Table 2.
Summary of retrieved studies in the literature.
| Authors country |
Year | Type of study | Patient n |
Burns n |
Type of laser Doppler device | Surgery needed | Findings | Limitation |
|---|---|---|---|---|---|---|---|---|
| Green et al. [4], USA |
1988 | Observational Study | 10 | 13 | LD flowmetry Nonspecified type of LD scanner |
6 | Statistically significant difference in LD value between healing and nonhealing group | Lack of description of methodology of measurement |
|
| ||||||||
| O'Reilly et al. [5], USA |
1989 | Prospective cohort LD measurements did not influence clinical judgement |
41 | 59 | LD flowmetry Laser flow blood perfusion monitor BPM403 |
8 | LD < 1.4 PPV 98.4%, LD > 1.4 deemed superficial and will heal within 21 days | 43 > 1.4 LD burned areas excised and grafted Day of measurement not specified |
|
| ||||||||
| Waxman et al. [7], USA |
1989 | Prospective cohort LDI within 48 h of burn Indeterminate depth only |
33 | 51 | LD Flowmetry Laser flow blood perfusion monitor BPM403 |
18 | 100% specificity re: healing if flow >6 mL/100 g/min NPV 75% |
TBSA not specified |
|
| ||||||||
| Niazi et al. [9], UK |
1993 | Prospective cohort Burns of indeterminate depth Children excluded |
13 | 13 | LD imaging Newcastle laser Doppler scanner |
7 | Good correlation of LDI with histological assessment | No statistical analysis |
|
| ||||||||
| Atiles et al. [8], USA |
1995 | Prospective cohort | 21 | 86 | LD flowmetry Perimed PF4000 |
33 | <40 PU; Sen: 0.46, Spec: 1.0, PPV: 1.0, NPV: 0.85 >80 PU; Sen: 0.85, Spec: 0.82, PPV: 0.79, NPV: 0.87 |
No histological assessment. No burn cause identified |
|
| ||||||||
| Park et al. [10], Korea | 1998 | Prospective cohort | 44 | 100 | LD flowmetry Periflux system 4001 |
Not specified | Primary outcome; healing at 2 weeks >100 PU 90% PPV 10–100 PU 96% PPV <10 100% PPV |
Surgery not specified—just said not healed 2 weeks |
|
| ||||||||
| Banwell et al. [11], UK |
1999 | Prospective cohort | 30 | n/a | LD flowmetry and LD imaging Moor LDI scanner |
Not specified | Good correlation LDI results and histology | No stats |
|
| ||||||||
| Pape et al. [12], UK |
2001 | Prospective cohort Intermediate depth 48–72 h of presentation |
48 | 76 | LD imaging Moor LDI scanner |
25 | 97% PPV of LDI compared with 70% of clinical assessment | |
|
| ||||||||
| Kloppenberg et al. [13], Netherlands |
2001 | Prospective cohort | 16 | 22 | LD imaging PIM 1.0 laser Doppler perfusion imager (Lisca development AB) |
6 | Sensitivity 100% and specificity 93.8% on day 4 | Invalid statistical analysis |
|
| ||||||||
| Holland et al. [14], Australia |
2002 | Prospective cohort Paediatric burns only 12 days cut-off point for healing |
57 | 57 | LD imaging Moor LDI V 3.1 |
17 | Deep dermal; partial thickness Clinical examination 66% LDI 90%; clinical 71%, LDI 96% |
Mobility of children No validated endpoint |
|
| ||||||||
| Jeng et al. [15], USA |
2003 | Prospective blinded trial Burns of indeterminate depth |
23 | 41 | LD imaging Moor LDI-VR |
7 | 56% agreement between clinician and LDI 71.4% accuracy of surgeon compared to histological diagnosis |
8/18 burns deemed superficial by LDI but required grafting |
|
| ||||||||
| Mileski et al. [16], USA |
2003 | Prospective cohort | 56 | 159 | LD flowmetry PF 4001 laser Doppler flowmeter |
53 | Sensitivity: 68% Specificity: 88% PPV: 81% NPV: 76% |
Clinical assessment once versus serial LDI |
|
| ||||||||
|
Riordan et al. [17], USA |
2003 | Prospective blinded trial Surgeon blinded to LDI result |
22 | 35 | PIM #II LISCA | 24 | At threshold value of 1.3 Sensitivity: 95% Specificity: 94% |
|
|
| ||||||||
| La Hei et al. [18], Australia |
2006 | Prospective blinded trial No clinical assessment done Assessment by images and LDI only |
31 | 50 | LD imaging Moor LDI V2 |
22 | Sensitivity: 97% Specificity: 100% |
Statistical analysis and small number |
|
| ||||||||
| McGill et al. [19], UK |
2007 | Prospective blinded comparison | 20 | 27 | LD imaging Moor LDI versus PW Allen videomicroscope: transcutaneous microscopy |
10 | LDI: sensitivity 100% VM: sensitivity for SPT 100% |
No histological assessment Expert user of VM VM not tolerated by children |
|
| ||||||||
| Hoeksema et al. [20], Belgium |
2009 | Prospective blinded trial Early assessment of burns using LDI Intermediate depths Day 0, 1, 3, 5, 8, and 21 |
40 | 40 | LD imaging Moor LDI |
12 | Sensitivity increases with days after burn. Statistically significantly better than clinical assessment from day 3 Sensitivity: 100% Specificity: 92.3% |
2 cases that required surgery and histology showed that burn wound was superficial in nature |
|
| ||||||||
| Cho et al. [21], Republic of Korea |
2009 | Prospective cohort study Paediatric burns Only burns of indeterminate depth 48–72 h |
103 | 181 | LD imaging Periscan PIM 3 |
n/a | Healing by 14 days at PU of 250 Sensitivity 80.6% and Specificity 76.9% | No confirmation of superficial nature of burn with histology |
|
| ||||||||
| Mill et al. [22], Australia |
2009 | Prospective cohort study Paediatric burns Testing different effect of dressings |
48 | 85 | LD imaging Moor LDI2 |
6 | Scans within 24 h accurately predict outcome Colour palette corresponds to healing time. Cut-off of 14 days |
No blinding Wide range of scanning time 0–120 h |
|
| ||||||||
| Kim et al. [23], Australia |
2010 | Case-control trial Only patients requiring grafting <16 years |
196 | 196 | LD imaging Moor LDI2 |
196 | Reduction in decision for surgery in LDI group 8.9 days versus 11.6 days in control group (P = 0.01) | No randomisation |
|
| ||||||||
| Merz et al. [24], Germany |
2010 | Retrospective cohort study | 28 | 173 | LD flowmetry Laser Doppler O2C |
88 | Sensitivity: 80.6% Specificity: 88.2% PPV: 93.1% NPV: 69.8% |
No histological assessment |
|
| ||||||||
| Nguyen et al. [25], Australia |
2010 | Prospective cohort Paediatric population Two groups; < and >48 h presentation |
400 | 637 | LD imaging Moor LDI2-BI |
89 | <48 h Sensitivity: 78% Specificity: 74% >48 h Sensitivity: 75% Specificity 85% |
No histological assessment in patients operated on |
|
| ||||||||
| Lindahl et al. [26], Sweden |
2013 | Prospective cohort | 14 | 45 | LD imaging Laser Speckle contrast imager (Perimed AB) |
n/a | Higher perfusion in burns healing in less than 14 days compared to more than 14 days from day 0 from burn. | Small sample of patients No gold standard to compare to |
|
| ||||||||
| Menon et al. [27], Australia |
2012 | Retrospective cohort Friction burns in paediatric population |
36 | 36 | Not specified | 12 | 64% accuracy of LDI predicting burn outcome | Small sample of patients No gold standard to compare to |
|
| ||||||||
| Pape et al. [28], Multicentre |
2012 | Prospective cohort | 137 | 433 | LD Imaging Moor LDI |
ns | Development of validated colour code for interpretation and link to burn outcome | |
|
| ||||||||
| Park et al. [29], Korea |
2013 | Retrospective cohort | 96 | 101 | LD imaging Periscan PIM3 (Perimed AB) |
46 | Cut-off point of 154.7PU Sensitivity: 78.3 Specificity: 92.7 |
|
|
| ||||||||
| Stewart et al. [30], Canada |
2012 | Prospective blinded control trial | 38 | 105 | LD imaging Moor LDI 2-B1 |
64 | LDI has PPV > 90% accurate in determining need for grafting | |