Assessing multimodal optical imaging of perfusion in burn wounds

Ben S Lertsakdadet; Gordon T Kennedy; Randolph Stone 2nd; Christine Kowalczewski; Andrew C Kowalczewski; Shanmugasundaram Natesan; Robert J Christy; Anthony J Durkin; Bernard Choi

doi:10.1016/j.burns.2021.08.026

Assessing multimodal optical imaging of perfusion in burn wounds

Burns. 2022 Jun;48(4):799-807. doi: 10.1016/j.burns.2021.08.026. Epub 2021 Sep 4.

Authors

Ben S Lertsakdadet¹, Gordon T Kennedy², Randolph Stone 2nd³, Christine Kowalczewski⁴, Andrew C Kowalczewski⁵, Shanmugasundaram Natesan⁶, Robert J Christy⁷, Anthony J Durkin⁸, Bernard Choi⁹

Affiliations

¹ Beckman Laser Institute and Medical Clinic, University of California, Irvine, CA 92612, USA; Department of Biomedical Engineering, University of California, Irvine, CA, 92697, USA. Electronic address: blertsak@uci.edu.
² Beckman Laser Institute and Medical Clinic, University of California, Irvine, CA 92612, USA. Electronic address: gtkenned@uci.edu.
³ United States Army Institute of Surgical Research, 36950 Chambers Pass, Fort Sam Houston, TX 78234, USA. Electronic address: randolph.stone4.civ@mail.mil.
⁴ United States Army Institute of Surgical Research, 36950 Chambers Pass, Fort Sam Houston, TX 78234, USA. Electronic address: christine.j.kowalczewski.ctr@mail.mil.
⁵ United States Army Institute of Surgical Research, 36950 Chambers Pass, Fort Sam Houston, TX 78234, USA. Electronic address: andrewkowalczewski@gmail.com.
⁶ United States Army Institute of Surgical Research, 36950 Chambers Pass, Fort Sam Houston, TX 78234, USA. Electronic address: shanmugasundaram.natesan.ctr@mail.mil.
⁷ United States Army Institute of Surgical Research, 36950 Chambers Pass, Fort Sam Houston, TX 78234, USA. Electronic address: robert.j.christy12.civ@mail.mil.
⁸ Beckman Laser Institute and Medical Clinic, University of California, Irvine, CA 92612, USA; Department of Biomedical Engineering, University of California, Irvine, CA, 92697, USA. Electronic address: adurkin@uci.edu.
⁹ Beckman Laser Institute and Medical Clinic, University of California, Irvine, CA 92612, USA; Department of Biomedical Engineering, University of California, Irvine, CA, 92697, USA; Department of Surgery, University of California, Irvine, CA, 92697, USA; Edwards Lifesciences Center for Advanced Cardiovascular Technology, University of California, Irvine, CA, 92697, USA. Electronic address: choib@uci.edu.

PMID: 34696954
DOI: 10.1016/j.burns.2021.08.026

Abstract

A critical need exists for early, accurate diagnosis of burn wound severity to help identify the course of treatment and outcome of the wound. Laser speckle imaging (LSI) is a promising blood perfusion imaging approach, but it does not account for changes in tissue optical properties that can occur with burn wounds, which are highly dynamic environments. Here, we studied optical property dynamics following burn injury and debridement and the associated impact on interpretation of LSI measurements of skin perfusion. We used spatial frequency domain imaging (SFDI) measurements of tissue optical properties to study the impact of burn-induced changes in these properties on LSI measurements. An established preclinical porcine model of burn injury was used (n = 8). SFDI and LSI data were collected from burn wounds of varying severity. SFDI measurements demonstrate that optical properties change in response to burn injury in a porcine model. We then apply theoretical modeling to demonstrate that the measured range of optical property changes can affect the interpretation of LSI measurements of blood flow, but this effect is minimal for most of the measured data. Collectively, our results indicate that, even with a dynamic burn wound environment, blood-flow measurements with LSI can serve as an appropriate strategy for accurate assessment of burn severity.

Keywords: Blood flow; Burns; Laser speckle contrast imaging; Optical properties; Perfusion; Spatial frequency domain imaging.

MeSH terms

Animals
Burns* / diagnostic imaging
Humans
Laser Speckle Contrast Imaging
Optical Imaging / methods
Perfusion
Perfusion Imaging
Skin / blood supply
Skin / diagnostic imaging
Swine