References

Moor Instruments laser Doppler systems are widely used globally, both for clinical and research applications. In this section we provide you with some of the references for specific topics – for a full reference list, please contact us.


1. Routine Use

“In our burn center we use the moorLDI2-BI imager (Moor Instruments Ltd., Axminster, UK) to objectively determine the healing potential of the burn [8]. LDI is now becoming a standard of care for early diagnosis of healing potential, which is a main determinant of subsequent treatment policy. In clinical trials LDI ensures exact comparison between two burns without depth difference bias.”

Pirayesh, A., Hoeksema, H., Richters C., Verbelen, J., Monstrey, S. (2015) Glyaderm dermal substitute: Clinical application and long-term results in 55 patients. Burns 41,p 132 – 144.

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“These papers and many others through the literature document the usefulness of laser Doppler imaging in burn care. Based on these and other findings, we question how this technique cannot be considered the standard of care for burns of indeterminate depth on physical exam?”

Wolf, S, E., Sterling, J.P., Hunt, J. L., Arnoldo, B.D. (2011) The year in burns 2010. Burns. 37 (8) p1275-1287.

2. Cost-Effectiveness

“Conclusions: Laser Doppler imaging improved therapeutic decisions. It resulted in a shorter wound healing time in the subgroup of admitted patients requiring surgery and has the potential for cost savings of €875 per scanned patient”

Hop, M.J., Stekelenburg, C.M., Hiddingh, J., Kuipers, H.C., Middelkoop, M.K., Polinder, S., van Baar, M.E. (2016) Cost-Effectiveness of laser Doppler Imaging in Burn care in The Netherlands: A Randomized Controlled Trial. Plastic and reconstructive Surgery, Vol 137 (1), p166e-176e.

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“Laser Doppler imaging scan is superior compared to clinical burn depth examination. Laser Doppler imaging is effective for assessment of deep burns in the early period of injury. The length of stay and the cost of treatment of burn patients depend on early diagnosis of deep burns and well-timed surgical treatment of burn wounds.”

Venclauskiene, A., Basevicius, A., Zacharevskij, E., Vaicekauskas, V., Rimdeika, R., Lukosevicius, S. (2014) Laser Doppler imaging as a tool in the burn wound treatment protocol. Videosurgery Miniinv 9 (1), p 24–30.

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“in pediatric burn patients, there was a significant reduction in the time to decision making for operative intervention in the LDI group compared with the non-LDI group. The decision of the need for operative intervention made earlier, an average of 3 days, but this also equated to earlier surgery and definitive care. This would translate to potential financial savings, with a reduction in the costs associated with additional dressings and other medical interventions.”

Kim, LH. Ward, D. Lam, L. Holland, AJ (2010) The Impact of Laser Doppler Imaging on Time to Grafting Decisions in Pediatric Burns. Journal of Burn Care and Research. 31 p328-332.

3. Paediatric Use

“The high accuracy of the new line-scan imager was comparable to that of the traditional LDI. Its size and mobility enabled easier ward and outpatient use. The higher scan speed was particularly beneficial for scans in paediatric patients.”

Hoeksema, H., Baker, R. D., Holland, A. J. A., Perry, T., Jeffery, S.L.A., Verbelen, J., Monstrey, S. (2014) A new, fast LDI for assessment of burns: A multi-centre clinical evaluation Burns 40 p1274 – 1282

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“in pediatric burn patients, there was a significant reduction in the time to decision making for operative intervention in the LDI group compared with the non-LDI group. The decision of the need for operative intervention made earlier, an average of 3 days, but this also equated to earlier surgery and definitive care. This would translate to potential financial savings, with a reduction in the costs associated with additional dressings and other medical interventions.”

Kim, LH. Ward, D. Lam, L. Holland, AJ (2010) The Impact of Laser Doppler Imaging on Time to Grafting Decisions in Pediatric Burns. Journal of Burn Care and Research. 31 p328-332.

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“The predominant colour of the scan was found to be significantly related to the re-epithelialisation, grafting and scar management outcomes and could be used to predict those outcomes........Laser Doppler imaging is accurate and effective in a paediatric population with a low-resolution fast-scan.”

Mill, J. Cuttle, L. Harkin, D G. Kravchuk, O. Kimble, R. M (2009) Laser Doppler imaging in a paediatric burns population. Burns. 34 p824-831.

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“LDI in children appears to be extremely accurate in predicting burn wound outcome in children…..burns surgeons should be guided by LDI data.”

La Hei, E.R. Holland, A.J.A. Martin, H.C.O (2006) Laser Doppler Imaging of Paediatric Burns: Burn wound outcome can be predicted independent of clinical examination. Burns. 32 (5) p550-553.

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“The LDI was also more specific; correctly diagnosing 96% of superficial partial thickness burns as opposed to 71% on clinical examination.”

Holland, AJ. Martin, HC. Cass, DT (2002) Laser Doppler imaging prediction of burn wound outcome in children. Burns. 28(1) p11–17.

4. Hypertrophic scarring

“Healing time and incidence of hypertrophic scarring in paediatric scalds”

Lonie, S. Baker, P. Teixeira, R.P. (2016) Healing time and incidence of hypertrophic scarring in paediatric scalds. Burns http://dx.doi.org/10.1016/j.burns.2016.09.011.

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“This study indicates that LDI can be used for predicting the risk of hypertrophic scarring and for guiding burn care”

Wang, X Q. Mill, J. Kravchuk, O. Kimble, R M (2010) Ultrasound assessed thickness of burn scars in association with laser Doppler imaging determined depth of burns in paediatric patients. Burns. 36 (8) p1254-62.

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“We believe that use of the moorLDI will allow burn clinicians to distinguish between burns with a healing potential of less than 21 days (low risk of HTS) and those with a healing potential of more than 21 days (high risk of HTS).”

Cubison, T.C.S. Pape, S.A. Parkhouse, N. (2006) Evidence for the link between healing time and the development of hypertrophic scars (HTS) in paediatric burns due to scald. Burns. 32 p992-999

5. Moor Laser Doppler Systems

“We have devised a new colour palette for LDI burn imaging based on healing times of a series of burns.”

Pape, S.A. Baker, R. D. Wilson, D. Hoeksema, H. Jeng, J.C. Spence, R.J. Monstrey, S (2012) Burn wound healing time assessed by laser Doppler imaging (LDI). Part 1: Derivation of a dedicated colour code for image interpretation. Burns. 38, p187-194.

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“The accuracies of burn depth assessments with LDI at days 0, 1, 3, 5 and 8 were 54.8%, 79.5%, 95%, 97% and 100% compared with the accuracies of clinical assessment alone of 40.6%, 61.5%, 52.5%, 71.4% and 100%.” “…all burns of intermediate depth should be analyzed with a combination of both LDI scanning and clinical evaluation... ensuring early appropriate management of the burn wound by avoiding unnecessary surgery and therefore reducing mortality, hospital stay and costs.”

Hoeksema, H. Van de Sijpe, K. Tondu, T. Hamdi, M. Van Landuyt, K. Blondeel, P. Monstrey, S (2009) Accuracy of early burn depth assessment by laser Doppler imaging on different days post burn. Burns. 35 (1) p36-45.

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“LDI can be used in a standardised way as a valid tool for improving on clinical assessment of burn wounds. This can enable earlier appropriate management.”

Monstrey, S M. Hoeksema, H. Baker, R D. Jeng, J. Spence, R J. Wilson, D. Pape, S A. (2011) Burn wound healing time assessed by laser Doppler imaging. Part 2: Validation of a dedicated colour code for image interpretation. Burns. 37 (2) p249-256.

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“Overall performance is that diagnoses are over 90% correct. Related questions addressed were what was the best blood flow summary statistic and whether, given the blood flow measurements, demographic and observational variables had any additional predictive power (age, sex, race, % total body surface area burned (%TBSA), site and cause of burn, day of LDI scan, burn center). It was found that mean laser-Doppler flux over a wound area was the best statistic. New medical findings are that age and %TBSA are not important predictors of healing time when the LDI results are known.”

Baker, R D. Weinand, C. Jeng, J C. Hoeksema, H. Monstrey, S. Pape, S A. Spence, R. Wilson, D (2009) Using ordinal logistic regression to evaluate the performance of laser-Doppler predictions of burn-healing time. BMC Medical Research Methodology. 9:11, ISSN 1471-2288.

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“In conclusion, our meta-analysis identified the high diagnostic accuracy of LDI in burn depth assessment, and excellent diagnostic accuracy was shown after standardization of assessment.”

Shin JY, Yi HS. Diagnostic accuracy of laser Doppler imaging in burn depth assessment: Systematic review and meta-analysis. Burns (2016), http://dx.doi.org/10.1016/j.burns.2016.03.012

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“...for the actual treatment decisions, laser Doppler imaging is the only technique that has been 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 the FDA.”

Monstrey, S. Hoeksema, H. Verbelen, J. Pirayesh, A. Blondeel, P (2008) Assessment of Burn Depth and Burn Wound healing Potential. Burns. 34 (6) p761-769.

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“LDI allowed for earlier, objective determination of need to operate.” “LDI should be seen as an effective aid to clinical judgment when contemplating excision of burns with indeterminate depth.”

Jeng, J C. Clarke, T J. Bridgeman, A. Shivnan, L. Thornton, PM. Alam, H. Clarke, TJ. Jablonski, KA. Jordan, M H (2003) Laser Doppler Imaging Determines Need for Excision and Grafting in Advance of Clinical Judgement: A Prospective Blinded Trial. Burns. 29 p665–670.

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“The accuracy of LDI in the assessment of burn depth was 97%, compared with 60–80% for established clinical methods.” “We recommend that all burns should be scanned by the LDI system.”

Pape, S A. Skoura,s C A. Byrne, P O (2001) An audit of the use of laser Doppler imaging (LDI) in the assessment of burns of intermediate depth. Burns. 27 p233-239.