WOFAPS 2025 8th World Congress of Pediatric Surgery

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Oral Presentation - 150

Towards better judgement of burn depth-An Optical Tomography-Based Score to Assess Paediatric Hand Burns

Judith Lindert 1, Tina Straube 2, Beke Larsen 3, Eirini Liodaki 4, Kianusch Tafazzoli 3, Lutz Wünsch 3
1 Department of Paediatric Surgery, University Rostock
2 Halle
3 Department of Paediatric Surgery, University Lübeck
4 Department of Plastic Surgery, University Lübeck

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:

  1. Can OCT differentiate burned from healthy skin?
  2. Can OCT distinguish deep burns requiring grafts from superficial burns that heal spontaneously within 48 hours?
  3. Can OCT findings be summarized into a clinically useful score?

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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