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Burn depth assessment using hyperspectral imaging in a prospective single center study.

Torsten Schulz1, Jörg Marotz2, Sebastian Seider3

  • 1Department of Orthopedic, Trauma and Plastic Surgery, Leipzig University Hospital, Germany.

Burns : Journal of the International Society for Burn Injuries
|October 27, 2021
PubMed
Summary

Hyperspectral imaging (HSI) shows promise in assessing thermal burn depth. The HSI burn index (BI) can predict the need for skin grafting with high sensitivity and specificity within 72 hours post-injury.

Keywords:
Hyperspectral imagingLaser doppler imagingThermal imaging, burn depth assessment, burn index

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Area of Science:

  • Medical Imaging
  • Burn Management
  • Wound Healing

Background:

  • Assessing thermal burn depth is clinically challenging.
  • Previous optical methods like infrared thermography and spectrophotometric intracutaneous analysis have shown limitations.
  • Laser Doppler imaging (LDI) is currently a reliable method for burn depth assessment.

Purpose of the Study:

  • To evaluate hyperspectral imaging (HSI) as a novel optical device for determining thermal burn depth.
  • To assess the accuracy of HSI in predicting the need for surgical intervention (skin grafting or prolonged wound closure).

Main Methods:

  • A prospective study included 59 patients with 2nd or 3rd-degree thermal burns treated between November 2019 and September 2020.
  • Hyperspectral imaging (HSI) and clinical assessment were performed at 24, 48, and 72 hours post-injury.
  • Patients were divided into two groups based on wound closure time (≤21 days vs. >21 days or requiring skin graft). The HSI burn index (BI) was calculated and analyzed using logistic regression and ROC curves.

Main Results:

  • The HSI burn index (BI) showed significant differences between groups at all time points.
  • At 72 hours post-injury, the BI demonstrated a sensitivity of 92% and a specificity of 71% in predicting the need for skin grafting.
  • ROC analysis indicated specific BI thresholds for predicting outcomes at 24, 48, and 72 hours.

Conclusions:

  • Changes in microcirculation within 72 hours post-thermal trauma are reflected by an increasing BI.
  • HSI, through the calculated BI, offers a promising non-invasive tool for early prediction of burn severity and management needs.
  • The HSI burn index (BI) can reliably predict the requirement for skin grafting after thermal injury.