Moustafa Elmasry1, Robin Mirdell2, Erik Tesselaar3, Simon Farnebo4, Folke Sjöberg4, Ingrid Steinvall5. 1. Department of Hand Surgery, Plastic Surgery and Burns, Linköping University, Linköping, Sweden; Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden; Plastic Surgery Unit, Surgery Department, Suez Canal University, Ismailia, Egypt. 2. Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden. 3. Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden; Department of Medical Radiation Physics and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden. 4. Department of Hand Surgery, Plastic Surgery and Burns, Linköping University, Linköping, Sweden; Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden. 5. Department of Hand Surgery, Plastic Surgery and Burns, Linköping University, Linköping, Sweden; Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden. Electronic address: Ingrid.Steinvall@regionostergotland.se.
Abstract
BACKGROUND: Scalds are the most common type of burn injury in children, and the initial evaluation of burn depth is a problem. Early identification of deep dermal areas that need excision and grafting would save unnecessary visits and stays in hospital. Laser speckle contrast imaging (LSCI) shows promise for the evaluation of this type of burn. The aim of this study was to find out whether perfusion measured with LSCI has an influence on the decision for operation, duration of healing and care period, and costs, in children with scalds. METHODS: We studied a group of children with scalds whose wounds were evaluated with LSCI on day 3-4 after injury during the period 2012-2015. Regression (adjustment for percentage total body surface area burned (TBSA%), age, and sex) was used to analyse the significance of associations between degree of perfusion and clinical outcome. RESULTS: We studied 33 children with a mean TBSA% of 6.0 (95% CI 4.4-7.7)%. Lower perfusion values were associated with operation (area under the receiver-operating characteristic curve 0.86, 95% CI 0.73-1.00). The perfusion cut-off with 100% specificity for not undergoing an operation was ≥191 PU units (66.7% sensitivity and 72.7% accurately classified). Multivariable analyses showed that perfusion was independently associated with duration of healing and care period. CONCLUSION: Lower perfusion values, as measured with LSCI, are associated with longer healing time and longer care period. By earlier identification of burns that will be operated, perfusion measurements may further decrease the duration of care of burns in children with scalds.
BACKGROUND: Scalds are the most common type of burn injury in children, and the initial evaluation of burn depth is a problem. Early identification of deep dermal areas that need excision and grafting would save unnecessary visits and stays in hospital. Laser speckle contrast imaging (LSCI) shows promise for the evaluation of this type of burn. The aim of this study was to find out whether perfusion measured with LSCI has an influence on the decision for operation, duration of healing and care period, and costs, in children with scalds. METHODS: We studied a group of children with scalds whose wounds were evaluated with LSCI on day 3-4 after injury during the period 2012-2015. Regression (adjustment for percentage total body surface area burned (TBSA%), age, and sex) was used to analyse the significance of associations between degree of perfusion and clinical outcome. RESULTS: We studied 33 children with a mean TBSA% of 6.0 (95% CI 4.4-7.7)%. Lower perfusion values were associated with operation (area under the receiver-operating characteristic curve 0.86, 95% CI 0.73-1.00). The perfusion cut-off with 100% specificity for not undergoing an operation was ≥191 PU units (66.7% sensitivity and 72.7% accurately classified). Multivariable analyses showed that perfusion was independently associated with duration of healing and care period. CONCLUSION: Lower perfusion values, as measured with LSCI, are associated with longer healing time and longer care period. By earlier identification of burns that will be operated, perfusion measurements may further decrease the duration of care of burns in children with scalds.