ICG angiography predicts burn scarring within 48h of injury in a porcine vertical progression burn model

• Published in: Burns 2015-08, Vol.41 (5), p.1043-1048
• Main Authors: Fourman, Mitchell S., McKenna, Peter, Phillips, Brett T., Crawford, Laurie, Romanelli, Filippo, Lin, Fubao, McClain, Steve A., Khan, Sami U., Dagum, Alexander B., Singer, Adam J., Clark, Richard A.F.
• Format: Article
• Language: English
• Subjects: Blood flow; Burns; Fluorescence; Indocyanine green; Scarring
• ISSN: 0305-4179; 1879-1409
• DOI: 10.1016/j.burns.2014.11.001

•We compare indocyanine green and laser Doppler in the prediction of burn scarring.•We utilized a validated vertical progression porcine burn model.•Indocyanine green fluorescence predicted burn contraction within 2 days of injury.•Laser Doppler failed to show significant predictive potential.•Human studies necessary to discern full utility of ICG angiography in burns. The current standard of care in determining the need to excise and graft a burn remains with the burn surgeon, whose clinical judgment is often variable. Prior work suggests that minimally invasive perfusion technologies are useful in burn prognostication. Here we test the predictive capabilities of Laser Doppler Imaging (LDI) and indocyanine green dye (ICG) angiography in the prediction of burn scarring 28 days after injury using a previously validated porcine burn model that shows vertical progression injury. Twelve female Yorkshire swine were burned using a 2.5×2.5cm metal bar at variable temperature and application times to create distinct burn depths. Six animals (48 injuries total) each were analyzed with LDI or ICG angiography at 1, 24, 48, and 72h following injury. A linear regression was then performed correlating perfusion measurements against wound contraction at 28 days after injury. ICG angiography showed a peak linear correlate (r2) of .63 (95% CI .34 to .92) at 48h after burn. This was significantly different from the LDI linear regression (p