First preliminary Clinical Experiences using Hyperspectral Imaging for Burn Depth Assessment of Hand Burns

2021 ◽  
Author(s):  
Dominik Promny ◽  
Juliane Aich ◽  
Moritz Billner ◽  
Bert Reichert
Keyword(s):  
Hyperspectral Imaging ◽  
Correct Diagnosis ◽  
Control Group ◽  
Clinical Experiences ◽  
Healthy Skin ◽  
Burn Wounds ◽  
Dorsal Hand ◽  
Hand Burns ◽  
Burn Depth ◽  
Burn Depth Assessment

Abstract The accurate assessment of burn wounds is challenging but crucial for correct diagnosis and following therapy. The most frequent technique to evaluate burn wounds remains the clinical assessment often subjective depending on the experience of the physician. Hyperspectral Imaging is intended to counteract this subjective diagnosis by an accurate and objective analysis of perfusion parameters. The purpose of this study was to analyse the ability of technical burn depth assessment and to investigate a possible link between a certain value to burn depth versus value of healthy skin references. Methods A total of 118 subjects were included in this study between July 2017 and July 2019. 74 images with dorsal hand burns and 44 images of healthy skin on the dorsal hand as control group were analysed. In Hyperspectral Imaging recordings burn wounds were analysed with special interest to wound centre, intermediate zone, and wound margin. Results Significant results were determined for the differentiation between superficial partial burns and healthy skin. Furthermore, the distinction of full thickness burns was significantly possible. Conclusion Currently, it cannot be shown that the use of Hyperspectral Imaging technology significantly assesses the actual burn depth of thermal wounds of the dorsal hand reliably. However, the results show tendencies to improved analysis for differentiations supporting physicians in early objective optimal treatment selection.

Use of 816 consecutive burn wound biopsies to inform a histologic algorithm for burn depth categorization

2021 ◽  
Author(s):  
Herb A Phelan ◽  
James H Holmes IV ◽  
William L Hickerson ◽  
Clay J Cockerell ◽  
Jeffrey W Shupp ◽  
...  
Keyword(s):  
New Technologies ◽  
A Priori ◽  
Machine Learning Algorithms ◽  
Burn Wound ◽  
Prospective Multicenter Study ◽  
Reticular Dermis ◽  
Burn Wounds ◽  
Misclassification Rates ◽  
Burn Depth ◽  
Burn Depth Assessment

Abstract Introduction Burn experts are only 77% accurate when subjectively assessing burn depth, leaving almost a quarter of patients to undergo unnecessary surgery or conversely suffer a delay in treatment. To aid clinicians in burn depth assessment (BDA), new technologies are being studied with machine learning algorithms calibrated to histologic standards. Our group has iteratively created a theoretical burn biopsy algorithm (BBA) based on histologic analysis, and subsequently informed it with the largest burn wound biopsy repository in the literature. Here, we sought to report that process. Methods The was an IRB-approved, prospective, multicenter study. A BBA was created a priori and refined in an iterative manner. Patients with burn wounds assessed by burn experts as requiring excision and autograft underwent 4mm biopsies procured every 25cm 2. Serial still photos were obtained at enrollment and at excision intraoperatively. Burn biopsies were histologically assessed for presence/absence of epidermis, papillary dermis, reticular dermis, and proportion of necrotic adnexal structures by a dermatopathologist using H&E with whole slide scanning. First degree and superficial 2 nd degree were considered to be burn wounds likely to have healed without surgery, while deep 2 nd and 3 rd degree burns were considered unlikely to heal by 21 days. Biopsy pathology results were correlated with still photos by five burn experts for consensus of final burn depth diagnosis. Results Sixty-six subjects were enrolled with 117 wounds and 816 biopsies. The BBA was used to categorize subjects’ wounds into 4 categories: 7% of burns were categorized as 1 st degree, 13% as superficial 2 nd degree, 43% as deep 2 nd degree, and 37% as 3 rd degree. Therefore 20% of burn wounds were incorrectly judged as needing excision and grafting by the clinical team as per the BBA. As H&E is unable to assess the viability of papillary and reticular dermis, with time our team came to appreciate the greater importance of adnexal structure necrosis over dermal appearance in assessing healing potential. Conclusions Our study demonstrates that a BBA with objective histologic criteria can be used to categorize BDA with clinical misclassification rates consistent with past literature. This study serves as the largest analysis of burn biopsies by modern day burn experts and the first to define histologic parameters for BDA.

Burn depth assessment using hyperspectral imaging in a prospective single center study

Burns ◽  
2021 ◽  
Author(s):  
Torsten Schulz ◽  
Jörg Marotz ◽  
Sebastian Seider ◽  
Stefan Langer ◽  
Sebastian Leuschner ◽  
...  
Keyword(s):  
Hyperspectral Imaging ◽  
Single Center ◽  
Single Center Study ◽  
Burn Depth ◽  
Burn Depth Assessment ◽  
Center Study

scholarly journals Hyperspectral Imaging for Burn Depth Assessment in an Animal Model

2015 ◽  
Vol 3 (12) ◽  
pp. e591 ◽  
Author(s):  
Michael S. Chin ◽  
Oksana Babchenko ◽  
Jorge Lujan-Hernandez ◽  
Lisa Nobel ◽  
Ronald Ignotz ◽  
...  
Keyword(s):  
Animal Model ◽  
Hyperspectral Imaging ◽  
Burn Depth ◽  
Burn Depth Assessment

The Use of Visible-Light Hyperspectral Imaging in Evaluating Burn Wounds: A Case Report

2021 ◽  
Author(s):  
Melissa McCarthy ◽  
Victoria Irene Prete ◽  
SeungJu Oh ◽  
Garrick Gu ◽  
Jorge Lujan-Hernandez ◽  
...  
Keyword(s):  
Case Report ◽  
Visible Light ◽  
Hyperspectral Imaging ◽  
Initial Evaluation ◽  
Contrast Imaging ◽  
Post Injury ◽  
Irreversible Damage ◽  
Thermal Burn ◽  
Burn Depth ◽  
Second Degree

Abstract Burn depth is a critical factor in determining the healing potential of a burn as the extent of injury ultimately guides overall treatment. Visible Light Hyperspectral Imaging is an FDA-approved, non-invasive, and non-contrast imaging technology that uses light waves within the visible spectrum to evaluate skin and superficial soft tissue perfusion. In this case report, Visible Light Hyperspectral Imaging was used to evaluate a 37-year-old male who presented to the Emergency Department with a thermal burn of the trunk, back, and right upper extremity. Images were taken at initial evaluation, 6-hours post-injury, and again during daily dressing changes until hospital day five when patient underwent surgical debridement. In this patient, operative treatment was postponed until 89.7-hours post-injury, at which point the clinical exam showed clear visual demarcation in regions of irreversible damage. Comparatively, Visible Light Hyperspectral Imaging analysis of the permanently injured tissue demonstrated acute but varying changes in both oxygenated hemoglobin and deoxygenated hemoglobin at the time of initial evaluation. The most dramatic change in tissue oxygenation occurred between 6.5 and 39.3 hours, demonstrating Visible Light Hyperspectral Imaging’s ability to detect significant differences in oxygenation values between areas of second-degree superficial burns and areas of second degree deep and third degree burns in the acute period. The data suggest that the utilization of Visible Light Hyperspectral Imaging in this 6.5-39.3-hour window may help predict final burn depth before clinical assessment, potentially allowing for surgical intervention within the first 48-hours following injury.

550 A retrospective Study of a Zinc-oxide/dimethicone for Pediatric Perineal Burn Treatment

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S123-S124
Author(s):  
Waseem Diab ◽  
Elika Ridelman ◽  
Dawn Cloutier ◽  
Lisa C Vitale ◽  
Justin D Klein ◽  
...  
Keyword(s):  
Zinc Oxide ◽  
Medical Records ◽  
Total Body Surface Area ◽  
Healing Time ◽  
Silver Sulfadiazine ◽  
Control Group ◽  
Post Discharge ◽  
Burn Wounds ◽  
Burn Center ◽  
At Home

Abstract Introduction Silver-based treatments have seen widespread use for the management of burns. Recent literature, however, has demonstrated silver nanoparticles may negatively impact healing time due to its toxic effect on keratinocytes and fibroblasts at higher concentrations. At our institution, an ABA-verified pediatric burn center, the use of a silver sulfadiazine cream for management of post-discharge perineal and genital burn wounds has been replaced by a zinc-oxide/dimethicone spray-on solution initiated for its comparative ease of use. The dimethicone allows the spray to be occlusive without interfering with clothing, yet easily removed. We believed this would improve compliance with at-home treatments. Zinc-oxide’s antimicrobial activity has been demonstrated in vitro and the results from animal studies are promising for burn management. This is the first study of zinc-oxide’s efficacy as a burn management agent in humans. Our burn center’s experience with both silver sulfadiazine and zinc-oxide/dimethicone creates an opportunity to compare these products for the treatment of burn wounds. We sought to analyze the time to healing of burns treated by silver sulfadiazine against zinc-oxide/dimethicone in order to determine if zinc-oxide/dimethicone, in its easy-to-use form, is a viable alternative to silver sulfadiazine. Methods A retrospective review of medical records was conducted at a large pediatric verified burn center. Data on 98 patients was collected from the burn registry and electronic medical records. 58 patients received silver sulfadiazine while 40 received zinc-oxide/dimethicone. Four patients were removed from the silver sulfadiazine group due to incomplete data. All patients were initially treated by the burn team with follow up in burn clinic on a weekly basis until healing was achieved. Results Time to healing was significantly lower in the zinc-oxide/dimethicone intervention group (10.61 +/- .918 days) than the silver sulfadiazine control group (16.88 +/- 2.134 days). The silver sulfadiazine group contained patients with total body surface area burns significantly greater than the zinc-oxide/dimethicone group (mean: 11.57% versus 6.64%); likely due to selective treatment when zinc-oxide/dimethicone was first introduced at our facility. Differences in depth and size of burn wounds may have confound our results and negatively impacted healing time in the control group. No infection, allergic reaction, or other adverse events were noted in any patient. Conclusions Zinc-oxide/dimethicone had a significantly lower healing time than silver sulfadiazine in the treatment of at-home, post-discharge 2nd degree pediatric burns to the perineum, genitalia, suprapubis, and buttocks. Further study is needed to quantify its efficacy.

673 Effect of Subcutaneous Topical Ozone Therapy on Second Degree Burn Wounds in Rats: An Experimental Study

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S193-S193
Author(s):  
Emre Karakaya ◽  
Aydincan Akdur ◽  
H Ebru ◽  
Ayvazoglu Soy ◽  
Alev Ok Atilgan ◽  
...  
Keyword(s):  
Wound Healing ◽  
Healing Process ◽  
Silver Sulfadiazine ◽  
Male Rats ◽  
Control Group ◽  
Ozone Therapy ◽  
Burn Wounds ◽  
Degree Burn ◽  
Significant Difference ◽  
Second Degree

Abstract Introduction Burn is one of the most severe traumas that causes coagulative destruction of the skin. The use of various products that accelerate wound healing in patients with burn may affect the patient’s survival and reduce the complications that may be seen. In the present study we aimed effects of subcutaneous ozone injection on second degree burn wound. Methods A total of 72 Sprague-Dawley male rats included in the study were divided randomly into three groups (control group (CG), silver sulfadiazine group (SG), ozone group (OG)) and each group was divided randomly two subgroups (as sacrificed on d7 and on d14).A deep second degree scald burns were created on the lower back. In CG subcutaneous 0.9% serum saline was injected daily into the burn area. In SG, burns were dressed with silver sulfadiazine daily and in OG subcutaneous ozone was injected daily into the burn area. Tissue hydroxyproline level measurement and histopathological evaluation were done. Results When the groups were compared in terms of weight change, no significant difference was found on the 7th and 14th days. In the evaluation made in terms of tissue hydroxyproline, tissue hydroxyproline level in OG was found to be significantly higher on both the 7th and 14th days (p < 0.001). In histopathological evaluations, it was determined that wound healing in OG was significantly higher than in the other groups. Conclusions According to the results, subcutaneous ozone therapy is more effective than silver sulphadiazine in the healing process of second-degree burn wounds and it can be safely used in the treatment of burn wounds.

scholarly journals Initial Tests on Selected Serological Reactions in Rabbits Burnt with Napalm and Subjected to Hyperbaric Oxygenation

2015 ◽  
Vol 50 (1) ◽  
pp. 41-45
Author(s):  
Kazimierz Ulewicz ◽  
Przemysław Michniewski ◽  
Brunon Kierznikowicz ◽  
Bogdan Łokucijewski ◽  
Jan Stencel
Keyword(s):  
Hyperbaric Oxygenation ◽  
Healing Process ◽  
Control Group ◽  
Complement Activity ◽  
Experimental Animals ◽  
Burn Wounds ◽  
Immunological Reactions

Abstract Hyperbaric oxygenation therapy has found its application in the treatment of various types of burns. The presented work describes the use of this method in treating napalm burns in experimental animals. The researchers took particular interest in the immunological reactions occurring in animals, as well as the effect of the said therapy on the healing process. Two groups of rabbits, previously anaesthetised with Evipan and immunised with S. typhi phage F7 microorganisms, were burnt with the use of napalm. The tested group was subjected to a series of treatment sessions with 100% oxygen at the pressure of 2 atm, whereas the control group did not undergo such treatment. Six repeated tests on complement activity with 50% haemolysis method and heamagglutination reaction quantification with antigens O and H S.typhi phage F7 were carried out on all of the researched animals. Moreover, for the purpose of control of the healing process, a number of histopathological exams on the burn wounds were conducted in both groups of rabbits. The research showed an increase in complement activity in all tested animals; however, in the tested group it occurred later. Histopathological tests confirmed a more advanced healing process in the group subjected to hyperbaric oxygenation.

scholarly journals A Framework for Automatic Burn Image Segmentation and Burn Depth Diagnosis Using Deep Learning

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Hao Liu ◽  
Keqiang Yue ◽  
Siyi Cheng ◽  
Wenjun Li ◽  
Zhihui Fu
Keyword(s):  
Deep Learning ◽  
Total Body Surface Area ◽  
High Morbidity ◽  
Learning Technology ◽  
Human Errors ◽  
Burn Wounds ◽  
Output Structure ◽  
Network Output ◽  
Total Body ◽  
Burn Depth

Burn is a common traumatic disease with high morbidity and mortality. The treatment of burns requires accurate and reliable diagnosis of burn wounds and burn depth, which can save lives in some cases. However, due to the complexity of burn wounds, the early diagnosis of burns lacks accuracy and difference. Therefore, we use deep learning technology to automate and standardize burn diagnosis to reduce human errors and improve burn diagnosis. First, the burn dataset with detailed burn area segmentation and burn depth labelling is created. Then, an end-to-end framework based on deep learning method for advanced burn area segmentation and burn depth diagnosis is proposed. The framework is firstly used to segment the burn area in the burn images. On this basis, the calculation of the percentage of the burn area in the total body surface area (TBSA) can be realized by extending the network output structure and the labels of the burn dataset. Then, the framework is used to segment multiple burn depth areas. Finally, the network achieves the best result with IOU of 0.8467 for the segmentation of burn and no burn area. And for multiple burn depth areas segmentation, the best average IOU is 0.5144.

scholarly journals Sufficient therapeutic effect of cryopreserved frozen adipose-derived regenerative cells on burn wounds

2018 ◽  
Author(s):  
Yasuhiko Kaita ◽  
Takehiko Tarui ◽  
Hideaki Yoshino ◽  
Takeaki Matsuda ◽  
Yoshihiro Yamaguchi ◽  
...  
Keyword(s):  
Wound Healing ◽  
Therapeutic Effect ◽  
Healing Process ◽  
Control Group ◽  
Type I ◽  
Burn Wound ◽  
Burn Wounds ◽  
Burn Wound Healing ◽  
Significant Difference ◽  
Regenerative Cells

AbstractThe purpose of this study was to evaluate whether cryopreserved (frozen) adipose-derived regenerative cells (ADRCs) have a therapeutic effect on burn wound healing as well as freshly isolated (fresh) ADRCs.Full thickness burns were created on dorsum of nude mice and burn wound was excised. The wound was covered by artificial dermis with; (i) fresh ADRCs, (ii) frozen ADRCs, and (iii) PBS (control). The assessment for wound healing was performed by morphological, histopathological and immunohistochemical analyses.In vivo analyses exhibited the significant therapeutic effect of frozen ADRCs on burn wound healing up to the similar or higher level of fresh ADRCs. There were significant differences of wound closure, epithelized tissue thickness, and neovascularization between the treatment groups and control group. Although there was no significant difference of therapeutic efficacy between fresh ADRC group and frozen ADRC group, frozen ADRCs improved burn wound healing process in dermal regeneration with increased great type I collagen synthesis compared with fresh ADRCs.These findings indicate that frozen ADRCs allow us to apply not only quickly but also for multiple times, and the cryopreserved ADRCs could therefore be useful for the treatment of burn wounds in clinical settings.

scholarly journals Effect of green tea on the second degree burn wounds in rats

2014 ◽  
Vol 47 (03) ◽  
pp. 370-374 ◽  
Author(s):  
Mohammad Javad Fatemi ◽  
Babak Nikoomaram ◽  
Amir Asadollah Khajeh Rahimi ◽  
Donya Talayi ◽  
Shahrzad Taghavi ◽  
...  
Keyword(s):  
Green Tea ◽  
Healing Process ◽  
Digital Camera ◽  
First Aid ◽  
Control Group ◽  
Burn Wounds ◽  
Beneficial Effects ◽  
Pathologic Evaluation ◽  
Degree Burn ◽  
Second Degree

ABSTRACT Background: Various studies indicate that the green tea has anti-inflammatory and anti-oxidative properties. Moreover, a few studies have been carried out that demonstrate beneficial effects of green tea on burned patients. Materials and Methods: In this study, green tea, Vaseline, and silver sulfadiazine dressings were used as first-aid treatment to deep dermal contact burns in rats, compared with a control of nothing. After creating second-degree burn on the dorsum of rats, the treatments were applied for 15 min in four groups. Wound dressing changes were daily. Macroscopic study was performed on days 1, 3, 7, and 14 by using a digital camera and software processing of photos. Microscopic examination was done by pathologic evaluation of skin specimens on day 14. Results: We observed that green tea usage significantly decreased burn size in comparison to the control group (P = 0.004). Conclusion: Green tea is effective on healing process of second degree burn wounds.

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