Journal of burn care & research : official publication of the American Burn Association
-
Burn injuries are severe problems for human. Accurate segmentation for burn wounds in patient surface can improve the calculation precision of %TBSA (total burn surface area), which is helpful in determining treatment plan. Recently, deep learning methods have been used to automatically segment wounds. ⋯ With nonsaturating loss with R2 regularization (NSLR2) and CASC, the segmentation network gains the best results. The framework achieved precision at 90.75%, PA at 96.88% and improved the DC from 84.5 to 89.3%. A burn data-generating framework have been built to improve the segmentation network, which can automatically segment burn images with higher accuracy and less time than traditional methods.
-
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, noninvasive, and noncontrast 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. ⋯ 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- to 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.
-
Split thickness skin grafts (STSG) are commonly required in reconstructive surgery but may cause significant pain. The goal of this investigator-initiated trial is to evaluate the effect of liposomal bupivacaine on donor site pain and opioid consumption. A parallel, randomized, controlled trial of adult acute burn patients with <20% total body surface area burns (TBSA) was conducted to evaluate the efficacy of liposomal bupivacaine at STSG donor sites. ⋯ The average length of stay was 7.7 days in both groups (p=.88). No adverse events occurred in either group. There is no statistical benefit to the use of liposomal bupivacaine for infiltration at STSG donor sites compared to standard of care with respect to pain control, opioid use, or length of stay when evaluated in a randomized, controlled fashion.
-
In order to address the confounder of TBSA on burn outcomes, we sought to analyze our experience with the use of autologous skin cell suspensions (ASCS) in a cohort of subjects with hand burns whose TBSA totaled 20% or less. We hypothesized that the use of ASCS in conjunction with 2:1 meshed autograft for the treatment of hand burn injuries would provide comparable outcomes to hand burns treated with sheet or minimally meshed autograft alone. ⋯ Despite being significantly older, having larger hand wounds, and larger overall wounds within the parameters of the study criteria, patients with 20% TBSA burns or smaller whose hand burns were treated with 2:1 mesh and ASCS overspray had comparable time to wound closure, proportion of returning to work, and time to return to work as subjects treated with 1:1 or pie-crust meshed STAG. Our group plans to follow this work with scar assessments for a more granular picture of pliability and reconstructive needs.
-
Burn wound depth assessments are an important component of determining patient prognosis and making appropriate management decisions. Clinical appraisal of the burn wound by an experienced burn surgeon is standard of care but has limitations. IR thermography is a technology in burn care that can provide a non-invasive, quantitative method of evaluating burn wound depth. IR thermography utilizes a specialized camera that can capture the infrared emissivity of the skin, and the resulting images can be analyzed to determine burn depth and healing potential of a burn wound. Though IR thermography has great potential for burn wound assessment, its use for this has not been well documented. Thus, we have conducted a systematic review of the current use of IR thermography to assess burn depth and healing potential. ⋯ IR thermography is an accurate, simple, and cost-effective method of burn wound assessment. FLIR has been demonstrated to have significant correlations with other methods of assessing burns such as LDI and can be utilized to accurately assess burn depth and healing potential.