Laser Doppler Imaging prediction of burn wound outcome in children: Is it possible before 48h?

Nguyen, Khanh; Ward, Diane; Lam, Lawrence; Holland, Andrew J.A.

doi:10.1016/j.burns.2009.11.016

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Volume 36, Issue 6 , Pages 793-798, September 2010

Laser Doppler Imaging prediction of burn wound outcome in children: Is it possible before 48h?

Khanh Nguyen
- Department of Academic Surgery, The Children's Hospital at Westmead, The University of Sydney, Westmead, NSW 2145, Australia
Diane Ward
- The Children's Hospital at Westmead Burns Research Institute, The Burns Unit and the NSW Severe Burns Injury Service, The Children's Hospital at Westmead, The University of Sydney, Westmead, NSW 2145, Australia
Lawrence Lam
- Department of Academic Surgery, The Children's Hospital at Westmead, The University of Sydney, Westmead, NSW 2145, Australia
- Centre for Trauma Care, Prevention, Education and Research, The Children's Hospital at Westmead, The University of Sydney, Westmead, NSW 2145, Australia
Andrew J.A. Holland
- Department of Academic Surgery, The Children's Hospital at Westmead, The University of Sydney, Westmead, NSW 2145, Australia
- The Children's Hospital at Westmead Burns Research Institute, The Burns Unit and the NSW Severe Burns Injury Service, The Children's Hospital at Westmead, The University of Sydney, Westmead, NSW 2145, Australia
- Centre for Trauma Care, Prevention, Education and Research, The Children's Hospital at Westmead, The University of Sydney, Westmead, NSW 2145, Australia
- Discipline of Paediatrics and Child Health, The Children's Hospital at Westmead Clinical School, The University of Sydney, Westmead, NSW 2145, Australia
- Corresponding author at: Department of Academic Surgery, The Children's Hospital at Westmead, The University of Sydney, Locked Bag 4001, Westmead NSW 2145, Australia. Tel.: +61 2 9845 1908; fax: +61 2 9845 3346.

Accepted 24 November 2009.

Abstract

Background

Laser Doppler Imaging (LDI) assists in prediction burn wound outcome. Previous data has validated this technique in children between 48 and 72h after burn.

Aim

To evaluate the ability of Laser Doppler Imaging (LDI) to predict burn wound outcome in paediatric patients prior to and after 48h from the time of injury.

Methods

A prospective evaluation was performed in 400 children over a 12-month period that presented to our burns clinic. Patients were divided into two groups: those that presented within 48h of injury (n=160) and those that presented after 48h (n=240). Patients were reviewed until healing had occurred or operative intervention was required.

Results

The median age of the patients was 2.4 years (range 0.1–15.9 years). For patients who presented within 48h, the sensitivity and specificity of the LDI was 78% and 74% respectively compared to 75% and 85% for those scanned after 48h. This difference was not statistically significant.

Conclusions

LDI predicted burn wound outcome in children within 48h of the burn wound. Moderate degrees of movement, infection, whether first aid was administered and type of dressing did not impact on the accuracy of LDI.

Keywords: Laser Doppler Imaging, Burn wound outcome, Paediatric