Cost-effectiveness of Laser Doppler Imaging in Burn Care

NCT ID: NCT01489540

Last Updated: 2013-09-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

200 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-12-31

Study Completion Date

2013-03-31

Brief Summary

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Accurate early burn depth assessment is important to determine the optimal treatment. The most applied method to asses burn depth is clinical assessment. This method is the least expensive, but not very accurate. Laser Doppler imaging (LDI) has been shown to accurately assess burn depth. The clinical effects, the costs and cost-effectiveness of this device however, are unknown. The hypothesis is that an eary accurate diagnosis will lead to an earlier therapeutic decision: surgery or no surgery. Earlier excision and grafting probably leads to a decrease in wound healing time, in length of hospital stay and in costs.

Before the investigators decide to implement LDI in Dutch burn care a study of the clinical effects and cost-effectiveness of LDI is necessary. Therefore a multicenter randomized controlled trial will be conducted, including all patients with burns of indeterminate depth (burns that are not obviously superficial or full thickness) treated in the Dutch burn centres. In total 200 patients will be included in an 18 months period. The patients are randomly divided in two groups: 'new diagnostic strategy' versus 'current diagnostic strategy'. Burn depth will be diagnosed both by clinical assessment and laser Doppler imaging in all patients. The results of the LDI-scan will be provided to the treating clinician in the 'new diagnostic strategy' group only. Time to wound healing, diagnostic and therapeutic decisions, and costs are observed.

Detailed Description

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Conditions

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Burns

Keywords

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Burn Depth Diagnosis Laser Doppler Imaging

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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new diagnostic strategy

Combination of laser Doppler imaging and clinical assessment of burn depth

Group Type ACTIVE_COMPARATOR

laser Doppler imager (Moor)

Intervention Type DEVICE

The laser Doppler imager measures the blood flow of the skin/burn

current diagnostic strategy

Clinical assessment of burn depth

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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laser Doppler imager (Moor)

The laser Doppler imager measures the blood flow of the skin/burn

Intervention Type DEVICE

Other Intervention Names

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Laser Doppler Imager, Moor Instruments Moor LDI Burn Imager

Eligibility Criteria

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Inclusion Criteria

* Patients with acute burns of indeterminate depth (=intermediate depth, not obviously superficial or full thickness) at presentation
* Outpatient treatment or admission in one of the three Dutch burn centres
* Presentation within 5 days post burn

Exclusion Criteria

* A presence of both burns of indeterminate depth and full thickness at presentation
* Patients with peri-orbital facial burns, in which the eyes are unable to shield
* Patients or their next of kin if they are under aged or temporary incompetent who can not be expected to give informed consent e.g. because of cognitive dysfunction or poor Dutch proficiency.
* Patients with a TBSA burned \> 20%
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Dutch Burns Foundation

OTHER

Sponsor Role collaborator

Stichting Nuts Ohra

OTHER

Sponsor Role collaborator

Association of Dutch Burn Centres

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Margriet E Baar, PhD

Role: STUDY_CHAIR

Associaton of Dutch Burns Centres

Locations

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Red Cross Hospital

Beverwijk, North Holland, Netherlands

Site Status

Martini Hospital

Groningen, Provincie Groningen, Netherlands

Site Status

Maasstad Hospital

Rotterdam, South Holland, Netherlands

Site Status

Countries

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Netherlands

References

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Kim LH, Ward D, Lam L, Holland AJ. The impact of laser Doppler imaging on time to grafting decisions in pediatric burns. J Burn Care Res. 2010 Mar-Apr;31(2):328-32. doi: 10.1097/BCR.0b013e3181d0f572.

Reference Type BACKGROUND
PMID: 20182369 (View on PubMed)

Monstrey S, Hoeksema H, Verbelen J, Pirayesh A, Blondeel P. Assessment of burn depth and burn wound healing potential. Burns. 2008 Sep;34(6):761-9. doi: 10.1016/j.burns.2008.01.009. Epub 2008 Jun 3.

Reference Type BACKGROUND
PMID: 18511202 (View on PubMed)

Jeng JC, Bridgeman A, Shivnan L, Thornton PM, Alam H, Clarke TJ, Jablonski KA, Jordan MH. Laser Doppler imaging determines need for excision and grafting in advance of clinical judgment: a prospective blinded trial. Burns. 2003 Nov;29(7):665-70. doi: 10.1016/s0305-4179(03)00078-0.

Reference Type BACKGROUND
PMID: 14556723 (View on PubMed)

Engrav LH, Heimbach DM, Reus JL, Harnar TJ, Marvin JA. Early excision and grafting vs. nonoperative treatment of burns of indeterminant depth: a randomized prospective study. J Trauma. 1983 Nov;23(11):1001-4. doi: 10.1097/00005373-198311000-00007.

Reference Type BACKGROUND
PMID: 6355500 (View on PubMed)

Herndon DN, Barrow RE, Rutan RL, Rutan TC, Desai MH, Abston S. A comparison of conservative versus early excision. Therapies in severely burned patients. Ann Surg. 1989 May;209(5):547-52; discussion 552-3. doi: 10.1097/00000658-198905000-00006.

Reference Type BACKGROUND
PMID: 2650643 (View on PubMed)

Bloemen MC, van Zuijlen PP, Middelkoop E. Reliability of subjective wound assessment. Burns. 2011 Jun;37(4):566-71. doi: 10.1016/j.burns.2011.02.004. Epub 2011 Mar 8.

Reference Type BACKGROUND
PMID: 21388743 (View on PubMed)

Bouillon B, Kreder HJ, Eypasch E, Holbrook TL, Kreder HJ, Mayou R, Nast-Kolb D, Pirente N, Schelling G, Tiling T, Yates D; MI Consensus Group. Quality of life in patients with multiple injuries--basic issues, assessment, and recommendations. Restor Neurol Neurosci. 2002;20(3-4):125-34.

Reference Type BACKGROUND
PMID: 12454361 (View on PubMed)

Raat H, Landgraf JM, Oostenbrink R, Moll HA, Essink-Bot ML. Reliability and validity of the Infant and Toddler Quality of Life Questionnaire (ITQOL) in a general population and respiratory disease sample. Qual Life Res. 2007 Apr;16(3):445-60. doi: 10.1007/s11136-006-9134-8. Epub 2006 Nov 17.

Reference Type BACKGROUND
PMID: 17111231 (View on PubMed)

Draaijers LJ, Botman YA, Tempelman FR, Kreis RW, Middelkoop E, van Zuijlen PP. Skin elasticity meter or subjective evaluation in scars: a reliability assessment. Burns. 2004 Mar;30(2):109-14. doi: 10.1016/j.burns.2003.09.003.

Reference Type BACKGROUND
PMID: 15019116 (View on PubMed)

Draaijers LJ, Tempelman FR, Botman YA, Kreis RW, Middelkoop E, van Zuijlen PP. Colour evaluation in scars: tristimulus colorimeter, narrow-band simple reflectance meter or subjective evaluation? Burns. 2004 Mar;30(2):103-7. doi: 10.1016/j.burns.2003.09.029.

Reference Type BACKGROUND
PMID: 15019115 (View on PubMed)

van der Wal MB, Tuinebreijer WE, Bloemen MC, Verhaegen PD, Middelkoop E, van Zuijlen PP. Rasch analysis of the Patient and Observer Scar Assessment Scale (POSAS) in burn scars. Qual Life Res. 2012 Feb;21(1):13-23. doi: 10.1007/s11136-011-9924-5. Epub 2011 May 20.

Reference Type BACKGROUND
PMID: 21598065 (View on PubMed)

Monstrey SM, Hoeksema H, Baker RD, Jeng J, Spence RS, Wilson D, Pape SA. Burn wound healing time assessed by laser Doppler imaging. Part 2: validation of a dedicated colour code for image interpretation. Burns. 2011 Mar;37(2):249-56. doi: 10.1016/j.burns.2010.08.013. Epub 2010 Nov 16.

Reference Type BACKGROUND
PMID: 21084164 (View on PubMed)

Hop MJ, Stekelenburg CM, Hiddingh J, Kuipers HC, Middelkoop E, Nieuwenhuis MK, Polinder S, van Baar ME; LDI Study Group. Cost-Effectiveness of Laser Doppler Imaging in Burn Care in The Netherlands: A Randomized Controlled Trial. Plast Reconstr Surg. 2016 Jan;137(1):166e-176e. doi: 10.1097/PRS.0000000000001900.

Reference Type DERIVED
PMID: 26710049 (View on PubMed)

Hop MJ, Hiddingh J, Stekelenburg C, Kuipers HC, Middelkoop E, Nieuwenhuis MK, Polinder S, van Baar ME; LDI study group. Cost-effectiveness of laser Doppler imaging in burn care in the Netherlands. BMC Surg. 2013 Feb 1;13:2. doi: 10.1186/1471-2482-13-2.

Reference Type DERIVED
PMID: 23369360 (View on PubMed)

Other Identifiers

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2011-47

Identifier Type: -

Identifier Source: org_study_id