Burn wound depth assessment – is laser Doppler imaging the best measurement tool available?

Abstract

Accurate early assessment of burn wound depth is increasingly important in clinical decision-making. Clinimetric principles are absolutely mandatory while developing a new test or tool for use in the clinical setting. This article critically evaluates the clinimetrics of a powerful tool for assessment of burn depth and whether Laser Doppler Imaging can meet those criteria by virtue of differentiation between superficial and deep burns.

A new, fast LDI for assessment of burns: A multi-centre clinical evaluation

“…Early studies using the laser Doppler monitoring technique showed a strong correlation between skin blood flow and healing time or need for surgery [6][7][8]. The laser Doppler imaging technique for skin blood flow mapping was introduced by Niazi et al [9] and has become more widely used to aid routine burn assessments [5,[10][11][12] and comparison of treatments [13,14] in recent years.…”

ICG angiography predicts burn scarring within 48h of injury in a porcine vertical progression burn model

“…Without early intervention, some partial thickness burns progress to full thickness injuries, exposing the patient to substantial morbidity and undergoing excision and grafting [2]. Despite multiple advances in acute treatment and surgical management, the decision to debride a burn still largely relies on the experience and visual perception of the individual surgeon [3]. Because early clinician accuracy is limited, ranging The current standard of care in determining the need to excise and graft a burn remains with the burn surgeon, whose clinical judgment is often variable.…”

A comparison of non-invasive imaging modalities: Infrared thermography, spectrophotometric intracutaneous analysis and laser Doppler imaging for the assessment of adult burns

“…Disruption of this blood flow correlates with the extent of injury, and is displayed by a colour map of the wound. This is then interpreted alongside the clinical examination findings or digital photographs when assessing depth [11,12]. To date, LDI remains the only evidence-based adjunct supported by the National Institute for Health and Care Excellence (NICE) [13].…”