Burn depth estimation--man or machine.

A Burn Depth Indicator, utilizing reflectance ratios of red, green, and infrared light, has been devised and clinically tested for 18 months at our Burn Center. Using the endpoint of wound healing in less than or more than 3 weeks, clinical assessment by two experienced surgeons of intermediate depth wounds was compared to readings from the BDI . In about one third of cases the surgeons were unwilling to commit themselves to a prediction. In the cases where the surgeons were willing to make a prediction, they were incorrect about 25% of the time. The BDI was significantly more accurate than the clinical assessment in those predicted not to heal by the surgeons and maintained an accuracy of 79% in the wounds where the surgeons would not make a prediction. The BDI is portable, noninvasive, and provides an immediate reading. It may have utility as a triage tool for emergency rooms or combat situations, and has utility at present in our Burn Center as a more accurate tool than our clinical judgment in predicting which wounds should be excised and grafted during the first few days after injury.