First Preliminary Clinical Experiences Using Hyperspectral Imaging for Burn Depth Assessment of Hand Burns.

The accurate assessment of burn wounds is challenging but crucial for correct diagnosis and following therapy. The most frequent technique to evaluate burn wounds remains the clinical assessment, often subjective depending on the experience of the physician. Hyperspectral imaging (HIS) is intended to improve on this subjective diagnosis by accurate and objective analyses of perfusion parameters. The purpose of this study was to analyze the ability of technical burn depth assessment and to investigate a link between a certain value to burn depth versus the value of healthy skin references. One hundred and eighteen HSI analyses were included in this study between July 2017 and July 2019. We analyzed 74 recordings with dorsal hand burns and 44 recordings of healthy skin on the dorsal hand as control group. HSI recordings' investigation was performed with special interest to wound center, intermediate zone, and wound margin. The results indicate that a differentiation between burned tissue and healthy skin was feasible and also significant in almost all HSI analysis parameters (P < .05). No significant distinction between superficial and deep partial thickness burns could be determined. However, in the wound center, we recorded smaller values with a more pronounced tissue damage. Our preliminary results demonstrate that HSI can distinguish between normal and burned hands. However, as currently used, HSI could not accurately determine the depth of indeterminate burns.

Evaluation of hyperspectral imaging as a modern aid in clinical assessment of burn wounds of the upper extremity.

The most common burn wound assessment continues to be the clinical inspection and the tactile examination, which are subjective and remain challenging even for experienced burn surgeons. Recently, hyperspectral imaging camera systems have been increasingly used to support the evaluation of burn wounds. The aim of our study was to determine if hyperspectral imaging analysis differentiates and objectifies the assessment of burn wounds in burns of the upper extremities. We included 97 superficial partial, deep partial dermal burns, and full thickness burns. Hyperspectral imaging analysis was performed for all burns using proprietary software. The software recorded parameters for tissue oxygenation (StO2), tissue hemoglobin index, and near-infrared perfusion. These values were compared with the recordings for healthy, non-burned skin. We found that hyperspectral imaging analysis effectively differentiates burn wounds and shows the ability to distinguish even superficial partial burns from deep partial burns in the near-infrared perfusion analysis feature. Although, it was not possible to differentiate burn wounds in all features. Currently, it is important to optimize the respective reference values of the individual burn degrees for an objectified assessment.

[Conservative management of grade IV kidney lacerations due to stab wounds]. / Konservatives Management bei Messerstichverletzung der Niere (Grad IV).

We report on two patients who were in initially circulatory stable condition with grade IV kidney trauma after knife stab accident. Patient 1 underwent reconstructive surgery to retrieve a broken knife blade, while patient 2 was treated conservatively for bleeding that did not require intervention. Both patients could ultimately be discharged in stable condition. These case studies show that even in the case of high-grade kidney trauma with the appropriate constellation of findings, conservative management and, if exploration is necessary, a reconstructive approach is possible.