LASER DOPPLER FLOWMETRY IN THE INTRAOPERATION DIAGNOSTICS OF BURN WOUND DEPTH

Abstract

The main technique for assessing the depth of burn lesions in the majority of specialized medical facilities is still the visual examination of a lesion and the assessment of the condition of its floor. The accuracy of currently available techniques for the objective assessment of the depth of burns is not more than 70%. Modern approaches to the treatment of large dermal burns imply that surgery is performed within 24 h and thus require accurate estimates of the depth of a thermal lesion. The aim of the present work was to assess the accuracy of estimating the depth of burn wounds based on laser doppler flowmetry data. Burn wounds were examined in operation rooms according to «Protocol for the Diagnostics of the Depth of Burns in Victims of Explosions of Methane-and-Coal Dust Mixtures» suggested by the present authors. The results of treatment of 115 miners admitted to the Department of Burns in 2004-2012 were analyzed. The suggested technique for estimating the depth of burn wounds is based on the use of laser doppler flowmetry for assessing capillary blood flow in the upper layers of derma. The technique made it possible to increase the accuracy of diagnostics of surface burns and deep burns by more than 1% and by 0,7% of whole body area, respectively, compared with the cases where the depth of burns was assesses based on clinical cues only. Thus, the use of laser doppler flowmetry makes it possible to significantly reduce inaccuracies in the determination of burn wound depth and to optimise treatment regimens.