title: Examination of the Early Diagnostic Applicability of Active Dynamic Thermography for Burn Wound Depth Assessment and Concept Analysis.
abstract: Despite advances in perfusion imaging, burn wound imaging technology continues to lag behind that of other fields. Quantification of blood flow is able to predict time for healing, but clear assessment of burn depth is still questionable. Active dynamic thermography (ADT) is a noncontact imaging modality capable of distinguishing tissue of different thermal conductivities. Utilizing the abnormal heat transfer properties of the burn zones, we examined whether ADT was useful in the determination of burn depth in a model of early burn wound evaluation. Duroc pigs (castrated male; n = 3) were anesthetized, and two burns were created with an aluminum billet at 3 and 12 seconds. These contact times resulted in superficial partial and deep partial thickness burn wounds, respectively. ADT and laser Doppler imaging (LDI) imaging were performed every 30 minutes postburn for a total of five imaging sessions ending 150 minutes postburn. For ADT, imaging excitation was performed for 42-120 seconds with dual quartz-infrared lamps, and subsequent infrared image capture was performed for 300 seconds. MATLAB-assisted image analysis was performed to determine burn zone region of interest thermal relaxation and characteristic patterns. LDI was performed with a moorLDI system, and biopsies were captured for histology following the 150-minute imaging session. Both ADT and LDI imaging modalities are able to detect different physical properties at 30, 60, 90 120, and 150 minutes postburn with statistical significance (P < 0.05). Resultant ADT cooling curves characterize greater differences with greater stimulation and a potentially more identifiable differential cooling characteristic. Histological analysis confirmed burn depth. This preliminary work confirms that ADT can measure burn depth and is deserving of further research either as a stand-alone imaging technology or in combination with a device to assess perfusion.
authors.affiliation: From *Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, District of Columbia; †Department of Bioengineering, University of Maryland, College Park; and ‡The Burn Center, Department of Surgery, MedStar Washington Hospital Center, District of Columbia.
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Prindeze
authors.forename: Payam
authors.initials: P
authors.lastname: Fathi
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Mino
authors.forename: Neil A
authors.initials: NA
authors.lastname: Mauskar
authors.forename: Taryn E
authors.initials: TE
authors.lastname: Travis
authors.forename: Dereck W
authors.initials: DW
authors.lastname: Paul
authors.forename: Lauren T
authors.initials: LT
authors.lastname: Moffatt
authors.forename: Jeffrey W
authors.initials: JW
authors.lastname: Shupp
mesh_terms: D000818:Animals; D001707:Biopsy, Needle; D002056:Burns / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy; D004195:Disease Models, Animal; D042241:Early Diagnosis; D007150:Immunohistochemistry; D015601:Injury Severity Score; D017078:Laser-Doppler Flowmetry / Q000379:methods*; D008297:Male; D011897:Random Allocation; D012680:Sensitivity and Specificity; D012867:Skin / Q000098:blood supply; D013552:Swine; D013817:Thermography / Q000379:methods*; D014945:Wound Healing / Q000502:physiology*