Abstract
Burn wounds are often characterized by injury depth, which then dictates wound management strategy. While most superficial burns and full thickness burns can be diagnosed through visual inspection, clinicians experience difficulty with accurate diagnosis of burns that fall between these extremes. Accurately diagnosing burn severity in a timely manner is critical for starting the appropriate treatment plan at the earliest time points to improve patient outcomes. To address this challenge, research groups have studied the use of commercial laser Doppler imaging (LDI) systems to provide objective characterization of burn-wound severity. Despite initial promising findings, LDI systems are not commonplace in part due to long acquisition times that can suffer from artifacts in moving patients. Commercial LDI systems are being phased out in favor of laser speckle imaging (LSI) systems that can provide similar information with faster acquisition speeds. To better understand the accuracy and usefulness of commercial LSI systems in burn-oriented research, we studied the performance of a commercial LSI system in three different sample systems and compared its results to a research-grade LSI system in the same environments. The first sample system involved laboratory measurements of intralipid (1%) flowing through a tissue simulating phantom, the second preclinical measurements in a controlled burn study in which wounds of graded severity were created on a Yorkshire pig, and the third clinical measurements involving a small sample of clinical patients. In addition to the commercial LSI system, a research grade LSI system that was designed and fabricated in our labs was used to quantitatively compare the performance of both systems and also to better understand the “Perfusion Unit” output of commercial systems.
Highlights
On an annual basis in the United States, 500,000 will require treatment for a burn injury and almost 10% of that number will be admitted into a specialized burn center[1]
Despite different units for measuring perfusion from both systems, there was no significant difference in the relative measurements of the systems at any of the speeds tested in the intralipid flow phantom
There were no significant differences between the two systems when measuring the relative changes in blood flow of our graded severity burn model
Summary
On an annual basis in the United States, 500,000 will require treatment for a burn injury and almost 10% of that number will be admitted into a specialized burn center[1]. A burn that is fairly superficial will not require any surgical intervention. A full thickness burn where significant damage is done requires surgical intervention. It is not difficult for clinicians to categorize burn wounds in their extreme state, but it is difficult to categorize the partial thickness burns that are in between the extreme categories. The accuracy of diagnosing these partial thickness burns by clinicians is typically 6080% when the diagnosis is done several days after the burn injury[2]. While early intervention has been shown to be beneficial for burn patients, clinical assessments are more accurate if clinicians wait to make a diagnosis[2]. New technologies that could aid clinicians in categorizing wound severity shortly after injury would provide great benefit to patients
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