Article
In vivo determination of superficial-partial thickness burn injuries by confocal-laserscanning microscopy
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Published: | March 19, 2009 |
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Objective: The current determination of burn depth is based both on a visual and clinical assessment.
Confocal-laser-scanning microscopy (CLSM) enables to determine in vivo histomorphological images. We hypothesized that CLSM can differentiate superficialpartial vs. deep-partial thickness burns on a histomorphological level.
Methods: 38 burn wounds in fourteen patients were clinically divided in three groups from superficial-(group1), superficial-partial-(group2) to deep-partial-(group3)thickness burns. CLSM was performed with the Vivascope1500 (Lucid Inc, Rochester, New-York; USA) 24h after burn injury. Following parameters were assessed: cell size of the granular-layer, thickness of the basal-layer, minimal thickness of the epidermis, number of perfused dermal-papillae.
Results: Superficial burns resulted in a significant increase of the cell size of the granular-layer and a higher increase of the minimal thickness of the epidermis as in superficial-partial-thickness burns. The granularlayer in partial- thickness burns was destroyed. Superficial burns had an increased thickness of the basal-layer; in superficial- partial-thickness burns the basal-layer was partly destroyed with complete destruction in deep-partial-thickness burns. In superficial burns the perfused dermal-papillae were increased significantly, while decreased in superficial-partial-thickness, and completely destroyed in deep-partial-thickness burns up to a depth of 350µm.
Conclusions: In vivo confocal-laser-scanning microscopy can differentiate superficial-partial vs. deep-partial thickness burns on a histomorphological level.