Accurate assessment of burn depth at an early stage is crucial to avoid unnecessary surgery or potential hypertrophic scarring. It is clinically proven that the status of the skin microcirculation can be used to estimate burn depth. Superficial dermal burns will show a higher skin perfusion as compared to normal skin, whereas the perfusion is compromised in deeper dermal burns.
PeriCam PSI System on cart
Blood perfusion imaging has been recognized as an excellent tool to estimate burn depth and its value in predicting the healing capacity of a burn wound has been well established. Laser Doppler perfusion imaging (LDI or LDPI) is used in many burn centers in standard clinical practice to assess burn wound depth and healing potential. Laser speckle contrast analysis (LASCA or LSCI) provides high resolution, high quality perfusion images in a fraction of the time needed for producing an LDI image. There is growing scientific evidence1Mirdell R, Farnebo S, Sjöberg F, Tesselaar E (2018). Accuracy of laser speckle contrast imaging in the assessment of pediatric scald wounds. Burns, 44(1):90-98. doi: 10.1016/j.burns.2017.06.010.,2Mirdell R, Iredahl F, Sjöberg F, Farnebo S, Tesselaar E (2016). Microvascular blood flow in scalds in children and its relation to duration of wound healing: A study using laser speckle contrast imaging. Burns, 42(3):648-54. doi: 10.1016/j.burns.2015.12.005. that LASCA can be used in the same way.
The PeriCam PSI System provides the user with instant, “live” images of the burn area, presenting valuable information regarding the healing potential of the burn wound.
Graph showing wound healing progress
PeriCam PSI System
Objective burn depth assessment
Flexible user friendly software
Follow the wound healing process
Increased blood flow in a burn indicates that the microcirculation is functioning and that there is a higher degree of wound healing potential. However, if skin blood flow is low or absent, burns will likely heal very slowly, and surgery will be needed to prevent infections and scarring. It is possible to evaluate the healing progress by taking repeated images at different intervals after injury. PIMSoft application software used to operate the blood perfusion imagers from Perimed include several features that facilitate this work.
Compare uninjured and injured skin
Specific regions of interest (ROIs) can be defined before, during or after a completed examination. In addition, ROIs may be implemented during sections of a run. This advanced ROI handling makes it possible to define reference areas of “uninjured skin”, that can be compared to “injured skin” allowing for better evaluation and understanding of the burn wound.
Burn on foot – healing progress Courtesy of University Hospital Brno, Czech Republic
Burn on hand – healing progress Courtesy of University Hospital Brno, Czech Republic
R. Mirdell, et al., Interobserver reliability of laser speckle contrast imaging in the assessment of burns, Burns (2019), https://doi.org/10.1016/j.burns.2019.01.011
Mirdell R, Farnebo S, Sjöberg F, Tesselaar E (2018). Accuracy of laser speckle contrast imaging in the assessment of pediatric scald wounds. Burns, 44(1):90-98. doi: 10.1016/j.burns.2017.06.010.
Mirdell R, Iredahl F, Sjöberg F, Farnebo S, Tesselaar E (2016). Microvascular blood flow in scalds in children and its relation to duration of wound healing: A study using laser speckle contrast imaging. Burns, 42(3):648-54. doi: 10.1016/j.burns.2015.12.005.
Assessment of scald burns in children using Laser Speckle Contrast Imaging
Erik Tesselaar, Ph.D. Associate Professor Department of Clinical and Experimental Medicine, Linköping University, Sweden
In Sweden, patients with skin burns that are classified as high-risk are referred to one of the two highly specialized burn units, one of which is at the University Hospital in Linköping. These include patients with a burn area of more than 10%, patients with deep burns, or burn injuries on hands or feet.