Accuracy of early burn depth assessment by laser Doppler imaging on different days post burn
Accuracy of early burn depth assessment by laser Doppler imaging on different days post burn
复制标题
DOI：
10.1016/j.burns.2008.08.011
复制
发表时间：
2009-02-01
期刊：
影响因子：
2.7
通讯作者：
Monstrey, Stan
中科院分区：
文献类型：
--
作者：
Hoeksema, Henk;Van de Sijpe, Karlien;Monstrey, Stan
背景：准确诊断烧伤深度对选择最合适的治疗方法至关重要。仅通过临床手段对烧伤深度的早期评估是不准确的，导致不必要的手术或移植手术的延迟。据报道，激光多普勒成像（LDI）是一种确定烧伤创面深度的客观技术，但烧伤后早期的准确性尚未得到研究。方法：对40例中深度烧伤患者在第0、1、3、5、8天的LDI测量结果与临床评估结果的准确性进行前瞻性评估和比较。烧伤深度的临床评估由两名对LDI图像不知情的观察者进行。准确性通过与结果的比较来评估：愈合时间超过21天被认为相当于深部皮肤伤口的活检结果。显然，浅表和全层伤口被排除在外。LDI通量水平用于LDI预测结果：低于220 PU预测第21天未愈合。结果：LDI在烧伤当天和烧伤后0、1、3、5、8天的烧伤深度评估准确率分别为54%、79.5%、95%、97%和100%，而临床评估准确率分别为40.6%、61.5%、52.5%、71.4%和100%。LDI的准确性在第3天（p < 0.001）和第5天（p = 0.005）显著高于临床准确性。燃烧深度转换也被考虑。这是第一个量化LDI扫描在烧伤后这些重要的早期临床评估中的优势的研究。(C) 2008爱思唯尔有限公司和ISBI。版权所有。
Background: Accurate diagnosis of burn depth is essential in selecting the most appropriate treatment. Early assessment of burn depth by clinical means only has been shown to be inaccurate, resulting in unnecessary operations or delay of grafting procedures. Laser Doppler imaging (LDI) was reported as an objective technique to determine the depth of a burn wound, but the accuracy on very early days post burn has never been investigated yet.Methods: in 40 patients with intermediate depth burns, we prospectively evaluated and compared the accuracy of the LDI measurements with the clinical assessments on days 0, 1, 3, 5, 8. Clinical evaluation of the depth of the burn was performed by two observers blinded to the LDI images. Accuracies were assessed by comparison with outcome: healing times longer than 21 days were considered to be equivalent to a biopsy finding of a deep dermal wound. Obviously superficial and full thickness wounds were excluded. LDI flux level was used for LDI prediction of outcome: less than 220 PU to predict non-healing at day 21. Results: The accuracies of burn depth assessments on the day of burn and post burn days 0, 1, 3, 5 and 8 using LDI were 54%, 79.5%, 95%, 97% and 100% compared with clinical assessment accuracies of 40.6%, 61.5%, 52.5%, 71.4% and 100%, respectively. LDI accuracy was significantly higher than clinical accuracy on day 3 (p < 0.001) and day 5 (p = 0.005). Burn depth conversion was also considered. This is the first study to quantify the advantage of LDI scanning over clinical assessments during these important early after burn days. (C) 2008 Elsevier Ltd and ISBI. All rights reserved.