The early determination of healing potential in indeterminate thickness burns may be diffi cult to establish by visual inspection alone,even for experienced burn practitioners.This case series explores the use of indo...The early determination of healing potential in indeterminate thickness burns may be diffi cult to establish by visual inspection alone,even for experienced burn practitioners.This case series explores the use of indocyanine green(ICG)fl uorescence using portable bedside assessment as a potential tool for early determination of burn depth.Three subjects with indeterminate thickness burns had daily perfusion assessment using ICG fl uorescence assessment using the SPY machine(SPY®,Lifecell Corp.,NJ,USA)in addition to standard burn care.The fl uorescence was quantifi ed as a percentage of the perfusion of intact skin,and areas of hypoand hyper-perfusion were indicated.The study was concluded when the burn surgeon,blinded to the ICG results,made a clinical determination of the need for skin grafting or discharge.The perfusion in areas of diff ering depth of burn were compared over the entire study period to determine both the magnitude of diff erence,and the point in the time course of healing when these changes became evident.Signifi cant diff erences in perfusion were noted between burned areas of varying depth.These diff erences were evident as early as the fi rst post-burn day,and persisted till the completion of the study.ICG fl uorescence represents a potential adjunct in burn assessment in this fi rst longitudinal study of its use;however much more systematic research will be required to judge the feasibility of clinical implementation.展开更多
文摘The early determination of healing potential in indeterminate thickness burns may be diffi cult to establish by visual inspection alone,even for experienced burn practitioners.This case series explores the use of indocyanine green(ICG)fl uorescence using portable bedside assessment as a potential tool for early determination of burn depth.Three subjects with indeterminate thickness burns had daily perfusion assessment using ICG fl uorescence assessment using the SPY machine(SPY®,Lifecell Corp.,NJ,USA)in addition to standard burn care.The fl uorescence was quantifi ed as a percentage of the perfusion of intact skin,and areas of hypoand hyper-perfusion were indicated.The study was concluded when the burn surgeon,blinded to the ICG results,made a clinical determination of the need for skin grafting or discharge.The perfusion in areas of diff ering depth of burn were compared over the entire study period to determine both the magnitude of diff erence,and the point in the time course of healing when these changes became evident.Signifi cant diff erences in perfusion were noted between burned areas of varying depth.These diff erences were evident as early as the fi rst post-burn day,and persisted till the completion of the study.ICG fl uorescence represents a potential adjunct in burn assessment in this fi rst longitudinal study of its use;however much more systematic research will be required to judge the feasibility of clinical implementation.
