Background: Hand burns account for 30% of pediatric burn admissions. Reliable burn wound assessment is challenging. Our study explores optical coherence tomography (OCT) and dynamic OCT (D-OCT) to improve wound assessment and guide definitive care. We aim to define the morphological patterns of pediatric hand burns addressing the following questions:
Methods: In a prospective longitudinal study (01/2016–12/2021) 67 hand burns in 48 children (0–15 years) admitted to a pediatric burn center were analyzed by two independent observers.
Main Results:
Relevant OCT findings were surface irregularity, loss of epidermis, loss of dermal pattern (skin lines or papillary spots), loss of surface regularity, and irregular vascular pattern of the plexus papillaris. A burn score was developed, assigning up to 6 points, see Figure 1. A score of 4 was associated with spontaneous healing, with a positive predictive value of 97%. Deeper wounds with delayed healing and/or the need for skin grafting received a score of =/>5, with an agreement of medical healing in 80% and a positive predictive value of 56%.
Conclusion: OCT and D-OCT reliably visualize the morphologic and microvascular patterns of pediatric burn injuries. The OCT images on the second day after injury show patterns that can be summarized in a clinical score with the potential to support clinical decision-making.
Keywords: burns, OCT, burn depth
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