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Dogan, S., Elmasry, M., Elserafy, A. T., Sjöberg, F., Vuola, J., Kankuri, E., . . . Lindford, A. (2022). A prospective dual-centre intra-individual controlled study for the treatment of burns comparing dermis graft with split-thickness skin auto-graft. Scientific Reports, 12(1), Article ID 21666.
Öppna denna publikation i ny flik eller fönster >>A prospective dual-centre intra-individual controlled study for the treatment of burns comparing dermis graft with split-thickness skin auto-graft
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2022 (Engelska)Ingår i: Scientific Reports, E-ISSN 2045-2322, Vol. 12, nr 1, artikel-id 21666Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

To investigate if donor and recipient site morbidity (healing time and cosmesis) could be reduced by a novel, modified split-thickness skin grafting (STSG) technique using a dermal component in the STSG procedure (DG). The STSG technique has been used for 150 years in surgery with limited improvements. Its drawbacks are well known and relate to donor site morbidity and recipient site cosmetic shortcomings (especially mesh patterns, wound contracture, and scarring). The Dermal graft technique (DG) has emerged as an interesting alternative, which reduces donor site morbidity, increases graft yield, and has the potential to avoid the mesh procedure in the STSG procedure due to its elastic properties. A prospective, dual-centre, intra-individual controlled comparison study. Twenty-one patients received both an unmeshed dermis graft and a regular 1:1.5 meshed STSG. Aesthetic and scar assessments were done using The Patient and Observer Scar Assessment Scale (POSAS) and a Cutometer Dual MPA 580 on both donor and recipient sites. These were also examined histologically for remodelling and scar formation. Dermal graft donor sites and the STSG donor sites healed in 8 and 14 days, respectively (p < 0.005). Patient-reported POSAS showed better values for colour for all three measurements, i.e., 3, 6, and 12 months, and the observers rated both vascularity and pigmentation better on these occasions (p < 0.01). At the recipient site, (n = 21) the mesh patterns were avoided as the DG covered the donor site due to its elastic properties and rendered the meshing procedure unnecessary. Scar formation was seen at the dermal donor and recipient sites after 6 months as in the standard scar healing process. The dermis graft technique, besides potentially rendering a larger graft yield, reduced donor site morbidity, as it healed faster than the standard STSG. Due to its elastic properties, the DG procedure eliminated the meshing requirement (when compared to a 1:1.5 meshed STSG). This promising outcome presented for the DG technique needs to be further explored, especially regarding the elasticity of the dermal graft and its ability to reduce mesh patterns. Trial registration: ClinicalTrials.gov Identifier (NCT05189743) 12/01/2022. © 2022, The Author(s).

Nyckelord
burns, cicatrix, dermis, humans, prospective studies, skin transplantation
Nationell ämneskategori
Kirurgi
Identifikatorer
urn:nbn:se:liu:diva-190855 (URN)10.1038/s41598-022-25346-4 (DOI)001015461100020 ()36522434 (PubMedID)2-s2.0-85144147270 (Scopus ID)
Anmärkning

Funding: Linkoping University; Department of Plastic and Hand Surgery Linkoping University Hospital; Department of Biomedical and Clinical Sciences, Linkoping University, Linkoping

Tillgänglig från: 2023-01-03 Skapad: 2023-01-03 Senast uppdaterad: 2024-01-10
Steinvall, I., Elmasry, M., Abdelrahman, I., El-Serafi, A. T., Fredrikson, M. & Sjöberg, F. (2022). ABO blood group and effects on ventilatory time, length of stay and mortality in major burns a retrospective observational outcome study. Burns, 48(4), 785-790
Öppna denna publikation i ny flik eller fönster >>ABO blood group and effects on ventilatory time, length of stay and mortality in major burns a retrospective observational outcome study
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2022 (Engelska)Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 48, nr 4, s. 785-790Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Blood group has been found to be important in the development of many diseases and the outcome of several disease processes, especially cardiovascular morbidity and mortality, such as caused by trauma and sepsis. The main reason is claimed to be related to glycobiology and effects mediated through the endothelium. This study investigated the possible effect of blood group (ABO) on burn care outcome. Burn outcome prediction models are extremely accurate and as such can be used to identify outcome effects even in single centre settings. In this retrospective risk adjusted observational study, we investigated the effect of ABO blood group on ventilatory time, length of hospital stay (LOS), and 90 day mortality among patients with burns. RESULTS: A total of 225 patients were included (2008-2019) with median TBSA of 26%; interquartile range (IQR) of 20-37%; median age 45 years (IQR 22-65 years); median Baux score (age + TBSA%); 76 (IQR 53- 97); 168 (75%) were male; median duration of hospital stay was 31 days (IQR 19-56); a total of 138 (61%) received treatment with mechanical ventilation; and 29 (13%) died. In a multivariable regression model, we were unable to isolate any significant effect of any blood group (O, A, B, AB) on the outcome measures studied (ventilatory time, LOS, and mortality). IN SUMMARY: contrary to many other major areas of disease in which ABO blood groups affect outcome, we were unable to find any such effect on patients with burns. Given the precision of the outcome models presented (AUC 0.93) any such an effect, if missed due to the limited study cohort, may be considered limited and to have only a minor clinical impact.

Ort, förlag, år, upplaga, sidor
Oxford, United Kingdom: Elsevier, 2022
Nyckelord
ICU; Large burns; Mortality prediction; Survival; Total Body Surface area burned (TBSA %)
Nationell ämneskategori
Kirurgi
Identifikatorer
urn:nbn:se:liu:diva-183534 (URN)10.1016/j.burns.2022.02.001 (DOI)000833489400007 ()35227532 (PubMedID)2-s2.0-85125505549 (Scopus ID)
Anmärkning

Funding agencies: Carnegie foundation (Stockholm, Sweden); Queen Victoria Foundation (Stockholm, Sweden); Department of Hand Surgery, Plastic Surgery and Burns, Linkoping University Hospital; Linkoping University Linkoping, Sweden

Tillgänglig från: 2022-03-17 Skapad: 2022-03-17 Senast uppdaterad: 2024-01-10Bibliografiskt granskad
Ellabban, M. A., Elmasry, M., Abdelrahman, I., Abdel Kader, G., Steinvall, I., Sjöberg, F., . . . Abdel Fattah, I. O. (2022). Experimental study of the effects of nitroglycerin, botulinum toxin A, and clopidogrel on bipedicled superficial inferior epigastric artery flap survival.. Scientific Reports, 12(1), Article ID 20891.
Öppna denna publikation i ny flik eller fönster >>Experimental study of the effects of nitroglycerin, botulinum toxin A, and clopidogrel on bipedicled superficial inferior epigastric artery flap survival.
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2022 (Engelska)Ingår i: Scientific Reports, E-ISSN 2045-2322, Vol. 12, nr 1, artikel-id 20891Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Beneficial effects could be achieved by various agents such as nitroglycerin, botulinum toxin A (BoTA), and clopidogrel to improve skin flap ischaemia and venous congestion injuries. Eighty rats were subjected to either arterial ischaemia or venous congestion and applied to a bipedicled U-shaped superficial inferior epigastric artery (SIEA) flap with the administration of nitroglycerin, BoTA, or clopidogrel treatments. After 7 days, all rats were sacrificed for flap evaluation. Necrotic area percentage was significantly minimized in flaps treated with clopidogrel (24.49%) versus the ischemic flaps (34.78%); while nitroglycerin (19.22%) versus flaps with venous congestion (43.26%). With ischemia, light and electron microscopic assessments revealed that nitroglycerin produced degeneration of keratinocytes and disorganization of collagen fibers. At the same time, with clopidogrel administration, there was an improvement in the integrity of these structures. With venous congestion, nitroglycerin and BoTA treatments mitigated the epidermal and dermal injury; and clopidogrel caused coagulative necrosis. There was a significant increase in tissue gene expression and serum levels of vascular endothelial growth factor (VEGF) in ischemic flaps with BoTA and clopidogrel, nitroglycerin, and BoTA clopidogrel in flaps with venous congestion. With the 3 treatment agents, gene expression levels of tumor necrosis factor-α (TNF-α) were up-regulated in the flaps with ischemia and venous congestion. With all treatment modalities, its serum levels were significantly increased in flaps with venous congestion and significantly decreased in ischemic flaps. Our analyses suggest that the best treatment option for ischemic flaps is clopidogrel, while for flaps with venous congestion are nitroglycerin and BoTA.

Ort, förlag, år, upplaga, sidor
Nature Publishing Group, 2022
Nationell ämneskategori
Kirurgi
Identifikatorer
urn:nbn:se:liu:diva-192151 (URN)10.1038/s41598-022-24898-9 (DOI)000969757300018 ()36463303 (PubMedID)
Tillgänglig från: 2023-03-06 Skapad: 2023-03-06 Senast uppdaterad: 2024-01-10Bibliografiskt granskad
Henricson, J., Sjöberg, F., Iredahl, F., Strömberg, T. & Björk Wilhelms, D. (2022). In vivo dose-response analysis to acetylcholine: pharmacodynamic assessment by polarized reflectance spectroscopy. Scientific Reports, 12(1), Article ID 6594.
Öppna denna publikation i ny flik eller fönster >>In vivo dose-response analysis to acetylcholine: pharmacodynamic assessment by polarized reflectance spectroscopy
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2022 (Engelska)Ingår i: Scientific Reports, E-ISSN 2045-2322, Vol. 12, nr 1, artikel-id 6594Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Transdermal iontophoresis offers an in vivo alternative to the strain-gauge model for measurement of vascular function but is limited due to lack of technical solutions for outcome assessment. The aims of this study were to, after measurement by polarized reflectance spectroscopy (PRS), use pharmacodynamic dose-response analysis on responses to different concentrations of acetylcholine (ACh); and to examine the effect of three consecutively administered iontophoretic current pulses. The vascular responses in 15 healthy volunteers to iontophorised ACh (5 concentrations, range 0.0001% to 1%, three consecutive pulses of 0.02 mA for 10 min each) were recorded using PRS. Data were fitted to a four-parameter logistic dose response model and compared. Vascular responses were quantifiable by PRS. Similar pharmacodynamic dose response curves could be generated irrespectively of the ACh concentration. Linearly increasing maximum vasodilatory responses were registered with increasing concentration of ACh. A limited linear dose effect of the concentration of ACh was seen between pulses. Polarized reflectance spectroscopy is well suited for measuring vascular responses to iontophoretically administrated ACh. The results of this study support further development of iontophoresis as a method to study vascular function and pharmacological responses in vivo.

Ort, förlag, år, upplaga, sidor
London, United Kingdom: Nature Publishing Group, 2022
Nationell ämneskategori
Annan fysik
Identifikatorer
urn:nbn:se:liu:diva-185028 (URN)10.1038/s41598-022-10617-x (DOI)000784878300039 ()35449189 (PubMedID)2-s2.0-85128631757 (Scopus ID)
Anmärkning

Funding Agencies: Linköping University; ALF grants; Region Östergotland, Linköping, Sweden [RO-726731]

Tillgänglig från: 2022-05-18 Skapad: 2022-05-18 Senast uppdaterad: 2022-09-15Bibliografiskt granskad
Pompermaier, L., Drake Af Hagelsrum, E., Ydenius, V., Sjöberg, F., Steinvall, I. & Elmasry, M. (2022). Patient Reported Experiences at a Swedish National Burn Centre. Journal of Burn Care & Research, 43(1), 249-254
Öppna denna publikation i ny flik eller fönster >>Patient Reported Experiences at a Swedish National Burn Centre
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2022 (Engelska)Ingår i: Journal of Burn Care & Research, ISSN 1559-047X, E-ISSN 1559-0488, Vol. 43, nr 1, s. 249-254Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Previous studies have shown that burn patients were satisfied with the received care. Satisfaction was not strongly associated to burns or to psycho-social characteristics, suggesting that other factors, related to burn care specific aspects, may be important. The aim of this study was to analyze the independent effect of provided workload on the general satisfaction in adult patients at a Swedish national Burn Centre. The study population (n = 122) included patients ≥18 years, treated at the Linköping Burn Centre between 2016 and 2017. Experienced burn care was evaluated with the PS-RESKA survey (score range: 0-4), and provided workload was scored with the Burn Scoring System (BSC). Groups were compared with χ 2 test, MW test, or Fisher´s exact test. Multivariable logistic regression analyzed the independent effect of BSC on the outcome High Satisfaction (= score ≥3 to the survey-question: "How would you score your global experience at the Burn Centre?"). In-patients (n = 60) had more often larger burns and required more workload than out-patients (median[IQR]: TBSA% = 6.3 [3-12.3] % vs. 0.7 [0.3-2] %, p < .001; BSC = 65 [25.5-135.5] vs. 6 [4-9], p < .001). Both groups were highly satisfied with the experienced care (mean score [SD] = 3.68 [0.57] vs. 3.41 [0.77], p = .03). Neither characteristics of the patients (age, sex), nor TBSA% nor provided workload (BSC) were independently associated with High Satisfaction. Regardless of burn severity, demographics and provided workload, adult patients with burns were highly satisfied with the experienced burn care. This finding suggested that the reason of the satisfaction was multifactorial.

Ort, förlag, år, upplaga, sidor
Oxford University Press, 2022
Nationell ämneskategori
Kirurgi
Identifikatorer
urn:nbn:se:liu:diva-178803 (URN)10.1093/jbcr/irab091 (DOI)000744007600034 ()34131732 (PubMedID)
Anmärkning

Funding agencies: Department of Hand Surgery, Plastic Surgery and Burns; Linkoping University, Linkoping, Sweden

Tillgänglig från: 2021-08-30 Skapad: 2021-08-30 Senast uppdaterad: 2022-05-19Bibliografiskt granskad
Abdelrahman, I., Steinvall, I., Sjöberg, F., Ellabban, M. A., Zdolsek, J. & Elmasry, M. (2022). Pros and Cons of Early and Late Skin Grafting in Children with Burns—Evaluation of Common Concepts. European Burn Journal, 3(1), 180-187
Öppna denna publikation i ny flik eller fönster >>Pros and Cons of Early and Late Skin Grafting in Children with Burns—Evaluation of Common Concepts
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2022 (Engelska)Ingår i: European Burn Journal, E-ISSN 2673-1991, Vol. 3, nr 1, s. 180-187Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background: There is no consensus regarding the timing of surgery in children with smallerburn size, specifically in deep dermal burns. Delayed surgery has risks in terms of infection anddelayed wound healing. Early surgery also risks the removal of potentially viable tissue. Our aim wasto investigate the effect of the timing of surgical intervention on the size of the area operated on andthe time to wound healing. Methods: A retrospective analysis for all children (<18 years) with burnsize <20% body surface area (BSA%) during 2009–2020 who were operated on with a split-thicknessskin graft. The patients were grouped by the timing of the first skin graft operation: early = operatedon within 14 days of injury; delayed = operated on more than two weeks after injury. Results: A totalof 84 patients were included in the study, 43 who had an early operation and 41 who had a delayedoperation. There were no differences between the groups regarding burn size, or whether the burnswere superficial or deep. The mean duration of healing time was seven days longer in the group withdelayed operation (p = 0.001). The area operated on was somewhat larger (not significantly so) in thegroup who had early operation. Nine children had two skin graft operations, eight in the early groupand one in the delayed group (p = 0.03). Conclusion: The patients who were operated on early hadthe advantage of a shorter healing time, but there was a higher rate of complementary operationsand a tendency towards a larger burn excision.

Ort, förlag, år, upplaga, sidor
MDPI, 2022
Nyckelord
burns; children; healing time; burn surgery; skin graft
Nationell ämneskategori
Kirurgi
Identifikatorer
urn:nbn:se:liu:diva-183535 (URN)10.3390/ebj3010015 (DOI)
Tillgänglig från: 2022-03-17 Skapad: 2022-03-17 Senast uppdaterad: 2024-01-10Bibliografiskt granskad
Steinvall, I., Elmasry, M., Abdelrahman, I., Elserafy, A. T. & Sjöberg, F. (2021). Addition of admission lactate levels to Baux score improves mortality prediction in severe burns.. Scientific Reports, 11(1), Article ID 18038.
Öppna denna publikation i ny flik eller fönster >>Addition of admission lactate levels to Baux score improves mortality prediction in severe burns.
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2021 (Engelska)Ingår i: Scientific Reports, E-ISSN 2045-2322, Vol. 11, nr 1, artikel-id 18038Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Risk adjustment and mortality prediction models are central in optimising care and for benchmarking purposes. In the burn setting, the Baux score and its derivatives have been the mainstay for predictions of mortality from burns. Other well-known measures to predict mortality stem from the ICU setting, where, for example, the Simplified Acute Physiology Score (SAPS 3) models have been found to be instrumental. Other attempts to further improve the prediction of outcome have been based on the following variables at admission: Sequential Organ Failure Assessment (aSOFA) score, determinations of aLactate or Neutrophil to Lymphocyte Ratio (aNLR). The aim of the present study was to examine if estimated mortality rate (EMR, SAPS 3), aSOFA, aLactate, and aNLR can, either alone or in conjunction with the others, improve the mortality prediction beyond that of the effects of age and percentage total body surface area (TBSA%) burned among patients with severe burns who need critical care. This is a retrospective, explorative, single centre, registry study based on prospectively gathered data. The study included 222 patients with median (25th-75th centiles) age of 55.0 (38.0 to 69.0) years, TBSA% burned was 24.5 (13.0 to 37.2) and crude mortality was 17%. As anticipated highest predicting power was obtained with age and TBSA% with an AUC at 0.906 (95% CI 0.857 to 0.955) as compared with EMR, aSOFA, aLactate and aNLR. The largest effect was seen thereafter by adding aLactate to the model, increasing AUC to 0.938 (0.898 to 0.979) (p < 0.001). Whereafter, adding EMR, aSOFA, and aNLR, separately or in combinations, only marginally improved the prediction power. This study shows that the prediction model with age and TBSA% may be improved by adding aLactate, despite the fact that aLactate levels were only moderately increased. Thereafter, adding EMR, aSOFA or aNLR only marginally affected the mortality prediction.

Ort, förlag, år, upplaga, sidor
Nature Publishing Group, 2021
Nationell ämneskategori
Kirurgi
Identifikatorer
urn:nbn:se:liu:diva-179204 (URN)10.1038/s41598-021-97524-9 (DOI)000694868000037 ()34508143 (PubMedID)
Anmärkning

Fundin agencies: Open access funding provided by Linköping University. This study was funded by the department of Hand Surgery, Plastic Surgery and Burns, and Linköping University, Linköping, Sweden; The Carnegie Foundation; and the research fund of King Gustaf the 5th and Queen Victoria, Stockholm, Sweden.

Tillgänglig från: 2021-09-13 Skapad: 2021-09-13 Senast uppdaterad: 2024-01-10Bibliografiskt granskad
Gus, E., Almeland, S. K., Barnes, D., Elmasry, M., Singer, Y., Sjöberg, F., . . . Cleland, H. (2021). Burn unit design - the missing link for quality and safety.. Journal of Burn Care & Research, 42(3), 369-375
Öppna denna publikation i ny flik eller fönster >>Burn unit design - the missing link for quality and safety.
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2021 (Engelska)Ingår i: Journal of Burn Care & Research, ISSN 1559-047X, E-ISSN 1559-0488, Vol. 42, nr 3, s. 369-375Artikel, forskningsöversikt (Refereegranskat) Published
Abstract [en]

The relationship between infrastructure, technology, model of care and human resources influences patient outcomes and safety, staff productivity and satisfaction, retention of personnel, and treatment and social costs. This concept underpins the need for evidence-based design, and has been widely adopted to inform hospital infrastructure planning. The aim of this review is to establish evidence-based, universally-applicable key features of a burn unit that support function in a comprehensive patient-centred model of care. A literature search in medical, architectural and engineering databases was conducted. Burn associations' guidelines and relevant articles published in English, between 1990 and 2020, were included, and the available evidence is summarized in the review. Few studies have been published on burn unit design in the last thirty years. Most of them focus on the role of design in infection control and prevention, and consist primarily of descriptive or observational reports, opportunistic historical cohort studies, and reviews. The evidence available in the literature is not sufficient to create a definitive infrastructure guideline to inform burn unit design, and there are considerable difficulties in creating evidence that will be widely applicable. In the absence of a strong evidence base, consensus guidelines on burn unit infrastructure should be developed, to help healthcare providers, architects and engineers make informed decisions, when designing new or renovated facilities.

Ort, förlag, år, upplaga, sidor
Oxford University Press, 2021
Nyckelord
burn care, burn centre, burn unit, evidence-based design, infection control, infrastructure
Nationell ämneskategori
Kirurgi
Identifikatorer
urn:nbn:se:liu:diva-173120 (URN)10.1093/jbcr/irab011 (DOI)000683376000004 ()33484267 (PubMedID)
Tillgänglig från: 2021-02-04 Skapad: 2021-02-04 Senast uppdaterad: 2021-12-28Bibliografiskt granskad
Ydenius, V., Larsen, R., Steinvall, I., Bäckström, D., Chew, M. S. & Sjöberg, F. (2021). Impact of hospital type on risk-adjusted, traffic-related 30-day mortality: a population-based registry study. Burns & Trauma, 9, Article ID tkaa051.
Öppna denna publikation i ny flik eller fönster >>Impact of hospital type on risk-adjusted, traffic-related 30-day mortality: a population-based registry study
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2021 (Engelska)Ingår i: Burns & Trauma, ISSN 2321-3876, Vol. 9, artikel-id tkaa051Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background: Traffic incidents are still a major contributor to hospital admissions and trauma-relatedmortality. The aim of this nationwide study was to examine risk-adjusted traffic injury mortality todetermine whether hospital type was an independent survival factor.

Methods: Data on all patients admitted to Swedish hospitals with traffic-related injuries, basedon International Classification of Diseases codes, between 2001 and 2011 were extracted fromthe Swedish inpatient and cause of death registries. Using the binary outcome measure of deathor survival, data were analysed using logistic regression, adjusting for age, sex, comorbidity,severity of injury and hospital type. The severity of injury was established using the InternationalClassification of Diseases Injury Severity Score (ICISS).

Results: The final study population consisted of 152,693 hospital admissions. Young individuals(0–25 years of age) were overrepresented, accounting for 41% of traffic-related injuries. Menwere overrepresented in all age categories. Fatalities at university hospitals had the lowest mean(SD) ICISS 0.68 (0.19). Regional and county hospitals had mean ICISS 0.75 (0.15) and 0.77 (0.15),respectively, for fatal traffic incidents. The crude overall mortality in the study population was 1193,with a mean ICISS 0.72 (0.17). Fatalities at university hospitals had the lowest mean ICISS 0.68(0.19). Regional and county hospitals had mean ICISS 0.75 (0.15) and 0.77 (0.15), respectively, forfatal traffic incidents. When regional and county hospitals were merged into one group and itsrisk-adjusted mortality compared with university hospitals, no significant difference was found. Acomparison between hospital groups with the most severely injured patients (ICISS ≤0.85) also didnot show a significant difference (odds ratio, 1.13; 95% confidence interval, 0.97–1.32).

Conclusions: This study shows that, in Sweden, the type of hospital does not influence risk adjustedtraffic related mortality, where the most severely injured patients are transported to the universityhospitals and centralization of treatment is common. 

Ort, förlag, år, upplaga, sidor
Oxford University Press, 2021
Nationell ämneskategori
Kirurgi
Identifikatorer
urn:nbn:se:liu:diva-174060 (URN)10.1093/burnst/tkaa051 (DOI)000635609400001 ()
Anmärkning

Funding: Carnegie Foundation; Region Ostergotland; Linkoping University

Tillgänglig från: 2021-03-12 Skapad: 2021-03-12 Senast uppdaterad: 2022-05-26Bibliografiskt granskad
Cirillo, M. D., Mirdell, R., Sjöberg, F. & Pham, T. (2021). Improving burn depth assessment for pediatric scalds by AI based on semantic segmentation of polarized light photography images. Burns, 47(7), 1586-1593
Öppna denna publikation i ny flik eller fönster >>Improving burn depth assessment for pediatric scalds by AI based on semantic segmentation of polarized light photography images
2021 (Engelska)Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 47, nr 7, s. 1586-1593Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

This paper illustrates the efficacy of an artificial intelligence (AI) (a convolutional neural network, based on the U-Net), for the burn-depth assessment using semantic segmentation of polarized high-performance light camera images of burn wounds. The proposed method is evaluated for paediatric scald injuries to differentiate four burn wound depths: superficial partial-thickness (healing in 0–7 days), superficial to intermediate partial-thickness (healing in 8–13 days), intermediate to deep partial-thickness (healing in 14–20 days), deep partial-thickness (healing after 21 days) and full-thickness burns, based on observed healing time.

In total 100 burn images were acquired. Seventeen images contained all 4 burn depths and were used to train the network. Leave-one-out cross-validation reports were generated and an accuracy and dice coefficient average of almost 97% was then obtained. After that, the remaining 83 burn-wound images were evaluated using the different network during the cross-validation, achieving an accuracy and dice coefficient, both on average 92%.

This technique offers an interesting new automated alternative for clinical decision support to assess and localize burn-depths in 2D digital images. Further training and improvement of the underlying algorithm by e.g., more images, seems feasible and thus promising for the future.

Ort, förlag, år, upplaga, sidor
Elsevier, 2021
Nyckelord
Artificial intelligence, Deep learning, Convolutional neural networks, U-Net, Semantic segmentation, Paediatric burns
Nationell ämneskategori
Medicinsk bildbehandling Radiologi och bildbehandling
Identifikatorer
urn:nbn:se:liu:diva-175890 (URN)10.1016/j.burns.2021.01.011 (DOI)000719797100015 ()33947595 (PubMedID)
Tillgänglig från: 2021-05-26 Skapad: 2021-05-26 Senast uppdaterad: 2021-12-07
Organisationer
Identifikatorer
ORCID-id: ORCID iD iconorcid.org/0000-0002-5903-2918

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