Dr Guy Stanley1, Dr Richard Bradbury1
1Royal Darwin Hospital, 105 Rocklands Drive, Australia
Introduction: There is some evidence data that Laser Doppler Imaging (LDI) results in improved clinical outcomes but no synthesis of data.
Methods: A systematic review and meta-analysis were performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. 3 cohort studies, 1 RCT and 1 set of guidelines related to LDI outcomes. Assessments for risk of bias and analysis were performed where data were available.
Results: Meta-analysis, showed a reduction in the time to reach a decision on surgery by 2.19 days (95% CI, 0.71-3.68, p = 0.004). Jenda et al performed the only RCT, finding a reduced time to healing of 3.9 days (p = 0.022) in the subset of patients admitted for surgery. There is a likely but non-significant reduction in the number of surgical interventions when using LDI: OR 0.75 (p = 0.14). There is some evidence to indicate that LDI may decrease unnecessary surgery. There are two studies that show an actual reduction in the length of stay for patients of between 1.3-5 days. There was no demonstrable effect of cost saving, but potential savings are likely. LDI has no demonstrable effect on improving quality of life, scar quality, nor decreasing prescription of pressure garments for scar prophylaxis.
Conclusion: LDI reduces time to surgical decision and decreases healing time in surgical inpatients. It can potentially reduce length of stay and costs. There may be benefit in using LDI in the Northern Territory, because of patient demographics.
PGY4 General Surgical Service Registrar at Royal Darwin Hospital,
– Completed a ‘Masters of Surgery (Plastic/Reconstructive Surgery)’ from University Sydney
– Holds position of Pre-SET lead for Clinical Trials: Australia & New Zealand (CTANZ), Plastic & Reconstructive Surgery