Optical coherence tomography provides an optical biopsy of burn wounds in children-a pilot study

Area of Science:

• Biomedical Optics
• Pediatric Dermatology
• Medical Imaging

Background:

• Thermic injuries represent severe childhood injuries where burn depth is a critical prognostic factor.
• Accurate burn depth assessment is challenging, leading to diagnostic uncertainty, repeated assessments, and risks of overtreatment or undertreatment.

Purpose of the Study:

• To investigate the utility of Optical Coherence Tomography (OCT) and dynamic OCT (D-OCT) in assessing burn wound depth in pediatric patients.
• To identify specific morphologic patterns in OCT and D-OCT images correlated with different burn depths.

Main Methods:

• Utilized noninvasive OCT and D-OCT, laser-based imaging techniques with a penetration depth of approximately 2 mm.
• Examined burns and scalds in 130 children, analyzing structural skin images and microvascular architecture provided by OCT and D-OCT.
• Correlated observed morphologic patterns with established burn depths.

Main Results:

• OCT and D-OCT images of burned skin showed consistent differences compared to normal skin.
• Identified several novel morphologic patterns associated with burn injuries, including epidermal loss and surface smoothness in superficial wounds.
• Deeper wounds exhibited surface irregularity, loss of dermal papillary patterns, effacement of skin lines, and altered microvascular architecture.

Conclusions:

• This study is the first systematic investigation of D-OCT for pediatric burn wound assessment.
• D-OCT provides an 'optical biopsy,' revealing significant information about burn severity.
• Identified burn-associated patterns using D-OCT can improve the precision of burn depth assessment in children.