Validity of laser speckle contrast imaging for predicting wound healing potential in burns: A critical examination

Abstract

Background

Accurate assessment of burn depth is imperative for the efficacious management of burns. Although clinical assessment is commonly used, its accuracy ranges only between 50 % and 70 %. Laser Doppler imaging (LDI) is considered as a gold standard - with an accuracy exceeding 95 %, - for the objective measurement of Healing Potential (HP), HP being the output of the LDI device, as colour-coded on LDI blood flow images. Despite its proven efficacy, widespread adoption is impeded by practical challenges. Laser Speckle Contrast Imaging (LSCI) emerges as a possible alternative. This study investigated the performance and accuracy of LSCI in comparison with LDI for predicting the HP of burns; LDI was assumed to provide ‘ground truth’ for the assessment of HP.

Methods

Hospitalized burn patients underwent LDI and LSCI scans between day 2 and day 5 postburn. Analysis involved selecting corresponding regions of interest (ROI) in target wounds prioritized by LDI and LSCI perspectives.

Results

In 19 patients, 112 ROI within LDI-priority ranges were collected from 50 target wounds. 130 ROI within LSCI-priority ranges were collected from 52 target wounds. Positive predictive values (PPV) were low, at only 50.8 % and 68.2 % for HP14–21 and HP21, respectively, and 86.9 % for HP14.

Conclusion

Objective assessment by LSCI for burns is not recommended, as it fails to detect deep dermal blood flow, leading to an overestimation of burn severity and potential inadequacies in therapy.