Burn depth diagnosis using laser assisted indocyanine green fluorescence angiography

Dr Goltsman David, Dr Zhe Li, A/Prof Peter Haertsch, A/Prof Peter Kennedy, Prof Peter Maitz

1Concord Hospital – Burns Unit

Clinical assessment of burn depth is frequently inaccurate. This unit has shown that in fact overestimation of a burn injury total body surface area is three times as likely to occur when compared to underestimation1. In order to effectively treat burn injuries and avoid inducing unnecessary harm and morbidity through over debridement, an accurate diagnosis of burn depth is essential. Clinical assessment of burn injuries is a subjective process which can lead to variability in the diagnosis of full thickness, deep dermal, superficial dermal and superficial burns. Florescence angiography is a novel method of assessing flow in tissue and has been shown to accurately intra-operatively predict mastectomy flap necrosis2. Our aim is to use this technology to provide an objective and repeatable assessment of burn injuries. In this preliminary study we have attempted to utilise the fluorescent properties of Indocyanine Green (ICG) and assess its potential for differentiating burn injury thickness based on perfusion mapping technology using the SPY system. Based on our experience with this new technology we feel that as demonstrated by other preliminary studies3,4, it is able to detect differential vascular patency of skin which correlate to different burn depth. This innovative technology is a practical and effective adjunct to clinical evaluation of burns. This trial aims to define what quantitative perfusion score accurately delineate different burn depth to ensure accurate, reliable and repeatable.

David Goltsman completed his MBBS at Sydney University, and concurrently completed a PhD with the Concord Burns and Reconstructive Surgery Department. He is currently a General Surgery Registrar at the Prince of Wales Hospital, Sydney.


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