Case Studies - Moor Instruments

Please refer to the selection of real case studies below (patient identities protected). They illustrate how laser Doppler images map tissue blood flow over burns, providing immediate predictions of healing times for all areas. Where available, clinical opinion is provided with a standard Lund and Browder chart, together with laser Doppler predictions, and final outcomes. In many cases, clinical opinion differs from the accurately interpreted laser Doppler prediction, illustrating the value of the LDI technique when clinical appearance is deceptive.

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Case Study 1 – Abdomen / Thigh – Paediatric Patient

Date of Birth:
1 Jan 2001 (Age: 2)

Time Post Burn:
58:56 hrs (Day 2 Post Burn)

Burn Cause:
scald - water/drink

Scan Size:
37.2 x 37.2 (cm x cm)

Clinical Picture

Extensive deep dermal and full thickness wounds were diagnosed and surgery for these was scheduled pending LDI scans.

Clinical Assessment (L&B)

The Lund and Browder chart recorded an initial clinical opinion for surgical treatment of abdomen and both thighs. The regions appear deep 2nd degree and full thickness.

Moor Burn Image

moorLDI2-BI shows high flow (HP14) on the abdomen and right thigh (except for a few regions of slightly lower flow, HP14-21) indicating a good healing potential. The left thigh shows low flow (HP>21) within the burn area indicating no healing within 21 days. The clinical decision was to treat the left thigh surgically and the remainder of the other burn areas conservatively.

Burn Wound Outcome

All areas treated conservatively healed well by day 23. The need for surgery of the upper left thigh was indicated by the moorLDI2-BI. This was confirmed by biopsy, the results of which showed full thickness burn within this area.

Case Study 2 – Chest – Paediatric Patient

Date of Birth:
1 Jan 2002 (Age: 1)

Time Post Burn:
67:50 hrs (Day 2 Post Burn)

Burn Cause:
scald - water/drink

Scan Size:
16.7 x 16.7 (cm x cm)

Clinical Picture

Here we see a clinical photograph, day 2 post burn. This paediatric patient suffered a scald burn to the chest, and right arm.

Clinical Assessment (L&B)

Initial clinical assessment, prior to moorLDI2-BI scan, diagnosed mainly deep second degree burn wounds, and some areas of 3rd degree burn wound, covering an area of 9% TBSA.

Moor Burn Image

moorLDI2-BI image of wounds predicts most will heal within 14 days (red and associated areas of pink on the scan).

Yellow areas will take longer to heal but should heal within 21 days.

Burn Wound Outcome

Almost complete healing of the wounds by day 17.

Case Study 3 – Hand – Paediatric Patient

Date of Birth:
1 Dec 2009 (Age: 11 months)

Time Post Burn:
47:40 hrs (Day 1 Post Burn)

Burn Cause:
contact - other

Scan Size:
12.0 x 10.1 (cm x cm)

Clinical Picture

The clinical photograph above shows a paediatric patient with a contact burn to the dorsum of the left hand.

Clinical Assessment (L&B)

Clinical assessment described a non-blanching wound, with sluggish capillary refill, in an area less than 1%.

Moor Burn Image

Wound mainly red indicating healing potential less than 14 days

Burn Wound Outcome

At 5 days post-burn the wound was clinically reviewed and the decision made to apply a split thickness skin graft, however, the patient was considered too unwell for surgery.

On day 9 post-burn the wound was again clinically reviewed: the dorsum of the hand had almost completely healed! Surgery was NOT required. By day 16 post-burn the wound had fully healed.

Case Study 4 – Torso – Adult Patient

Date of Birth:
1 Jan 1971 (Age: 32)

Time Post Burn:
62:39 hrs (Day 2 Post Burn)

Burn Cause:
scald - water/drink

Scan Size:
19.7 x 39.4 (cm x cm)

Clinical Picture

The clinical photograph above shows the chest/axilla are of a young adult male patient, who suffered scald burns. The image was taken on Day 3 post burn.

Clinical Assessment (L&B)

The Lund and Browder chart showed a burn area of 20% TBSA in total. The clinical assessment for the chest/axilla was that this was a 3rd degree burn wound, requiring surgical intervention.

Moor Burn Image

moorLDI2-BI shows a significant area of very low flow (blue) in the right, upper chest near the axilla, indicating poor healing potential (HP), predicting the wound will take more than 21 days to heal (HP>21). The outer edges of the burn wound have slightly higher flow, yellow (HP14-21) increasing to red (HP14).

Burn Wound Outcome

Surgery was delayed. The clinical photograph taken on post burn day 23 and biopsy of the unhealed area confirms the moorLDI2-BI prediction: unhealed for LDI blue; the outer edges of the wound, shown as green, yellow, pink and red, healed before day 23.

Case Study 5 – Left Hand – Paediatric Patient

Date of Birth:
01/01/2011 (Age 16 months)

Time Post Burn:
5 days 5 hours

Burn Cause:
Contact

Scan Size:
14.2cm x 11.5cm

Clinical Picture

The clinical photograph above shows a paediatric patient with a contact burn to the fingers of the left hand.

Clinical Assessment (L&B)

Clinical assessment was performed and the Lund and Browder chart shows the wound to be considered mixed depth, a combination of deep 2nd degree and 1st degree.

Moor Burn Image

The Moor burn image shows high blood flow in most areas of the fingers (red on the blood flow image) indicating HP14 for the majority of this wound. There are some smaller areas of mostly yellow – indicating HP14-21.

Burn Wound Outcome

The wounds had completely healed by Day 22 post burn, as shown in the clinical photograph above.

Case Study 6 – Left Hand – Paediatric Patient

Date of Birth:
1/1/98 Age 13

Time Post Burn:
2 days 1 hour

Burn Cause:
Friction burn

Scan Size:
15.8cm x 12.5cm

Clinical Picture

Clinical assessment recorded a 0.5% 3rd degree burn to the left hand.

Clinical Assessment (L&B)

The Lund and Browder chart completed by the clinical team on initial assessment describes the left hand as a 0.5% 3rd degree wound.

Moor Burn Image

The Moor burn image shows high blood flow (red on the blood flow image) indicating HP14 for the wound. The wound was treated conservatively.

Burn Wound Outcome

The clinical photograph, taken on post burn day 23 shows great wound healing progress.

Case Study 7 – Left Leg / Thigh – Adult Patient

Date of Birth:
01/01/1986 Age 24

Time Post Burn:
3 days 12 hours

Burn Cause:
Flame - fire

Scan Size:
18.8cm x 14.4cm

Clinical Picture

The clinical photograph above shows a flame burn to the left thigh of an adult patient.

Clinical Assessment (L&B)

The Lund and Browder chart completed by the clinical team on initial assessment describes a 2nd degree (partial thickness wound) of 0.75% TBSA.

Moor Burn Image

The Moor burn image shows a central area of low blood flow – mostly blue, which in contrast to the clinical assessment indicates a full thickness area. The blood flow image shows high blood flow in the surrounding areas (red on the blood flow image) indicating HP14 for the wound. The wound was treated surgically.

Burn Wound Outcome

The clinical photograph, taken on post burn day 23 shows great wound healing progress for this grafted wound.

Case Study 8 – Right Forearm – Paediatric Patient

Date of Birth:
1/1/2009 Age ,1 year

Time Post Burn:
3 days 0 hours

Burn Cause:
Scald - Food

Scan Size:
17.2cm x 13.4cm

Clinical Picture

The clinical photograph above shows a scald burn to the forearm of a paediatric patient, day 3 post burn.

Clinical Assessment (L&B)

The Lund and Browder chart, and clinical assessment form was completed indicating a 1%TBSA scald to the right forearm of 2nd degree (partial thickness wound).

Moor Burn Image

The Moor burn image clearly shows high blood flow in the whole wound area (red on the blood flow image) indicating HP14 for the wound. The wound was treated conservatively.

Burn Wound Outcome

The Moor burn image clearly shows high blood flow in the whole wound area (red on the blood flow image) indicating HP14 for the wound. The wound was treated conservatively.

Case Study 9 – Head, Neck and Trunk – Paediatric Patient

Date of Birth:
1/1/2008 Age 1 year

Time Post Burn:
3 days 17 hours

Burn Cause:
Scald - water/drink

Scan Size:
18.0cm x 13.9cm

Clinical Picture

The clinical photograph above shows a scald burn to the face, neck and trunk of a paediatric patient, day 2 post burn.

Clinical Assessment (L&B)

The Lund and Browder chart, and clinical assessment form was completed indicating a 6 %TBSA scald indicating all areas were 2nd degree (partial thickness wound), with ‘deeper areas for the left cheek, jaw and right side of chest’.

Moor Burn Image

The Moor burn image clearly shows high blood flow in the whole wound area (red on the blood flow image) indicating HP14 for the wound.

Burn Wound Outcome

The clinical photographs, taken on post burn day 15 show great wound healing.

Case Study 10 – Left Forearm – Adult Patient

Date of Birth:
1/1/1969 Age 40

Time Post Burn:
2 days 16 hours

Burn Cause:
Scald-steam

Scan Size:
17.2cm x 13.4cm

Clinical Picture

The clinical photograph above shows a scald burn to the left forearm of an adult patient, day 3 post burn.

Clinical Assessment (L&B)

The Lund and Browder chart, and clinical assessment form was completed indicating a 0.5 %TBSA burn wound 2nd degree (partial thickness).

Moor Burn Image

The Moor burn image clearly shows high blood flow in the whole wound area (red on the blood flow image) indicating HP14 for the wound. The wound was treated conservatively.

Burn Wound Outcome

The clinical photograph, taken on post burn day 14 shows great wound healing, and the clinical notes on wound healing progression described the wound as fully healed at post burn day 9.

Case Study 11 – Chest – Paediatric Patient

Date of Birth:
1/1/2008 Age 2 years

Time Post Burn:
2 days 11 hours

Burn Cause:
Scald - water/drink

Scan Size:
13.4cm x 17.2cm

Clinical Picture

The clinical photograph above shows a scald burn to the chest of a paediatric patient, day 3 post burn.

Clinical Assessment (L&B)

The Lund and Browder chart, and clinical assessment form was completed indicating a 6 %TBSA burn wound 2nd degree (partial thickness).

Moor Burn Image

The Moor burn image indicates a central area of HP>21, mostly blue, indicating more than 3 weeks to healing. This is surrounded by an area of HP14-21, yellow/green, and a large area of HP14, red on the blood flow image.

Burn Wound Outcome

The clinical photograph, taken on post burn day 15 shows the outcome following grafting of the central portion of the wound. The surrounding area, which was HP14 on the Moor burn image can be seen to have clearly healed.

Information and advice for Medical professionals

Information for Burn patients, friends and family

moorLDLS-BI

moorLDI2-BI

Support

Case Study 1 – Abdomen / Thigh – Paediatric Patient

Clinical Picture

Clinical Assessment (L&B)

Moor Burn Image

Burn Wound Outcome

Case Study 2 – Chest – Paediatric Patient

Clinical Picture

Clinical Assessment (L&B)

Moor Burn Image

Burn Wound Outcome

Case Study 3 – Hand – Paediatric Patient

Clinical Picture

Clinical Assessment (L&B)

Moor Burn Image

Burn Wound Outcome

Case Study 4 – Torso – Adult Patient

Clinical Picture

Clinical Assessment (L&B)

Moor Burn Image

Burn Wound Outcome

Case Study 5 – Left Hand – Paediatric Patient

Clinical Picture

Clinical Assessment (L&B)

Moor Burn Image

Burn Wound Outcome

Case Study 6 – Left Hand – Paediatric Patient

Clinical Picture

Clinical Assessment (L&B)

Moor Burn Image

Burn Wound Outcome

Case Study 7 – Left Leg / Thigh – Adult Patient

Clinical Picture

Clinical Assessment (L&B)

Moor Burn Image

Burn Wound Outcome

Case Study 8 – Right Forearm – Paediatric Patient

Clinical Picture

Clinical Assessment (L&B)

Moor Burn Image

Burn Wound Outcome

Case Study 9 – Head, Neck and Trunk – Paediatric Patient

Clinical Picture

Clinical Assessment (L&B)

Moor Burn Image

Burn Wound Outcome

Case Study 10 – Left Forearm – Adult Patient

Clinical Picture

Clinical Assessment (L&B)

Moor Burn Image

Burn Wound Outcome

Case Study 11 – Chest – Paediatric Patient

Clinical Picture

Clinical Assessment (L&B)

Moor Burn Image

Burn Wound Outcome