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Prospective comparative evaluation study of Laser Doppler Imaging and thermal imaging in the assessment of burn depth
Christopher Wearn1, Kwang Chear Lee1, Joseph Hardwicke1
1Scar Free Foundation Centre for Burns Research, University Hospital Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK; University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
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.