IIb can be treated conservatively. Grade III and IV, but also some deeper grade IIb should be operated. Burns IIb cause the most diagnostic difficulties and the indications for surgical treatment is determind by depth of corium affection, which correlates with blood circulation in the dermis and the length of healing. Clinically, it is very difficult to estimate the depth of the affected dermis. LDI, laserdoppler imaging is the one of the ways to objectively and non-invasively assess the depth of the burns. LDI is an imaging technique that uses a laser radiation and the Doppler effect to detect blood flow in the skin capillaries. When thermal trauma directly damages the walls of capillaries, the subsequent tissue necrosis occures. Specificity and sensitivity of LDI in determining of the burn depth states 95% [1]. In our work, we propose a diagnostic algorithm for evaluation of capillary perfusion measured by LDI. Testing can be done up to 9th posttraumatic day, taking into account the current day after the accident. LDI is a suitable tool for the indication of surgical treatment. The following procedures should facilitate this process.