Optical, Tomographic, and Mass Spectrometry Imaging Methods for Burn Wounds: Capabilities, Limitations, and Clinical...

This review systematizes the principal methods for imaging and morphological analysis of burn wounds, ranging from light, electron, and fluorescence microscopy to tomographic techniques and mass spectrometry imaging. Light microscopy with histological staining and immunohistochemistry remains the morphological gold standard, enabling visualization of the zones of coagulation, stasis, and hyperemia, as well as molecular characterization of inflammation, angiogenesis, and fibrosis. Electron microscopy allows the study of the ultrastructure of cells and the extracellular matrix at nanometer resolution. Among optical methods, wide-field indocyanine green angiography demonstrates high accuracy in burn depth stratification, whereas fluorescence lifetime imaging microscopy assesses cellular metabolism without exogenous labels. Among tomographic techniques, high-frequency ultrasound is the most accessible bedside modality with submillimeter resolution, permitting evaluation of tissue anatomy, perfusion, and biomechanical properties. magnetic resonance imaging is limited by its high cost and long examination time, while mass spectrometry imaging is used solely for research purposes. For clinical practice, the optimal combination is high-frequency ultrasound and wide-field fluorescence imaging. All methods retain high relevance for experimental research, enabling the validation of novel therapeutic strategies.