Burn depth estimation using indocyanine green fluorescence.
Expedient primary excision of deep dermal and full-thickness burn wounds with subsequent skin grafting is the standard of care in most burn institutions, but differentiating full-thickness from partial-thickness burns is often difficult. Because accurate early assessment of burn depth may improve care, a variety of technical methods have attempted to measure burn depth but these methods have had limited success. We describe a new technique to determine burn depth that uses infrared (840- to 850-nm) fluorescence emission from intravenously administered indocyanine green following excitation with infrared (780 nm) and UV light (369 nm). Full-thickness and partial-thickness burns in hairless rat skin were distinguished based on the infrared-induced and UV-induced fluorescence intensity ratios relative to normal, unburned skin immediately after the burn and on post-burn days 1 through 3 and 7. Dual-wavelength excitation of indocyanine green infrared fluorescence can delineate full-thickness from partial-thickness burns at an early date, allowing prognosis, surgical planning, and early primary excision and grafting.
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Harvard Medical School, Department of Dermatology, Massachusetts General Hospital, Boston 02114.
Bua
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Anderson
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Nishioka
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D000818:Animals; D002056:Burns / Q000175:diagnosis* / Q000473:pathology; D003937:Diagnosis, Differential; D005336:Fiber Optic Technology / Q000295:instrumentation; D007208:Indocyanine Green / Q000008:administration & dosage; D007259:Infrared Rays; D007275:Injections, Intravenous; D008297:Male; D051381:Rats; D011923:Rats, Nude; D012867:Skin / Q000473:pathology; D013050:Spectrometry, Fluorescence / Q000295:instrumentation / Q000379:methods; D013997:Time Factors; D014466:Ultraviolet Rays
D007208:Indocyanine Green