Critical Review of Burn Depth Assessment Techniques: Part I. Historical Review

• Published in: Journal of burn care & research Vol. 30; no. 6; pp. 937 - 947
• Main Authors: JASKILLE, Amin D, SHUPP, Jeffrey W, JORDAN, Marion H, JENG, James C
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA Lippincott Williams & Wilkins 01-11-2009
• Subjects: Biological and medical sciences; Biopsy - history; Burns; Burns - classification; Burns - pathology; Burns - therapy; Decision Making; Dermatology; Diagnostic Imaging - history; False Negative Reactions; False Positive Reactions; History, 20th Century; Humans; Laser-Doppler Flowmetry - history; Medical sciences; Photometry - history; Prognosis; Skin Transplantation - history; Staining and Labeling - history; Trauma Severity Indices; Traumas. Diseases due to physical agents; Burn; Skin disease; Technique; Bibliographic review
• ISSN: 1559-047X; 1559-0488
• DOI: 10.1097/BCR.0b013e3181c07f21

The assessment of burn depth, and as such, the estimation of whether a burn wound is expected to heal on its own within 21 days, is one of the most important roles of the burn surgeon. A false-positive assessment and the patient faces needless surgery, a false-negative one and the patient faces increased length of stay, risks contracture, and hypertrophic scar formation. Although many clinical signs can aid in this determination, accurate assessment of burn depth is possible only 64 to 76% of the time, even for experienced burn surgeons. Through the years, a variety of tools have become available, all attempting to improve clinical accuracy. Part 1 of this two-part article reviews the literature supporting the different adjuvants to clinical decision making is, providing a historical perspective that serves as a framework for part 2, a critical assessment of laser Doppler imaging.