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THE IMPACT OF LASER DOPPLER IMAGING (LDI) ON TIME TO GRAFTING DECISION
Author(s) -
Kim L.,
Ward D.,
Holland A. J. A.,
Lam L.
Publication year - 2009
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2009.04914_2.x
Subject(s) - medicine , grafting , referral , clinical decision making , surgery , total body surface area , skin grafting , burn wound , burn injury , intensive care medicine , wound healing , chemistry , organic chemistry , family medicine , polymer
Purpose: Early definitive treatment of burns gives optimal results by reducing the risk of developing hypertrophic scar. LDI has been shown to assist in predicting burn wound outcome with good accuracy, optimising clinical management. This is particularly beneficial in paediatric burns where the predominant type is scald injury, known to be heterogeneous in thickness. This study was sought to determine whether LDI has led to earlier decision making for grafting. Methodology: Patients who underwent grafting procedure at a single paediatric institute, a state referral centre for all major paediatric burns, between June 2006 and December 2007 formed the basis of this study. Time of burn injury to time of decision making for grafting procedure was calculated in days for both patients that had LDI imaging and those patients not scanned. Results: 50% of 196 patients underwent LDI. Comparatively, there was no significant difference in type, body surface area percentage and microbiology swab results. The mean time from the date of injury to decision making for graft procedure was 8.9 days in those patients scanned by LDI and 11.6 days in group diagnosed on the basis of clinical observation alone. This trend for earlier decision for grafting in the LDI group was statistically significant (p = 0.01). Conclusion: There was a significant reduction in time to grafting decision in the LDI group. This would potentially reduce length of hospital stay, number of visits and facilitate planning of surgery. Earlier diagnosis of burn depth may enhance parental satisfaction by allowing greater opportunities for discussion of potential surgery and improving long term outcome.