Prospective comparative evaluation study of Laser Doppler Imaging and thermal imaging in the assessment of burn depth. Issue 1 (February 2018)

• Record Type: Journal Article
• Authors: Wearn, Christopher; Lee, Kwang Chear; Hardwicke, Joseph; Allouni, Ammar; Bamford, Amy; Nightingale, Peter; Moiemen, Naiem
• Is Part Of: Burns. Volume 44:Issue 1(2018)
• Page Start: 124
• Page End: 133
• Publication Date: 2018-02
• Subjects: Burn depth -- Thermal imaging -- Laser Doppler Imaging -- Clinical assessment; Burns and scalds -- Periodicals; 617.11
• DOI: 10.1016/j.burns.2017.08.004
• Languages: English
• ISSNs: 0305-4179

Abstract

Highlights: Accuracies for LDI, thermal imaging and photographic clinical assessment were greater on day 3 after burn compared to day 0. Accuracy in assessing burn depth was highest for real-time clinical assessment on day 0 and LDI on day 3. Thermal imaging was found to be no better than photographic clinical assessment in predicting wounds that would heal in <21 days.. Thermal imaging accuracy is likely to be significantly influenced by external factors such as room ambient temperature. Abstract: Introduction: The accurate assessment of burn depth is challenging but crucial for surgical excision and tissue preservation. Laser Doppler Imaging (LDI) has gained increasing acceptance as a tool to aid depth assessment but its adoption is hampered by high costs, long scan times and limited portability. Thermal imaging is touted as a suitable alternative however few comparison studies have been done. Methods: Sixteen burn patients with 52 regions of interests were analysed. Burn depth was determined using four methods LDI, thermal imaging, photographic and real-time clinical evaluation at day 1 and day 3. LDI flux and Delta T values were used for the prediction of outcomes (wound closure in <21 days). Photographic clinical evaluation of burn depth was performed by 4 blinded burn surgeons. Results: Accuracy of assessment methods were greater on post burn day 3 compared to day 0. Accuracies of LDI on post burn day 0 and 3 were 80.8% and 92.3% compared to 55.8% and 71.2% for thermal imaging and 62.5% and 71.6% for photographic clinical assessment. Real-time clinical examination had an accuracy of 88.5%. Thermal imaging scan times were significantly faster compared to LDI. Discussion: LDI outperforms thermal imaging in terms of diagnostic accuracy of burn depth likely due to the susceptibility of thermal imaging to environmental factors.