Insights into the use of thermography to assess burn wound healing potential: a reliable and valid technique when compared to laser Doppler imaging.
Adequate assessment of burn wounds is crucial in the management of burn patients. Thermography, as a noninvasive measurement tool, can be utilized to detect the remaining perfusion over large burn wound areas by measuring temperature, thereby reflecting the healing potential (HP) (i.e., number of days that burns require to heal). The objective of this study was to evaluate the clinimetric properties (i.e., reliability and validity) of thermography for measuring burn wound HP. To evaluate reliability, two independent observers performed a thermography measurement of 50 burns. The intraclass correlation coefficient (ICC), the standard error of measurement (SEM), and the limits of agreement (LoA) were calculated. To assess validity, temperature differences between burned and nonburned skin (?T) were compared to the HP found by laser Doppler imaging (serving as the reference standard). By applying a visual method, one ?T cutoff point was identified to differentiate between burns requiring conservative versus surgical treatment. The ICC was 0.99, expressing an excellent correlation between two measurements. The SEM was calculated at 0.22°C, the LoA at ?0.58°C and 0.64°C. The ?T cutoff point was ?0.07°C (sensitivity 80%; specificity 80%). These results show that thermography is a reliable and valid technique in the assessment of burn wound HP.
Burn Center, Red Cross Hospital, P.O. Box 1074, 1940 EB Beverwijk, The NetherlandsbAssociation of Dutch Burn Centers, P.O. Box 1015, 1940 EA Beverwijk, The NetherlandscRed Cross Hospital, Department of Plastic, Reconstructive and Hand Surgery, P.O. Box 1074, 1940 EB Beverwijk, The NetherlandsdVU Medical Center, Department of Plastic, Reconstructive and Hand Surgery, P.O. Box 7057, 1007 MB Amsterdam, The NetherlandseResearch Institute MOVE VU University Medical Center of Amsterdam, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
Mariëlle E H
ME
Jaspers
Burn Center, Red Cross Hospital, P.O. Box 1074, 1940 EB Beverwijk, The Netherlands.
Ilse
I
Maltha
VU University Medical Center, Department of Physics and Medical Technology, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
John H G M
JH
Klaessens
VU University Medical Center, Department of Epidemiology and Biostatistics, P.O. Box 7057, 1007 MB Amsterdam, The NetherlandshVU University Medical Center, EMGO Institute for Health and Care Research, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
Henrica C W
HC
de Vet
VU University Medical Center, Department of Physics and Medical Technology, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
Rudolf M
RM
Verdaasdonk
Burn Center, Red Cross Hospital, P.O. Box 1074, 1940 EB Beverwijk, The NetherlandsbAssociation of Dutch Burn Centers, P.O. Box 1015, 1940 EA Beverwijk, The NetherlandscRed Cross Hospital, Department of Plastic, Reconstructive and Hand Surgery, P.O. Box 1074, 1940 EB Beverwijk, The NetherlandsdVU Medical Center, Department of Plastic, Reconstructive and Hand Surgery, P.O. Box 7057, 1007 MB Amsterdam, The NetherlandseResearch Institute MOVE VU University Medical Center of Amsterdam, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
Paul P M
PP
van Zuijlen
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D002056:Burns / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D017078:Laser-Doppler Flowmetry; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012867:Skin / Q000000981:diagnostic imaging; D013817:Thermography / Q000379:methods*; D014945:Wound Healing / Q000502:physiology*; D055815:Young Adult