title: The impact of laser Doppler imaging on time to grafting decisions in pediatric burns.
abstract: Early definitive treatment of burns facilitates optimal results by reducing the risk of subsequent hypertrophic scarring. Laser Doppler imaging (LDI) has been shown to assist in predicting burn wound healing potential. This study sought to determine whether use of LDI in pediatric burn patients has led to earlier decision making for grafting. The study cohort were patients who underwent a skin grafting procedure for a burn wound at a single institution, a state referral center for all major pediatric burns, between June 2006 and December 2007. Patients were divided into two groups: those who underwent LDI scanning and those who were only assessed clinically. Time of burn injury to time of decision making for the grafting procedure was calculated in days. Forty-nine percent of 196 patients underwent LDI. The mean time from the date of injury to decision making for graft procedure was 8.9 days in those patients who had an LDI scan vs 11.6 days in the group assessed by clinical observation alone. This trend for earlier decision for grafting procedure in the LDI group was statistically significant (P = .01). There was no significant difference between those patients who were scanned and those only assessed clinically in relation to gender, age, mechanism of injury, percentage BSA burnt, and wound culture results. There was a significant reduction in time to grafting decision in the LDI group. This would potentially lead to reduced length of stay, reduced number of hospital visits, and streamlined care for the patient and their family.
authors.affiliation: Children's Hospital Burns Research Institute and Burns Unit, Department of Surgery, New South Wales, Australia.
authors.forename: Lawrence H C
authors.initials: LH
authors.lastname: Kim
authors.forename: Diane
authors.initials: D
authors.lastname: Ward
authors.forename: Lawrence
authors.initials: L
authors.lastname: Lam
authors.forename: Andrew J A
authors.initials: AJ
authors.lastname: Holland
mesh_terms: D000704:Analysis of Variance; D002056:Burns / Q000473:pathology / Q000601:surgery; D016009:Chi-Square Distribution; D002648:Child; D017439:Cicatrix, Hypertrophic / Q000517:prevention & control*; D003657:Decision Making; D005260:Female; D006801:Humans; D017078:Laser-Doppler Flowmetry; D008297:Male; D011446:Prospective Studies; D016038:Skin Transplantation; D013997:Time Factors; D014945:Wound Healing / Q000502:physiology