USE OF LASER-DOPPLER FLOWMETRY FOR ESTIMATION OF THE DEPTH OF BURNS

The trend for treatment of deep second degree burns and third degree b urns is toward early excision and skin grafting. The ability to predic t burn depth accurately as early as possible is important for early ex cision and skin grafting. This study prospectively evaluated the abili ty of laser Doppler flow measurements, obtained within 72 hours after burn injury, to predict the depth of burn wounds. A Periflux system 40 01 laser Doppler flowmeter was used to measure the cutaneous microflow circulation of 100 selected points of burn wounds on 44 inpatients an d of 1680 selected points on 120 volunteers from March of 1993 to Febr uary of 1994. The mean value of superficial second degree burns checke d by laser Doppler was 194.6 perfusion units (PU). The value of deep s econd degree burns was 59.7 PU, and the value of third degree burns wa s 5.1 PU. The mean normal cutaneous blood flow of 120 volunteers (cont rol group) was between 4 and 9 PU, except on the head, neck, hand, and foot. Blood flow of more than 100 PU correctly predicted (90.2 percen t of cases) a superficial second degree burn. Blood now between 100 an d 10 PU correctly predicted (96.2 percent of cases) a deep second degr ee dermal burn. That of less than 10 PU correctly predicted (100 perce nt of cases) a third degree burn. There was also a significant correla tion between initial flow measurements and the depth of burn wounds. W e conclude that laser Doppler flow measurements performed early after burn injury are useful in predicting the depth of burn wounds. Laser D oppler flowmetry has the advantage of being easy to use and noninvasiv e and of providing immediate results for early determination of burn d epth. Laser Doppler flowmetry is useful in selecting patients for earl y excision and grafting of burn wounds.