OCT‐Based Angiography and Surface Topography in Burn‐Damaged Skin

Abstract

Background and Objectives There is a clinical need for an accurate, non‐invasive imaging tool that can provide the objective assessment of burn wounds. The aims of this study are to demonstrate the potential of optical coherence tomography (OCT) in evaluating burn wound healing, as well as exploring the physiological basis of human wound healing. Study Design/Materials and Methods This was a retrospective study. Seven patients with severe burn wounds who were admitted to Harborview Medical Center were imaged using an in‐house‐built, clinical‐prototype OCT system. OCT imaging was carried out at multiple scan sites on the burned skin across two time points (imaging session #1 and #2) with a field of view of ~9 × 9 mm. Due to pathological differences among burn zones, scan sites were classified into red sites (zone of hyperemia), white sites (zone of coagulation), and mixed sites. In addition to obtaining qualitative en face vascular and surface topography maps, we quantified vascular area density and surface roughness for comparative purposes. Results En face vascular and surface topography maps demonstrated numerous morphological changes over both imaging sessions associated with burn injury, such as altered blood flow and loss of regular texture. Quantitative analyses revealed that during imaging session #1, vascular area density was significantly increased within the red sites compared with that of a healthy control (P = 0.0130), while vascular area density was significantly decreased within the white sites compared with that of a healthy control (P < 0.0001). During imaging session #2, vascular area density was significantly reduced to a more normal range within the red sites compared with imaging session #1 (P = 0.0215); however, vascular area density was still significantly lower within the white sites compared with that of a healthy control (P < 0.0001). Furthermore, vascular area density and surface roughness were significantly increased within the white sites during imaging session #2 compared with imaging session #1 (both P < 0.0001). Conclusions OCT is clinically feasible to monitor vascular changes and alterations in skin surface roughness during the process of burn wound healing. Variations in vascular area density and roughness measurements within the burn wounds revealed by OCT offer some key insights into the underlying pathophysiological mechanisms responsible for wound healing, which may become critical biological indicators in future clinical evaluation and monitoring of wound healing. Lasers Surg. Med. © 2020 Wiley Periodicals LLC

Basic fibroblast growth factor gel preparation induces angiogenesis during wound healing

“…With the gradual popularization of OCTA applications, their application value in various fields of medicine has been increasingly reflected. 19,32,33 Using OCTA techniques, this study provides an overview of changes in vascular and structural characteristics during skin healing at a spatiotemporal level. In this study, it was observed that the gelling agent could significantly promote angiogenesis on the wound surface of full-thickness skin defects in Wistar rats, mainly by significantly increasing the diameter, density, and circumference of blood vessels, indicating that PDGF had a significant effect on the improvement of wound microcirculation.…”

Retrospective Study from a Single Center on the Efficacy of Pulsed Lavage Following Excision of Burns ≥30% of the Total Body Surface Area in 63 Patients

“…The wound should be rinsed with a sufficient quantity of fluid and a certain impact to achieve a better effect. However, wounds need adequate hemostasis before pulsed lavage to prevent blood coagulation or damage to the exposed nerve endings [ 39 ].…”

Application of OCT‐Derived Attenuation Coefficient in Acute Burn‐Damaged Skin

“…OCT scanning was performed using an in-house-built swept-source OCT (SS-OCT) system with a central wavelength of 1310 nm, and a bandwidth of 100 nm. More detailed system information is available in our previous publications [15,16,43]. The handheld probe was specifically designed with a sample spacer to keep the skin at a fixed distance from the objective lens.…”

“…Another promising form of OCT is OCT-based angiography (OCTA), which is a functional extension of OCT that can provide vascular information without the need for invasive contrast agents. A number of studies, such as those conducted by Deegan et al [13][14][15] and Lu et al [16], have demonstrated the potential of OCTA to both qualitatively and quantitatively assess the vascular response to burn injury over time. Despite the increased applicability of OCT in its various forms, however, studies regarding the visualization and subsequent measuring of epidermal thickness in skin post-injury are limited.…”