Cutaneous microcirculatory assessment of the burn wound is associated with depth of injury and predicts healing time.
BACKGROUND
Current trends for the treatment of deep partial thickness and full-thickness burns include early excision and skin grafting. In this study we retrospectively evaluated the ability of Laser Doppler Flowmetry (LDF), taken within 24h of the burn to predict: (1) burn wound depth and (2) wounds which would heal in less than 21 days.


METHODS
The Laser Doppler Flowmeter (O2C, LEA Medizintechnik, Germany) was employed to non-invasively measure the cutaneous microcirculation of 173 selected areas on 28 patients who suffered burns.


RESULTS
A distinct association between initial flow (<24h after burn injury) and the clinical assessment of depth of burn wounds was observed. Wounds demonstrating an initial blood flow of >100 AU were, in 93.1% of cases, correctly (positively) predicted for spontaneous healing within 21 days. A blood flow of <100 AU (negatively) predicted in 88.2%, those wounds which would not go on to heal within 21 days. Sequential measurement analysis (<24h, 3 days after injury and 6 days after injury) revealed no significant decrease in skin perfusion velocity or flow rate.


CONCLUSIONS
LDF can provide immediate results for early determination of burn wound depth and is useful in selecting patients for conservative treatment of their burn wounds.
Department of Orthopaedic, Plastic and Hand Surgery, University of Bern, Bern, Switzerland.
K M
KM
Merz
M
M
Pfau
G
G
Blumenstock
M
M
Tenenhaus
H E
HE
Schaller
H O
HO
Rennekampff
D000293:Adolescent; D000328:Adult; D000368:Aged; D002056:Burns / Q000473:pathology*; D005260:Female; D006801:Humans; D017078:Laser-Doppler Flowmetry; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D012189:Retrospective Studies; D012867:Skin / Q000098:blood supply*; D013997:Time Factors; D014945:Wound Healing; D055815:Young Adult