| Laser Doppler imaging determines need for excision and grafting in advance of clinical judgment: a prospective blinded trial. | |
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MedLine Citation:
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PMID: 14556723 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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INTRODUCTION: Clinicians' judgment as to which burns require excision and grafting remains one aspect of burn care without objective measurements. This study presents a prospective, blinded trial to assess decision to operate by laser Doppler imaging (numerical criteria) versus the clinical judgment of an experienced burn surgeon. METHODS: A number of 23 patients were enrolled in this prospective trial and 41 representative wounds of indeterminate depth were selected for observation. Daily determination of need to operate (burn depth) was made by a single burn surgeon. Laser Doppler imager (LDI) scans of the same wounds were simultaneously obtained, and not revealed to the clinician. Data analysis compared quickness of decision to operate by LDI to the clinician's judgment. Concurrence of decisions by either method was compared. RESULTS: A total of 23 patients and 41 wounds were analyzed. LDI and the surgeon agreed in determination of wound depth 56% of the time (23/41, P=0.031). Biopsy confirmation was obtained for 21 wounds. The surgeon's determination of burn depth was accurate in 71.4% of wounds biopsied (15/21). When the LDI scan median flux indicated need for excision, it was 100% accurate (7/7). When both the surgeon and the LDI were correct in assessing wound depth, LDI would have saved median number of 2 days (minimum=0, maximum=4). CONCLUSION: LDI allowed for earlier, objective determination of need to operate. Concurrence with clinical judgment in this blinded study was excellent. LDI should be seen as an effective aid to clinical judgment when contemplating excision of burns with indeterminate depth. |
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Authors:
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J C Jeng; A Bridgeman; L Shivnan; P M Thornton; H Alam; T J Clarke; K A Jablonski; M H Jordan |
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Publication Detail:
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Type: Clinical Trial; Journal Article |
Journal Detail:
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Title: Burns : journal of the International Society for Burn Injuries Volume: 29 ISSN: 0305-4179 ISO Abbreviation: Burns Publication Date: 2003 Nov |
Date Detail:
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Created Date: 2003-10-14 Completed Date: 2004-02-23 Revised Date: 2010-03-23 |
Medline Journal Info:
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Nlm Unique ID: 8913178 Medline TA: Burns Country: England |
Other Details:
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Languages: eng Pagination: 665-70 Citation Subset: IM |
Affiliation:
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The Burn Center, MedStar Research Institute, Washington, DC, USA. james.c.jeng@medstar.net |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over Biopsy Burns / pathology*, surgery* Decision Making Humans Image Processing, Computer-Assisted Laser-Doppler Flowmetry / methods* Middle Aged Prospective Studies Single-Blind Method Skin Transplantation |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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