Laser Doppler Imaging – the Role of Poor Burn Perfusion in Predicting Healing Time and Guiding Operative Management

Aim: To identify if the proportion of poor blood flow (blue) within an LDI (Laser doppler Imaging) image of a burn independently correlates with healing time.Methods: Patient age, gender, burn type, and burn surface area were collected from the IBID (International Burn Injury Database). All LDI images were copied from the MoorLDI2-BI-Laser Doppler (MLDI) Scanner, onto Adobe Photoshop (R) version 2020 for pixel counting analysis and calculation of % TBSA (Total Body Surface Area) blue. Multiple linear regres-sion analysis determined whether a proportional relationship was present for each para-meter (age, gender, % TBSA Blue and comorbidities) with healing time.Results: 110 patients with 197 burns were scanned with MLDI. Median age was 5 years (IQR 1-6). Median burn surface area was 1.5% (IQR 1-2.4). 56.4% of patients were male and pa-tients were scanned an average of 2.68 days (SD +/- 1.37) following burn injury. Number of physical comorbidities and age were found to have a statistically significant relationship with healing time (p = 0.03, p = 0.002). Gender and %TBSA blue did not have a statistically significant relationship with healing time (p = 0.07 and p = 0.058 respectively). We found a statistically significant difference in the mean healing time between burns with and without blue (3.43 weeks vs. 2.80 weeks, p = 0.0001). % TBSA Blue was more than four times higher in the operated group (0.48% vs. 0.11%) and was shown to have a statistically sig-nificant relationship with decision to operate (p = 0.027). Positive predictive value for the presence of blue on operative rate was 71.6%. Age, gender and number of comorbidities did not have a statistically significant influence on operative rate (p = 0.07, p = 0.50 and p = 0.49).Conclusion: % TBSA blue was not found to be a reliable independent indicator of burn healing time, but the presence of blue within an LDI image, advanced patient age and