Advances in Burn Care

Reconsidering the H&E stain as the gold standard in assessing the depth of burn wounds

“…LDI is noninvasive and uses a laser beam to measure superficial blood flow. When laser light is directed at the skin, circulating red blood cells scatter the light, resulting in a change in frequency (Doppler shift), which is then used to calculate the average velocity of blood flow . LDI has been shown to have good correlation with histological assessment of burn depth and has been reported to have a diagnostic accuracy higher than clinical judgment (97% vs 60%‐80%), when using outcome data of wound healing by 21 days as the clinical standard .…”

“…Thermography uses temperature measurements to determine depth based on the assumption that deep wounds are cooler due to less vascular perfusion. However, ambient heat loss may result in overestimating the depth of the burn . Fluorescent dyes, such as indocyanine green, when administered intravenously, binds to albumin and can be used with videography.…”

“…Fluorescent dyes, such as indocyanine green, when administered intravenously, binds to albumin and can be used with videography. Currently, it is being used in the operating room in real‐time as a device known as SPY Elite (Novadaq, Burnaby, Vancouver, Canada), but it is invasive and expensive for general use . For those interested in more detail regarding various technologies, a comprehensive review is available …”