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Assessment of burn depth and burn wound healing potential
Egypt (IFMSA-Egypt) - Suez Canal University, Suez Canal
Plastic surgery department, Suez Canal university hospital.
Prof. Dr.Osama Antar
Dr. Ashraf Hussin
Type of Research Project
- Clinical Project without Laboratory work
What is the background of the project?
The depth of a burn wound and/or its healing potential are the most important determinants of the therapeutic management and of the residual morbidity or scarring .Traditionally, burn surgeons divide burns into superficial which heal by rapid re-epithelialization with minimal scarring and deep burns requiring surgical therapy .Clinical assessment remains the most frequent technique to measure the depth of burn wound although this has been shown to be accurate in only 60-70 % of the cases ,even when carried out by experienced burn surgeon .In this project we review all current modalities useful to provide an objective assessment of burn wound depth ,from simple clinical evaluation to biopsy and histology and to various perfusion measurement techniques such as thermography ,vital dyes ,video angiography,video microscopy ,and laser Doppler techniques .The different needs according to the different diagnostic situations are considered .It is concluded that for the initial emergency assessment ,the use of telemetry and simple burn photographs are the best option, that for research purposes a wide range of different techniques can be used but that ,most importantly ,for the actual treatment decisions ,laser Dopler imaging is the only technique that has shown to accurately predict wound outcome with a large weight of evidence .Moreover this technique has been approved for burn depth assessment by regulatory bodies including FDA.
What is the aim of the project?
Assessment of burn depth and burn wound healing potential.
What techniques and methods are used?
We considered a range of different needs according to specific diagnostic situations which can be divided in three different categories: 1. early assessment of acute burns in the accident and emergency departments where rapid decisions are made concerning the extension and the depth of the burn which determines fluid needs, an eventual referral and the indication for escharotomy. 2. Burn depth assessment for treatment decisions of the actual burn wound as to whether or not to operate and what to excise or leave. 3. Measurement of burn depth for research purposes: when comparing different treatments, it is essential to ensure that burn depth/severity is similar in each group. This is equally important for research into wound mechanisms to help devise new treatments.
What is the role of the student?
- The student will observe the practical experiments but will be highly involved in the analysis of the results
- The tasks will be done under supervision
What are the tasks expected to be accomplished by the student?
Collecting medical history. (under supervision) Performing general and local examination. Collecting blood samples for lab measurements. (under supervision) Taking biopsies and using Doppler for clinical assessment of burns. (under supervision) Study and explain the basics of burns and their types and classification (done alone)
Will there be any theoretical teaching provided (preliminary readings, lectures, courses, seminars etc)
Theoretical teaching about history, examination, clinical skills, interpreting lap results in form of lectures and clinical talks.
What is expected from the student at the end of the research exchange? What will be the general outcome of the student?
- The student will prepare a poster
What skills are required of the student? Is there any special knowledge or a certain level of studies needed?
The student will review all current modalities useful to provide an objective assessment of burn wound depth ,from simple clinical evaluation to biopsy and histology and to various perfusion measurement techniques such as thermography ,vital dyes ,video angiography,video microscopy ,and laser Doppler techniques .The different needs according to the different diagnostic situations are considered
Are there any legal limitations in the student’s involvement
Type of students accepted
This project accepts: - Medical students - Graduated students (less than 6 months)
- Devgan L; Bhat S; Aylward B; Spence S. Modalities for the assessment of burn wound depth. J Burns & Wounds 2006;5:7–15.
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