Early visualization of skin burn severity using a topically applied dye-loaded liquid bandage

Skin burns are a significant source of injury in both military and civilian sectors. They are especially problematic in low resource environments where non-fatal injuries can lead to high morbidity rates, prolonged hospitalization, and disability. These multifaceted wounds can be highly complex and must be quickly diagnosed and treated to achieve optimal outcomes. When the appropriate resources are available, the current gold standard for assessing skin burns is through tissue punch biopsies followed by histological analysis. Apart from being invasive, costly, and time-consuming, this method can suffer from heterogeneous sampling errors when interrogating large burn areas. Here we present a practical method for the early visualization of skin burn severity using a topically applied fluorescein-loaded liquid bandage and an unmodified commercial digital camera. Quantitative linear mixed effects models of color images from a four day porcine burn study demonstrate that colorimetric changes within the HSB colorspace can be used to estimate burn depth severity immediately after burning. The finding was verified using fluorescence imaging, tissue cross-sectioning, and histopathology. This low-cost, rapid, and non-invasive color analysis approach demonstrates the potential of dye-loaded liquid bandages as a method for skin burn assessment in settings such as emergency medicine triage and low resource environments.