Burn depth and its histological measurement.
This paper describes a new technique for burn depth measurement, based on the histological assessment of dermal microvascular occlusion in burn biopsies. The technique was validated in a preliminary study of acute progressive microvascular damage in five adults with partial thickness burns. Burn depth was calculated at three time points post burn from the mean histological measurement of the most superficial patent and the deepest blocked vessels in five separate sections from each biopsy. The results were expressed as a percentage of the total dermal thickness and correlated well with the laser Doppler measurement of dermal blood flow and clinical estimation of burn depth. The reproducibility of the technique was tested by the repeated blind analysis of five randomly chosen biopsies on a separate occasion. Altman-Bland plot analysis demonstrated a median variation of 0.1% (95% confidence interval -1 to 2%). A second independent observer (MPHT), who carried out a blind analysis of the same randomly chosen biopsies, tested the precision of the technique. The median variation was 2% (95% confidence interval -5 to 8.5%).
Department of Plastic Surgery, Northern General Hospital, Herries Road, Yorkshire S57AU, Sheffield, UK.
A M
AM
Watts
M P
MP
Tyler
M E
ME
Perry
A H
AH
Roberts
D A
DA
McGrouther
D000328:Adult; D001707:Biopsy, Needle; D002056:Burns / Q000175:diagnosis / Q000473:pathology*; D016001:Confidence Intervals; D020405:Dermis / Q000098:blood supply* / Q000473:pathology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D015601:Injury Severity Score; D017078:Laser-Doppler Flowmetry / Q000379:methods*; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012867:Skin / Q000098:blood supply