Robin Mirdell1, Fredrik Iredahl1, Folke Sjöberg2, Simon Farnebo2, Erik Tesselaar3. 1. Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden. 2. Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden; Department of Hand and Plastic Surgery and Burns, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden. 3. Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden; Department of Radiation Physics and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden. Electronic address: erik.tesselaar@liu.se.
Abstract
BACKGROUND: Microvascular perfusion changes in scalds in children during the first weeks after injury is related to the outcome of healing, and measurements of perfusion, based on laser Doppler imaging, have been used successfully to predict the need for excision and grafting. However, the day-to-day changes in perfusion during the first weeks after injury have not to our knowledge been studied in detail. The aim of this study, based on a conservative treatment model where excision and grafting decisions were delayed to day 14 after injury, was to measure changes in perfusion in scalds using laser speckle contrast imaging (LSCI) during the first three weeks after injury. METHODS: We measured perfusion with LSCI in 34 patients at regular intervals between 6h after injury until complete reepithelialization or surgery. Duration of healing was defined as the time to complete reepithelialization. RESULTS: Less perfusion, between 6 and 96h after injury, was associated with longer duration of healing with the strongest association occurring between 72 and 96h. Burns that healed within 14 days had relatively high initial perfusion, followed by a peak and subsequent slow decrease. Both the maximum perfusion and the time-to-peak were dependent on the severity of the burn. Burns that needed excision and grafting had less initial perfusion and a gradual reduction over time. CONCLUSION: The perfusion in scalds in children shows characteristic patterns during the first weeks after injury depending on the duration of wound healing, the greatest difference between wounds of different severity being on the 4th day. Perfusion should therefore preferably be measured on the fourth day if it is to be used in the assessment of burn depth.
BACKGROUND: Microvascular perfusion changes in scalds in children during the first weeks after injury is related to the outcome of healing, and measurements of perfusion, based on laser Doppler imaging, have been used successfully to predict the need for excision and grafting. However, the day-to-day changes in perfusion during the first weeks after injury have not to our knowledge been studied in detail. The aim of this study, based on a conservative treatment model where excision and grafting decisions were delayed to day 14 after injury, was to measure changes in perfusion in scalds using laser speckle contrast imaging (LSCI) during the first three weeks after injury. METHODS: We measured perfusion with LSCI in 34 patients at regular intervals between 6h after injury until complete reepithelialization or surgery. Duration of healing was defined as the time to complete reepithelialization. RESULTS: Less perfusion, between 6 and 96h after injury, was associated with longer duration of healing with the strongest association occurring between 72 and 96h. Burns that healed within 14 days had relatively high initial perfusion, followed by a peak and subsequent slow decrease. Both the maximum perfusion and the time-to-peak were dependent on the severity of the burn. Burns that needed excision and grafting had less initial perfusion and a gradual reduction over time. CONCLUSION: The perfusion in scalds in children shows characteristic patterns during the first weeks after injury depending on the duration of wound healing, the greatest difference between wounds of different severity being on the 4th day. Perfusion should therefore preferably be measured on the fourth day if it is to be used in the assessment of burn depth.
Authors: Adrien Ponticorvo; David M Burmeister; Rebecca Rowland; Melissa Baldado; Gordon T Kennedy; Rolf Saager; Nicole Bernal; Bernard Choi; Anthony J Durkin Journal: Lasers Surg Med Date: 2017-02-21 Impact factor: 4.025
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Authors: Johan Zötterman; Dries Opsomer; Simon Farnebo; Phillip Blondeel; Stan Monstrey; Erik Tesselaar Journal: Plast Reconstr Surg Glob Open Date: 2020-01-20