title: Rationalization of thermal injury quantification methods: application to skin burns.
abstract: Classification of thermal injury is typically accomplished either through the use of an equivalent dosimetry method (equivalent minutes at 43 °C, CEM43 °C) or through a thermal-injury-damage metric (the Arrhenius method). For lower-temperature levels, the equivalent dosimetry approach is typically employed while higher-temperature applications are most often categorized by injury-damage calculations. The two methods derive from common thermodynamic/physical chemistry origins. To facilitate the development of the interrelationships between the two metrics, application is made to the case of skin burns. This thermal insult has been quantified by numerical simulation, and the extracted time-temperature results served for the evaluation of the respective characterizations. The simulations were performed for skin-surface exposure temperatures ranging from 60 to 90 °C, where each surface temperature was held constant for durations extending from 10 to 110 s. It was demonstrated that values of CEM43 at the basal layer of the skin were highly correlated with the depth of injury calculated from a thermal injury integral. Local values of CEM43 were connected to the local cell survival rate, and a correlating equation was developed relating CEM43 with the decrease in cell survival from 90% to 10%. Finally, it was shown that the cell survival/CEM43 relationship for the cases investigated here most closely aligns with isothermal exposure of tissue to temperatures of ~50 °C.
authors.affiliation: Department of Radiology, University of Michigan, Ann Arbor, MI 48108, United States. Electronic address: benjamin.viglianti@alumni.duke.edu.
authors.forename: Benjamin L
authors.initials: BL
authors.lastname: Viglianti
authors.affiliation: Department of Radiation Oncology, Duke University Medical Center, Durham, NC 27710, United States.
authors.forename: Mark W
authors.initials: MW
authors.lastname: Dewhirst
authors.affiliation: School of Engineering, University of St. Thomas, St. Paul, MN 55105, United States. Electronic address: jpabraham@stthomas.edu.
authors.forename: John P
authors.initials: JP
authors.lastname: Abraham
authors.affiliation: School of Engineering, University of St. Thomas, St. Paul, MN 55105, United States.
authors.forename: John M
authors.initials: JM
authors.lastname: Gorman
authors.affiliation: Department of Mechanical Engineering, University of Minnesota, Minneapolis, MN 55455, United States.
authors.forename: Eph M
authors.initials: EM
authors.lastname: Sparrow
mesh_terms: D002056:Burns / Q000175:diagnosis*; D002470:Cell Survival; D006358:Hot Temperature; D006801:Humans; D012867:Skin / Q000293:injuries*; D012881:Skin Temperature
keywords: CEM43°C; Hyperthermia; Thermal ablation; Thermal dosimetry; Thermal injury; Thermal injury index