Related Experiment Video
Updated: Jun 18, 2025
Dual-mode Imaging of Cutaneous Tissue Oxygenation and Vascular Function
Published on: December 8, 2010
Depth of intact vascular plexus - visualized with optical coherence tomography - correlates to burn depth in thoracic
Valerie Dalicho1, Tina Straube1, Kathrin Kelly1
1Paediatric Burn Center Lübeck, Department of Paediatric Surgery, University Hospital Lübeck, Lübeck, Germany.
Insights
Optical coherence tomography (OCT) accurately assesses burn depth in children by measuring capillary network depth. This technology helps differentiate between burn grades, aiding in prognosis and treatment planning for thermal injuries.
Area of Science:
- Dermatology
- Medical Imaging
- Pediatric Surgery
Background:
- Deep thermal injuries in children pose significant challenges due to potential scarring and functional impairment.
- Accurate clinical assessment of burn depth is often difficult, impacting treatment decisions.
- Optical coherence tomography (OCT) offers a non-invasive method to visualize skin structures and microcirculation.
Purpose of the Study:
- To determine the depth of the capillary network in healthy and thermally injured pediatric skin using OCT.
- To compare OCT measurements with clinical assessments of burn depth (grades IIa and IIb).
- To evaluate the reliability of OCT in differentiating burn depths and predicting healing potential.
Main Methods:
- Twenty-five children with thermal injuries on the ventral thoracic wall were included.
- OCT was used to measure the depth of the capillary network in healthy skin and at the injury site.
- Measurements were compared between healthy skin and injuries classified as grade IIa or IIb.
Main Results:
- The capillary network in healthy skin was located at 0.33 mm depth.
- In grade IIa burns, the capillary network was found at a more superficial 0.23 mm depth.
- In grade IIb burns, the capillary network was deeper at 0.36 mm, with an overall prediction accuracy of 84%.
Conclusions:
- OCT reliably detects and differentiates capillary network depth in healthy and burned skin.
- Superficial capillary visualization in grade IIa burns suggests intact superficial vasculature and good healing prognosis.
- Deeper visualization in grade IIb burns indicates impaired blood flow and potential for poorer outcomes.
Objectives:
Deep thermal injuries are among the most serious injuries in childhood, often resulting in scarring and functional impairment. However, accurate assessment of burn depth by clinical judgment is challenging. Optical coherence tomography (OCT) provides structural images of the skin and can detect blood flow within the papillary plexus. In this study, we determined the depth of the capillary network in healthy and thermally injured skin and compared it with clinical assessment.
Methods:
In 25 children between 7 months and 15 years of age (mean age 3.5 years (SD±4.14)) with thermal injuries of the ventral thoracic wall, we determined the depth of the capillary network using OCT. Measurements were performed on healthy skin and at the center of the thermal injury (16 grade IIa, 9 grade IIb). Comparisons were made between healthy skin and thermal injury.
Results:
The capillary network of the papillary plexus in healthy skin was detected at 0.33 mm (SD±0.06) from the surface. In grade IIb injuries, the depth of the capillary network was 0.36 mm (SD±0.06) and in grade IIa injuries 0.23 mm (SD±0.04) (Mann-Whitney U test: p<0.001). The overall prediction accuracy is 84 %.
Conclusions:
OCT can reliably detect and differentiate the depth of the capillary network in both healthy and burned skin. In clinical IIa wounds, the capillary network appears more superficial due to the loss of the epidermis, but it is still present in the upper layer, indicating a good prognosis for spontaneous healing. In clinical grade IIb wounds, the papillary plexus was visualized deeper, which is a sign of impaired blood flow.
