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A Methodological Approach to Non-invasive Assessments of Vascular Function and Morphology
Published on: February 7, 2015
Noninvasive methods for determining lesion depth from vesicant exposure
Ernest H Braue1, John S Graham, Bryce F Doxzon
1U.S. Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, Maryland 21010-5400, USA.
Summary
Accurate assessment of sulfur mustard (SM) burn depth is crucial for effective treatment. Noninvasive imaging techniques, laser Doppler perfusion imaging (LDPI) and indocyanine green fluorescence imaging (ICGFI), show promise in estimating SM lesion depth.
Area of Science:
- Biomedical Engineering
- Dermatology
- Toxicology
Background:
- Sulfur mustard (SM) exposure causes chemical burns requiring accurate depth assessment for appropriate treatment.
- Current methods of burn depth assessment rely on physical examination, which can be subjective, especially for intermediate-depth lesions.
- Objective, noninvasive methods are needed to improve the accuracy of burn depth diagnosis.
Purpose of the Study:
- To evaluate the efficacy of laser Doppler perfusion imaging (LDPI) and indocyanine green fluorescence imaging (ICGFI) in assessing sulfur mustard (SM) burn depth.
- To compare the diagnostic accuracy of these noninvasive imaging techniques with histological evaluation.
- To determine if LDPI and ICGFI can accurately predict the need for aggressive versus nonaggressive treatment.
Main Methods:
- A weanling swine model was used, exposing ventral skin sites to varying durations of sulfur mustard (SM).
- Lesion depth was assessed using LDPI and ICGFI at 24, 48, and 72 hours post-exposure.
- Histological evaluation (hematoxylin and eosin staining) served as the gold standard for determining true lesion depth.
Main Results:
- Both LDPI and ICGFI effectively characterized skin perfusion and provided reliable estimates of SM lesion depth.
- The imaging techniques accurately differentiated between lesions requiring aggressive treatment (longer SM exposure) and those needing less aggressive management (shorter SM exposure).
- Histological analysis confirmed the accuracy of the LDPI and ICGFI assessments.
Conclusions:
- LDPI and ICGFI are valuable noninvasive tools for estimating sulfur mustard (SM) burn depth and guiding treatment decisions.
- ICGFI offers advantages such as real-time imaging and portability, though intravenous dye injection may be a limitation in field settings.
- Further research is needed to optimize parameters and establish a graded series of SM lesions for comprehensive evaluation.
