激光多普勒烧伤扫描成像系统

利用激光多普勒技术判断烧伤创面的损伤程度、预后情况判断。
临床实验证明：
bi扫描发现血流灌注量丰富的创面14天之内就会愈合良好
bi扫描发现灌注量中等的创面愈合期在14天-21天之间
bi扫描发现灌注量很低的烧伤创面明确提示医生可能需要手术、愈合期在21天以上
本结果经全球烧伤科临床医学专家验证准确
专业软件帮助轻松分析监测结果！
注：影响烧伤愈后的因素很多，请根据多种情况分析判断！
introduction
the moorldi2-bi (moorldi2 burns imager) uses the laser doppler technique to predict the healing potential (hp) of a burn wound.
clinical trials have shown that burn wounds heal within 14 days where there is high ld blood flow, between days 14 and 21 with ‘medium’ blood flow, and take longer than 21 days where there is low ld blood flow (the latter usually indicating that surgery is required).
with the introduction of moorldi2-bi laser doppler imager different regions of a mixed depth burn can be mapped in a single image. a full resolution scan includes 65,536 individual laser doppler measurements and these are displayed alongside a corresponding ccd image, as a colour coded image.
accuracy of moorldi2-bi
since the development of the moorldi, a number of publications have shown the higher accuracy of ldi in burn depth assessment.
niazi et al. (1993) first evaluated the technique of burn depth measurement using ldi. they found that the commonest error (in four out of 17 cases) was overestimation of burn depth by the clinician. in only two cases did they underestimate burn depth. by comparison, when they used ldi to measure burn depth this was correct in all cases (4 superficial dermal and 13 deep-dermal or sub-dermal burns).
pape et al. (2001) published an audit of the use of ldi in the assessment of burn depth. they reported that the ldi allowed accurate assessment of burn depth in 97% of burns, compared with 73% for clinical observation alone. these findings were similar to those reported by monstrey et al. (2001, abstract) who reported ldi accuracy of 93.3�96.6% compared to 61�67% for clinical evaluation, when ldi scanning was performed at day 3 and day 5 post-burn, respectively.
jeng et al. (2001) stated that use of the ldi enabled them to make earlier and more ob-jective determination of the need to excise and graft burns. in a separate study, pape and byrne (2001) presented evidence that the use of ldi avoided unnecessary surgery, resulting in a reduction of both costs and workload.
in 2002 holland et al. also reported that the moorldi was an accurate method for the prediction of burn wound healing in children (holland et al., 2002). this study involved 57 children with a mean age of 1 year and 10 months. the sensitivity and the specificity of the moorldi were higher than clinical evaluation:
sensitivity ldi � 0.90; clinical evaluation � 0.66.
specificity ldi � 0.96; clinical evaluation � 0.71 (holland et al., 2002)
equipment required
the moorldi2-bi package includes the moorldi2-bi scan head, scan controller, touch-screen panel pc, all mounted on a mobile clinical stand that can be used in the ward, operating theatre, consulting room or special laser room. full installation, clinical training and certification is included together with a premium service contract.
summary
the moorldi2-bi can help the burn surgeon by indicating the healing potential (hp) of burn wounds. the current clinical practice is to report burn depth. for example, some burn surgeons use the latarjet classification (first-degree, superficial second-degree, deep second-degree and third-degree). we have introduced the term healing potential (hp) when interpreting moorldi2-bi burn scan images because healing is the recordable outcome measure relevant to large areas of burn, whereas assessment of depth (using biopsy) is only available at discreet points.
a multi-centre study was carried out using the moorldi2-bi to analyse the ranges of blood flow that correlated with healing within 3 specified time-periods; by post-burn day 14, between post-burn day 14 and 21, and greater than 21 days.
the hp categories are:
hp 14: the wound has the potential to heal within 14 days of the burn injury
hp 14-21: the wound has the potential to heal between 14 to 21 days post burn
hp >21: the wound will take longer than 21 days to heal
the actual healing time of the wound will, however, depend upon other factors that can prolong wound healing (e.g. wound infection or use of inotropes). thus, the moorldi2-bi can provide an indication of the potential of the wound to heal but the actual healing time is dependent upon other clinical, biological and environmental factors.
use of the moorldi2-bi has been shown to avoid unnecessary surgery in patients with superficial dermal wounds and promote early surgery for deep dermal wounds.
the moorldi2 laser doppler blood perfusion imagers use a near infra-red laser beam (785nm in the standard moorldi2-ir imager) or a visible red 633nm laser beam (moorldi2-vr imager). in the moorldi2-2λ dual wavelength system 633 and 830nm lasers are combined to allow simultaneous imaging with the two wavelengths.
the imagers are able to map tissue blood flow over areas from 5cm x 5cm up to 50cm x 50cm with 256 x 256 pixel resolution; - each pixel being an actual measurement. at high scan rates, over 64,000 measurements are made in less than 5 minutes.
the moorldi2 is suitable for a wide range of clinical and research investigations and measurement of blood flow in the microcirculation. the moorldi2 range features a ccd camera which produces a colour image of the scanned area, making the positioning and comparison of images easier. the moorldi2-hr highest resolution version is available with resolution to 100 microns.