Abstract
The standard of care for clinical assessment of burn severity and extent lacks a quantitative measurement. In this work, spatial frequency domain imaging (SFDI) was used to measure 48 thermal burns of graded severity (superficial partial, deep partial, and full thickness) in a porcine model. Functional (total hemoglobin and tissue oxygen saturation) and structural parameters (tissue scattering) derived from the SFDI measurements were monitored over 72 h for each burn type and compared to gold standard histological measurements of burn depth. Tissue oxygen saturation (stO₂) and total hemoglobin (ctHbT) differentiated superficial partial thickness burns from more severe burn types after 2 and 72 h, respectively (p < 0.01), but were unable to differentiate deep partial from full thickness wounds in the first 72 h. Tissue scattering parameters separated superficial burns from all burn types immediately after injury (p < 0.01), and separated all three burn types from each other after 24 h (p < 0.01). Tissue scattering parameters also showed a strong negative correlation to histological burn depth as measured by vimentin immunostain (r² > 0.89). These results show promise for the use of SFDI-derived tissue scattering as a correlation to burn depth and the potential to assess burn depth via a combination of SFDI functional and structural parameters.
Highlights
An estimated 11 million people suffer from burn injuries globally.[1]
We present an extension of these NIR spectroscopy concepts to quantitative, wide-field imaging using a method called spatial frequency domain imaging (SFDI)
A total of 48 wounds were analyzed for this study, 16 of each severity
Summary
An estimated 11 million people suffer from burn injuries globally.[1]. In the United States, this number is estimated to be 450,000, of which 40,000 injuries are severe enough to cause hospitalization.[2]. Thermal burn injuries are clinically classified according to the depth of the injury as superficial, superficial partial thickness, deep partial thickness, or full thickness. The true clinical challenge lies in determining the outcome of partial thickness injuries where the dermal layer is partially damaged. In these injuries, re-epithelialization can occur if adequate vasculature is present. The vasculature is often compromised too much and re-epithelialization cannot occur making excision and grafting necessary. In these cases, clinical determination may occur days after the initial injury due to the evolution of the wound, leaving the patient susceptible to infection, increased scarring, and pain
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