Artikel
In vivo determination of superficial second degree burn injuries on histomorphological level by confocal-laser-scanning microscopy
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Veröffentlicht: | 30. Juni 2008 |
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Background: The determination of burn depth is based on a visual assessment and can be subjective. Confocal-laser-scanning microscopy (CLSM) provides a non-invasive alternative to diagnostic various types of skin lesions. The aim of this study was to examine the CLSM to the demarcation of superficial second degree burn injuries.
Methods: 38 burn wounds (n=38) in fourteen patients were divided in three groups from first-(group 1), superficial (group 2) to deep (group 3) second-burn injuries. CLSM was performed with the Vivascope 1500 (Lucid Inc, Rochester, New York; USA) 24 h after injury to investigate the burn site and a comparable unburned site. Following parameters were assessed: cell size of the granular layer (Agran), thickness of the basal layer (tbl), minimal thickness of the epidermis (Emin), number of perfused dermal papillae (ppI) per area.
Results: CLSM data showed in group 1 a significant increase of Agran and a higher increase of Emin as in group 2. The granular layer in group 2 and 3 showed destroyed. In group 1 tbl increase significantly in burn skin. In group 2 tbl measurements were not statistically significant; the basal layer showed partly and in group 3 completely destroyed. In first-degree burn ppI increase significantly, in group 2 ppI decrease, in group 3 dermal structures showed completely destroyed up to deep by 200 µm.
Conclusions: In vivo CLSM permitted as a sensitive tool to characterize and quantify histomorphological changes of the epidermis and papillary dermis in burn injuries. CLSM provides an estimate of burn wounds and could easily distinguish first-, superficial and deep second-burn wounds.