Ultrasound assessed thickness of burn scars in association with laser Doppler imaging determined depth of burns in paediatric patients Xue-Qing Wang a, *, Julie Mill a , Olena Kravchuk b , Roy M. Kimble a a Department of Paediatrics and Child Health, University of Queensland, Royal Children’s Hospital, Brisbane 4029, Australia b Biometrics Unit of School of Land, Crop and Food Sciences, University of Queensland, Brisbane 4072, Australia 1. Introduction One of the main characteristics of hypertrophic scars in burn victims is the elevation of scar tissue that, clinically, is associated with the loss of normal skin function and disfiguring appearance and, histologically, consists of a mass of hypercellular and disorganised connective tissue [1–3]. The thickness or elevation of these hypertrophic scars represents the outcome of burn wound healing in general. It is widely used to evaluate the efficacy of potential new burn treatments during the acute phase in clinical trials, and for scar management regimes in the long-term. The proper assess- ment of these scars has been a subject of intensive investiga- tions by both subjective and objective approaches. The subjective assessment has been conducted either in vivo or/ and scar digital photographs and scored from 1 representing depressed scars to 1–4 (or 3) representing raised scars of various severity with or without specific measurement in ‘‘mm’’, comparing to surround normal skin level [4–8]. Though this subjective approach provides undoubted advantages, such as convenience and judging scars as a whole, and will remain as a major method of scar assessment in general burns 36 (2010) 1254–1262 article info Article history: Accepted 25 May 2010 Keywords: Burns Burn depth Scars Scar thickness Ultrasound Scar assessment Laser Doppler imaging Hypertrophic scarring Paediatric burns abstract This study describes the ultrasound assessment of burn scars in paediatric patients and the association of these scar thickness with laser Doppler imaging (LDI) determined burn depth. A total of 60 ultrasound scar assessments were conducted on 33 scars from 21 paediatric burn patients at 3, 6 and 9 months after-burn. The mean of peak scar thickness was 0.39  0.032 cm, with the thickest at 6 months (0.40  0.036 cm). There were 17 scald burn scars (0.34  0.045 cm), 4 contact burn scars (0.61  0.092 cm), and 10 flame burn scars (0.42  0.058 cm). Each group of scars followed normal distributions. Twenty-three scars had original burns successfully scanned by LDI and various depths of burns were presented by different colours according to blood perfusion units (PU), with dark blue <125, light blue 125–250, and green 250–440 PU. The thickness of these scars was significantly different between the predominant colours of burns, with the thinnest scars for green coloured burns and the thickest for dark blue coloured burns. Within light blue burns, grafted burns healed with significantly thinner scars than non-grafted burns. This study indicates that LDI can be used for predicting the risk of hypertrophic scarring and for guiding burn care. To our knowledge, this is the first study to correlate the thickness of burns scars by ultrasound scan with burn depth determined by LDI. # 2010 Elsevier Ltd and ISBI. All rights reserved. * Corresponding author at: University of Queensland, Department of Paediatrics and Child Health, Royal Children’s Hospital, Level 3 Foundation Building, Brisbane 4029, Australia. Tel.: +61 7 3365 5019; fax: +61 7 3365 5455. E-mail address: x.wang@uq.edu.au (X.-Q. Wang). available at www.sciencedirect.com journal homepage: www.elsevier.com/locate/burns 0305-4179/$36.00 # 2010 Elsevier Ltd and ISBI. All rights reserved. doi:10.1016/j.burns.2010.05.018