Burn Depth Assessment Research Articles

Non-invasive Resonance Raman Spectroscopy provides an early estimation of depth in a pig model of multi-depth burns

Accurate burn depth diagnosis in the early post-burn phase is critical for treatment; however, current assessment methods are subjective, resulting in reduced diagnostic accuracy. Using a compact and portable benchtop setup, we propose a Resonance Raman Spectroscopy protocol to assess burn depth in this phase. By developing a Hemoglobin Index for wounds, we measure hemoglobin in the wound as a marker for wound perfusion, which is altered in burn injuries due to vascular damage. We tested the Hemoglobin Index for wound categorization in a clinically relevant multi-depth burns model in Yucatan pigs. We found a high accuracy of diagnosis on post-burn day 3, an 85% AUC in a binary classifier model for superficial partial-thickness and deep-partial thickness burns, with nearly perfect classification in other categories. Simultaneously, we discuss the potential use of Raman-associated fluorescence in measuring fluorophore deposition in later phases for healing management. Thus, non-invasive measurements with our device may have a high potential for clinical translation.

Validity of laser speckle contrast imaging for predicting wound healing potential in burns: A critical examination.

Validity of laser speckle contrast imaging for predicting wound healing potential in burns: A critical examination.

A systematic review of advances in the use of spectral imaging in burn depth assessment.

A systematic review of advances in the use of spectral imaging in burn depth assessment.

634 Patient Experience of Using Artificial Intelligence-Enhanced Multispectral Imaging: A Regional Burns Centre Review

Abstract Introduction Artificial intelligence (AI) has a wide range of potential uses in medicine, one of which is diagnostic aids and prediction models. Whilst the opinions of healthcare professionals on this have been considered, establishing whether this technology is acceptable to patients is also extremely important. Within our burns service we utilized a multispectral imaging device which uses AI to assess burn depth and predicts whether a burn wound will heal within 21 days. The device takes a picture of a patient’s wound and produces an computerized image as well as an image of its predictive assessment superimposed over the burn area. This can be viewed by both the clinician and the patient. We aimed to identify the patient’s experience of undergoing predictive wound assessment as well as their thoughts of using AI technology as part of a clinical consultation. Methods Adult patients with mental full mental capacity, presenting to a UK regional burns center between 08/30/24-09/20/24 who sustained a burn wound underwent both a clinical assessment and assessment using the AI device. All patients were asked to rate their experience of the device using a 4-item questionnaire. Each question asked them to rate an aspect of using the machine on a 10-point Likert scale. Patients were asked about “speed of the process”, “how comfortable it was”, “how satisfied they would be to have further photos images taken of their wounds” and “whether using the machine helped them understand the depth of their burn” following reviewing their images on the monitor. Results 51 patients completed the questionnaire after a doctor assessed their burn wound as well as taking a picture using the AI machine. The median score for speed was 10 with an interquartile range (IQR) of 1. In terms of comfort, 84% of patients rated the device as 10, resulting in a median of 10 and IQR of 0 (range 8-10). 82% of patients gave the device a 10 for how satisfied they would be to have further images taken (range 7-10). With regards to how much the device helped them understand their burn depth, 82% of patients rated it 8 or above. This gave a median score of 10, with an IQR of 2. Conclusions Patients found the use of multispectral imaging with AI to be a fast, comfortable and helpful tool to understand the depth of their burn wound. Most were happy for the device to be used on them in the future. Our questionnaire also demonstrates that patients are accepting of this form of technology as part of their clinical consultation. Applicability of Research to Practice Due to the comfort and speed of the device in assessing wounds, it would potentially be even more beneficial to use the device on a paediatric cohort or in patients who may not tolerate prolonged clinical examination. Patients also noted that it aided them in making decisions regarding planning hospital visits and the potentiality of surgical intervention. Due to high satisfaction for further clinical imaging, patients could be re-evaluated in order to amend their clinical treatment plan. Funding for the Study N/A

Ambiance Preservation Augmenting for Semantic Segmentation of Pediatric Burn Skin Lesions

Burn injuries pose a significant threat to human life, with high morbidity and mortality rates. Accurate diagnosis, including the assessment of burn area and depth, is essential for effective treatment and can sometimes be lifesaving. However, access to specialized medical professionals is often limited, particularly in remote or underserved regions. To address this challenge and alleviate the burden on healthcare providers, researchers are investigating automated diagnostic tools. The severity of the burn and the affected body surface area are critical factors in diagnosis. From a computer vision perspective, this requires semantic segmentation of burn images to assess the affected area and determine burn severity. In collaboration with medical personnel, we have gathered a dataset of in situ images from a local children’s hospital annotated by specialist burn surgeons. However, due to the limited amount of data, we propose a two-step augmentation approach: training with synthetic burn images and controlling the encoder by ambiance preservation. The latter is a technique that forces the encoder to represent closely the embeddings of images that are similar and is a key contribution of this paper. The method is evaluated on the BAMSI database, demonstrating that the proposed augmentations lead to better performance compared with strong baselines and other potential algorithmic improvements.

Використання безконтактного термографа FLIR One для оцінювання глибини опікової рани

The treatment of burn injuries is complicated by the proper diagnosis of areas requiring immediate necrectomy (deep burn) and those that can heal on their own (superficial burn). Non-contact thermography using the FLIR One device may be a reliable, non-invasive, and cost-effective method for assessing the depth of thermal injury. Aim - to study the temperature of healthy skin, deep and superficial burns using the FLIR One non-contact thermograph, the temperature difference between them, and the diagnostic value of the method for assessing burn depth. Materials and methods. The study involved 22 patients with limb burns. Thermometry of the affected areas was performed using the FLIR One thermograph within the first 48 hours after injury, before and during wound sanitation, with images analyzed using the FLIR One application. Results. The temperature of healthy skin was 34.7°C (34.4-35.1°C), the temperature of superficial burns was 35.8°C (35.5-36.2°C), and the temperature of deep burns was 32.4°C (32.0-32.8°C). The difference between healthy skin and deep burns was 2.3°C (2.2-2.4°C), and between superficial and deep burns was 3.4°C (3.0-3.8°C). A temperature of 33.7°C with non-contact thermography indicated a deep burn with 95% sensitivity and specificity. A decrease in the temperature of the affected skin by more than 2.0°C compared to healthy skin (2.2-2.4°C) or superficial burns (3.0-3.8°C) also indicated deep thermal damage. Conclusions. Thermography using FLIR One is a reliable and accessible method for analyzing the depth of burn wounds. The temperature of healthy skin during thermography is 34.7°C (34.4; 35.1)°C and is lower than the temperature of superficial burns (35.8°C (35.5; 36.2)°C) but higher than the temperature of deep burns (32.4°C (32.0; 32.8)°C). A temperature of 33.7°C with high sensitivity and specificity indicates a deep burn. The study showed that a temperature decrease of more than 2.0°C compared to healthy skin or superficial burns indicates deep thermal damage. The research was carried out in accordance with the principles of the Declaration of Helsinki. Informed consent of the child and child's parents was obtained for the research. The authors declare no conflict of interest.

Comparing Artificial Intelligence Guided Image Assessment to Current Methods of Burn Assessment.

Appropriate identification of burn depth and size is paramount. Despite the development of burn depth assessment aids [eg, laser Doppler imaging (LDI)], clinical assessment, which assesses partial-thickness burn depth with 67% accuracy, currently remains the most consistent standard of practice. We sought to develop an image-based artificial intelligence system that predicts burn severity and wound margins for use as a triaging tool in thermal injury management. Modified EfficientNet architecture trained by 1684 mobile-device-captured images of different burn depths was previously used to create a convoluted neural network (CNN). The CNN was modified to a novel boundary attention mapping (BAM) algorithm using elements of saliency mapping, which was used to recognize the boundaries of burns. For validation, 144 patient charts that included clinical assessment, burn location, total body surface area, and LDI assessment were retrieved for a retrospective study. The clinical images underwent CNN-BAM assessment and were directly compared with the LDI assessment. CNN using a 4-level burn severity classification achieved an accuracy of 85% (micro/macro-averaged receiver operating characteristic scores). The CNN-BAM system can successfully highlight burns from surrounding tissue with high confidence. CNN-BAM burn area segmentations attained a 91.6% accuracy, 78.2% sensitivity, and 93.4% specificity, when compared to LDI methodology. Results comparing the CNN-BAM outputs to clinical and LDI assessments have shown a high degree of correlation between the CNN-BAM burn severity predictions to those extrapolated from LDI healing potential (66% agreement). CNN-BAM algorithm gives equivalent burn-depth detection accuracy as LDI with a more economical and accessible application when embedded in a mobile device.

Depth of intact vascular plexus- visualized with optical coherence tomography- correlates to burn depth in thoracic thermic injuries in children.

Deep thermal injuries are among the most serious injuries in childhood, often resulting in scarring andfunctional impairment. However, accurate assessment of burn depth by clinical judgment is challenging. Optical coherence tomography (OCT) provides structural images of the skin and can detect blood flow within the papillary plexus. In this study, we determined the depth of the capillary network in healthy and thermally injured skin and compared it with clinical assessment. In 25 children between 7months and 15 years of age (mean age 3.5 years (SD±4.14)) with thermal injuries of the ventral thoracic wall, we determined the depth of the capillary network using OCT. Measurements were performed on healthy skin and at the center of the thermal injury (16 grade IIa, 9 grade IIb). Comparisons were made between healthy skin and thermal injury. The capillary network of the papillary plexus in healthy skin was detected at 0.33 mm (SD±0.06) from the surface. In grade IIb injuries, the depth of the capillary network was 0.36 mm (SD±0.06) and in grade IIa injuries 0.23 mm (SD±0.04) (Mann-Whitney U test: p<0.001). The overall prediction accuracy is 84 %. OCT can reliably detect and differentiate the depth of the capillary network in both healthy and burned skin. In clinical IIa wounds, the capillary network appears more superficial due to the loss of the epidermis, but it is still present in the upper layer, indicating a good prognosis forspontaneous healing. In clinical grade IIb wounds, the papillary plexus was visualized deeper, which is a sign of impaired blood flow.

The effect of anatomic location on porcine models of burn injury and wound healing.

Porcine models are frequently used for burn healing studies; however, factors including anatomic location and lack of standardised wound methods can impact the interpretation of wound data. The objectives of this study are to examine the influence of anatomical locations on the uniformity of burn creation and healing in porcine burn models. To optimise burn parameters on dorsal and ventral surfaces, ex vivo and in situ euthanized animals were first used to examine the location-dependence of the burn depth and contact time relationship. The location-dependent healing in vivo was then examined using burn and excisional wounds at dorsal, ventral, caudal and cranial locations. Lactate dehydrogenase (LDH) and H&E were used to assess burn depth and wound re-epithelialization. We found that burn depth on the ventral skin was significantly deeper than that of the dorsal skin at identical thermal conditions. Compared with burns created ex vivo, burns created in situ immediately post-mortem were significantly deeper in the ventral location. In live animals, 2 out of 12 burn wounds were fully re-epithelialized after 14 days in contrast to complete re-epithelialization of all excisional wounds. Among the burn wounds, those at the cranial-dorsal site exhibited faster healing than at the caudal-dorsal site. This study showed that anatomical location is an important consideration for the consistency of burn depth creation and healing. These data support symmetric localization of treatment and control for comparative assessment of burn healing in porcine models to prevent misinterpretation of results and increase the translatability of findings to humans.

133 Early Assessment of Burn Depth in a Yucatan Minipig Model Using Resonance Raman Spectroscopy

Abstract Introduction Assessment of thermal burns in the acute phase is critical since healing may require surgical intervention depending on the depth of injury. Early depth estimation guides debridement and planning care strategy. Current assessment standard has limitations, and biopsies are invasive and painful. There is an urgent need for a rapid, non-invasive, and objective metric of burn depth. Methods We created a model to study intermediate burn depth in Yucatan miniature pigs, which is clinically relevant. Brass blocks of 4cm radius create contact burns by preheating to 63°C for 2nd-degree (intermediate), and 95°C for 3rd-degree (full thickness) burns. Contact duration varied between 15 to 45 seconds for 2-degree burns to create different depths. Burns are evenly distributed and randomized on the dorsal paravertebral region of the pigs. Full-thickness burns were debrided on POD 3. Each wound was assessed using a custom bench-top Resonance Raman Spectroscopy (RRS) device to measure oxygen saturation, hemoglobin content, and autofluorescence spectrum. Measurements with RRS were performed immediately ( &amp;lt; 2 hours), 2 days, and 3 days after injury. Animals received punch biopsies and dressing changes every week for 9 wks and photographic documentation of healing. Post hoc analysis was performed in GraphPad Prism software to observe correlation between RRS readings on POD 0 to 3 and wound healing duration. Results We successfully created intermediate and full-thickness burns, as confirmed by visual observation and histological analysis. We also created different depths of intermediate burns that vary in healing potential (&amp;gt;95% re-epithelialization). Of 9 wounds on 2 pigs, 4 healed in 5 wks, 3 in 7 wks, and 2 did not heal by 9 wks. RRS measurements had 4 technical replicates for each wound on POD 0, 2, and 3, and were correlated with wound type (2nd vs. 3rd) and duration of healing for 2nd-degree burns. We defined Burn Index (BI) as a marker of burn severity- Burn Index B.I. = Oxygen Saturation / (Normalized Laser Induced Fluorescence * Normalized Hemoglobin Content) BI distinguished between 2nd-degree (n=9) and 3rd-degree (n=4) burns on POD 0 with an area under the curve (AUC) for a receiver operating characteristic (ROC) of 79.17%. It could also distinguish wounds taking more than 9 wks to heal (n=2) from those that healed earlier (n=7) by POD 2, with AUC 97.77%, indicating high sensitivity and specificity. By POD 3, BI distinguished healing in less than 5 wks (n=4) from others (n=5) with AUC 79.38%. Conclusions We established a model of intermediate burns with Yucatan miniature pigs. Resonance Raman Spectroscopy (RRS) based Burn index (BI) could distinguish full and intermediate thickness burns by POD 0 and predict healing time by POD 2 and POD 3 with high specificity and sensitivity. Applicability of Research to Practice Rapid, early, non-invasive quantification of burn depth using our portable device can aid decision-making regarding intermediate-depth wound care, such as skin grafting.

130 Comparing Artificial Intelligence Guided Image Assessment to Current Methods of Burn Assessment

Abstract Introduction Appropriate identification of burn depth and size is paramount. Despite the development of assessment aids [e.g., laser doppler imaging (LDI)], clinical assessment remains a gold standard, which assesses partial thickness burn depth with ~67% accuracy. We sought to develop an image-based artificial intelligence system that predicts burn severity and wound margins for use as a triaging tool in the community. Methods Modified EfficientNet architecture trained by 1684 mobile-device-captured burn datasets of different burn depths were previously utilized to create a convoluted neural network (CNN). The CNN was modified to a novel Boundary-Attention Mapping (BAM) algorithm using elements of saliency mapping, which was utilized to recognize the boundaries of burns. For validation, 144 patient charts that included clinical assessment, burn location, total body surface area, and LDI assessment were retrieved for a retrospective study at an academic burn center. The clinical images underwent CNN-BAM assessment and were directly compared with the LDI assessment. Results A CNN using a four-level burn severity classification achieved an accuracy of 85% (micro/macro-averaged ROC scores). The CNN-BAM system can successfully highlight burns from surrounding tissue with high confidence. Our method's burn area segmentations attained an accuracy of 91.60%, sensitivity of 78.17%, and specificity of 93.37%, when compared to LDI methodology and conducting a pixel-wise comparison of LDI’s from 104 patients (Figure 1). Results comparing the CNN-BAM outputs to clinical and LDI assessments have shown a high degree of correlation between the CNN-BAM burn severity predictions to those extrapolated from LDI healing potential (66% agreement Cohen’s Kappa analysis). This is in comparison to clinical vs LDI assessment, which had 28% agreement, and clinical vs CNN-BAM, which had 32% agreement (Figure 2). Conclusions CNN-BAM algorithm gives equivalent accuracy in detecting burn depth as LDI with a more economical and accessible application when embedded in a mobile device. Applicability of Research to Practice CNN-BAM algorithm can be embedded in a mobile application, which can be easily accessible to healthcare providers to rapidly assess burn depth. This can be especially useful in rural communities to accurately assess and transfer patients to specialized burn centres and reduce unnecessary transfers when injuries are less severe.

Accuracy of infrared thermography evaluation in burn wound healing: a systematic review and meta-analysis.

Accurate assessment of burn depth and burn wound healing potential is essential to determine early treatments. Infrared thermography (IRT) is a non-invasive and objective tool to do this. This systematic review evaluated the accuracy of IRT to determine burn wound healing potential. This systematic review and meta-analysis used MEDLINE, EMBASE, CINAHL, PEDro, DiTA and CENTRAL databases. IRT data were extracted from primary studies and categorised into four cells (i.e., true positives, false positives, true negatives and false negatives). Subgroup analysis was performed according to methods used to capture thermal images. The search strategy identified 2727 publications; however, 15 articles were selected for review and 11 for meta-analysis. In our meta-analysis, the accuracy of IRT was 84.8% (63% sensitivity and 81.9% specificity). IRT is a moderately accurate tool to identify burn depth and healing potential. Thus, IRT should be used carefully for evaluating burn wounds.

In vivo visualization of burn depth in skin tissue of rats using hemoglobin parameters estimated by diffuse reflectance spectral imaging.

Burn injuries represent a global public health problem that kills an estimated 180,000 people annually. Non-fatal burns result in prolonged hospitalization, disfigurement, and disability. The most common, convenient, and widely used method for assessing burn depth is physical or visual examination, but the accuracy of this method is reportedly poor (60% to 75%). Rapid, correct assessment of burn depth is very important for the optimal management and treatment of burn patients. New methods of burn depth assessment that are inexpensive, simple, rapid, non-contact, and non-invasive are therefore needed. The aim of this study was to propose an approach to visualize the spatial distribution of burn depth using hemoglobin parameters estimated from spectral diffuse reflectance imaging and to demonstrate the feasibility of the proposed approach for differentiating burn depth in a rat model of scald burn injury. The new approach to creating a spatial map of burn depth was based on canonical discriminant analysis (CDA) of total hemoglobin concentration, tissue oxygen saturation, and methemoglobin saturation as estimated from spectral diffuse reflectance images. Burns of three different degrees of severity were created in rat dorsal skin by 10-s exposure to water maintained at 70°C, 78°C, and 98°C, respectively. Spectral images for dorsal regions were acquired under anesthesia immediately after burn injury and at 24h, 48h, and 72h after injury. Most areas of images in the group with skin exposed to 70°C water and 98°C water were classified as 70°C burn and 98°C burn, respectively. In contrast, no significant difference between areas classified as 78°C burn and 98°C burn from 24h to 72h was evident in the group with skin exposed to 78°C water, suggesting that burn depth was heterogeneous. The proposed approach combining diffuse reflectance spectral imaging and CDA appears promising for differentiating 70°C burns from 78°C burns and 98°C burns, and 98°C burns from 70°C burns and 78°C burns at 24 to 72h after burn injury in a rat model of scald burn injury.

Medico-legal evaluation of burn trauma injuries. Epidemiological features and predictors of mortality and other adverse outcomes

Medico-legal evaluation of burn trauma injuries. Epidemiological features and predictors of mortality and other adverse outcomes

Medical thermography as a method to assessment of burn depth and treatment effectiveness in patients with burn injury

In this revue discuss the usefulness of static and active dynamic thermography for burn depth assessment as well as for estimation of the effectiveness of the different treatment modalities (cell therapy, humid ambience, evaluation of the donor skin area).

Ultrasonography for Skin and Soft Tissue Infections, Noninfectious Cysts, Foreign Bodies, and Burns in the Critical Care Setting.

There are multiple opportunities for the use of ultrasonography in the diagnosis of skin and soft tissue differentials. Ultrasonography is inexpensive, easily reproducible, and able to provide real-time data in situations where condition changes and progression are common. Not only does bedside ultrasonography provide the clinician an in-depth look beyond epidermal structures into body cavities, it remains a safe, nonionizing radiating, effective, cost-efficient, reliable, and accessible tool for the emergency management of life- and limb-threatening integumentary infections. Unnecessary invasive procedures are minimized, providing improved patient outcomes. Integumentary abnormalities secondary to trauma, surgery, and hospitalization are common among critical care patients. This article provides a brief overview and evidence-based recommendations for the use of ultrasonography in the critical care setting for integumentary system conditions, including common skin and soft tissue differentials, foreign bodies, and burn depth assessment.

Photographic Evaluation of Burn Depth via Telemedicine: Insights from Iranian Surgeons

Background:The accurate assessment of burn depth is crucial for determining appropriate treatment. Telemedicine has emerged as a promising tool for supporting burn diagnosis and decision-making, as it allows for remote consultation with burn specialists and access to high-quality imaging. The aim of this study was to evaluate the diagnostic capabilities of telemedicine in diagnosing burn depth.Methods:A total of 15 Iranian surgeons participated in this study; they were presented with 13 images of partial thickness burn ulcers located on the extremities and trunk of patients. The participating surgeons were required to provide their diagnoses of burn type and depth, as well as the necessity of surgical intervention, and their responses were recorded.Results:Data from 11 participants and 143 responses were analyzed. The average diagnostic accuracy for superficial burns was 79.3%, while for deep burns, it was 13.72%. The mean total diagnostic accuracy was 75.2%.Conclusion:The results of this study suggest that photographs can be a reliable diagnostic tool for evaluating superficial burns. However, photographs are neither valid nor reliable for assessing burn depth. These findings have important implications for the use of telemedicine in burn diagnosis and indicate that additional diagnostic tools may be necessary for accurate assessment of deep burns.

47 Burn Injury Assessment Study (BIAS): Is There Room To Improve?

Abstract Introduction The treatment of burn injured patients requires accurate wound assessment to determine appropriate interventions. Clinical assessment of burn depth, even by experts in the field, has an accuracy of only 60–80%. The purpose of this study is to estimate the performance of burn wound assessment by burn care professionals from still images. Methods This was an IRB-approved prospective cohort study in which burn care providers used a tablet-based digital interface to answer a 10-item questionnaire and to identify non-healing burn wounds from 5 patients scenarios. Each wound was evaluated using a polygon software interface to mark non-healing regions within the wound. Each wound had a ground truth determined by a consensus panel of study investigators using still photograph at 21-days post-injury to discern healing and non-healing regions. A power analysis and sample size of 100 participants produced a two-sided 95% confidence interval with a width equal to 0.20 when the sample proportion is 0.60. Continuous variables were analyzed by mean, standard deviations, median and quartiles while categorical data was analyzed as exact number and percentage. Burn wound assessment performance metrics for the providers were calculated for the whole cohort and then for subgroups using point estimate at a pixel level. Accuracy, sensitivity, specificity, area positive predictive value (APPV), and area negative predictive value (ANPV) were calculated from the ground truth and participants selected regions of non-healing wounds. Results One hundred fifty-six healthcare providers enrolled (50 physicians, 14 APPs, 63 nurses, 24 therapists, and 5 paramedics) with 9.96 ± 9.49 mean years of experience and 70% employed at a verified burn center. All five regions were represented in the analysis (Eastern Great Lakes (4%), Midwestern (6.5%), Northeastern (22%), Southern (53.5%), and Western (14%). 29.3% of the participants selected “schedule for surgery” when reviewing images of wounds that healed without surgery. 28.7% of the participants selected, “local wound care no surgery needed or, “local wound care, reassess in 7+ days for possible surgery.” Performance measures were not associated with years of experience. Overall performance is available in Table 1. Conclusions Improving burn wound assessment performance could improve our use of limited resources in burn care by optimizing patient transfers/treatments and avoiding unnecessary surgeries. Our study expands upon prior work in the field and demonstrates that burn wound assessment has significant room for improvement. These findings open the proverbial door for diagnostic devices found in other fields of medicine and our partnership with emergency room providers to advance burn care. Applicability of Research to Practice More accurate wound assessment will lead to improved treatment and triage by EM and Burn practitioners.

72 Multi-Spectral SWIR Imaging in Humans Reveals Correlations with Distinct Skin Burn Depths

Abstract Introduction Burn depth determination is a critical aspect of burn patient care but currently lacks accuracy in clinical practice. We have shown first in animal models and then in a two-patient characterization that Short Wave Infrared (SWIR) imaging, which penetrates tissue better than visual or near-infrared light and is very sensitive to water content, can distinguish between superficial and deep tissue necrosis. Here we present the findings from our pilot study of 10 patients showing the use of multi-spectral SWIR imaging of human burn injury as a potential technique for burn depth determination. Methods Ten patients admitted for mixed depth thermal injuries between 5-40% TBSA were analyzed using our SWIR assessment tool. Prior to burn excision the SWIR system was used to image burn areas and normal skin at 4 different SWIR wavelengths (Figure 1A). Standard photographs from imaged areas were collected and presented for 5 independent, blinded, surgeons’ assessments. Using the visual and SWIR images, 5-15 regions of interest (ROI) were selected from each of the burned areas and normalized to adjacent normal skin and the reflected light intensity in each ROI was averaged at each wavelength. Statistics were done using Mann-Whitney U tests. Results Visual and SWIR images were collected from burn areas in 10 patients for a total of 273 burn ROIs. The ROIs were assessed by the surgeons with ROIs being agreed upon as being superficial or superficial partial thickness (SPT) (n=47), deep partial thickness (DPT) (n=97), or full thickness (FT) (n=129) burns by a majority (60% or above) consensus. As seen in Figure 1B, the reflectance intensities (RIs) from superficial and SPT burns were significantly different than the DPT burns at the 1940 nm wavelength (p=0.05) and significantly different than FT burns at 1200 nm (p=0.008) and 1940 nm (p=0.009). When DPT and FT burns were compared there was a significant difference a 1200 nm (p=0.003) and 2250 nm (p=0.01). Conclusions Here we present a 10 patient SWIR pilot study demonstrating distinct ROIs of SWIR wavelengths for different burn depths based on consensus surgeon assessments. Overall, as burn depth increases, the 1200 and 2250 nm wavelengths show increasing RIs and 1940 nm show decreasing RIs. These results motivate further studies of SWIR imaging including pending histological analysis in the hope to non-invasively and accurately identify operative versus non-operative burns. Applicability of Research to Practice This new SWIR technology may enable us to more objectively assess burn depth, leading to improved surgical decision making and better patient outcomes.

A Hand-Held, Single-Sided NMR Sensor for Full-Thickness Skin Detection

To rapidly assess burn depth, a hand-held, single-sided NMR sensor was designed for full-thickness skin detection. The sensor is composed of a single-sided magnet, a radio frequency coil, a matching circuit, and an aluminum shell. The permanent magnet array was optimized using the sparrow search algorithm with low vertical gradient strength and each layer obtaining maximal uniformity in field of view. The actual measured magnetic field of the single-sided magnet is perfect match with the simulation results. Experimental results of depth–transverse relaxation time(T <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">2</sub> ) map prove that this sensor has high sensitivity to distinguish deep dermal and full thickness burns and superficial partial-thickness burns.