Burns 30 (2004) 232–235 The influence of dressings and ointments on the qualitative and quantitative evaluation of burn wounds by ICG video-angiography: an experimental setup W. Haslik a,* , L.-P. Kamolz a , H. Andel b , W. Winter b , G. Meissl a , M. Frey a a Department of Surgery, Division of Plastic and Reconstructive Surgery, Medical School, University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria b Department of Anaesthesia and Intensive Care, Medical School, University of Vienna, Vienna, Austria Accepted 27 October 2003 Abstract Burn wound depth is difficult to determine. Even for experienced investigators the exact differentiation between superficial and deep dermal burns is not always possible. Therefore, methods for objective and reproducible measurements estimating the depth of burn wounds are of great clinical interest. One technique that appears to be able to differentiate between superficial and deep dermal burn wounds is ICG video-angiography. Since burn wounds are often covered with dressings and ointments or soiled with blood, it is necessary to evaluate the influence of these substances on ICG video-angiography and its performance as a measurement method. The most commonly used ointments and dressings were tested. All studied substances had a massive influence on ICG video-angiography and its measurements. They caused decreases by absorption of up to 63 ± 36% and thereby falsely reported deeper burn wounds. The results of this study, suggest that in clinical practice, all dressings, ointments and blood should be completely removed at least 10 min prior to measurement by ICG video-angiography to gain exact and reproducible results. © 2003 Elsevier Ltd and ISBI. All rights reserved. Keywords: ICG video-angiography; Burn wound; Burn depth; Dressings and ointments 1. Introduction Burn wounds can be divided into three groups, depend- ing on the depth of the lesion. Superficial wounds heal without surgical treatment; deeper injuries need early exci- sion and grafting to gain satisfying results [1,2]. Even for experienced investigators an exact differentiation between superficial and deep dermal burns is not always possible [3] within the first 72 h. Moreover burn wounds tend to progress in depth within the first 2 days after injury [4]. Therefore, methods for objective and reproducible evaluation of burn wound depth are of great clinical interest, not only for primary diagnosis, but also for follow up. Currently there is no widely accepted “gold standard” for qualitative and quantitative determination of burn wound depth. However, several techniques have been evaluated [5–12]. One of these techniques is ICG video analysis, which assesses the patency of the vessels within the skin. Based * Corresponding author. Tel.: +43-1-40400-6980; fax: +43-1-40400-6988. E-mail address: werner.haslik@univie.ac.at (W. Haslik). on data obtained in previous studies in our group [10] ICG video analysis is capable of estimating the depth of burn wounds in a reproducible manner. Due to the fact that burn wounds are often covered with ointments or blood, which may interface into light through in and out of skin, it may be that these substances are causing a clinically relevant additive extinction of the fluorescence intensity of the ICG in blood vessels. This could lead to false results when used for the qualitative and quantitative evaluation of burn depth. This study investigate the potential problem and set out to develop a practicable protocol for ICG use to minimize artefacts in the clinical setting. 2. Material and methods The extinction of fluorescence by different kinds of dress- ings and ointments was analysed using the technique of dy- namic laser-fluorescence-videography (IC-View ® , Pulsion Medical Systems, Munich, Germany). For this purpose an ICG sample tile (30 cm × 15 cm) with a mean pixel in- tensity of 41.1 (ICG-Pulsion ® , Pulsion Medical Systems, 0305-4179/$30.00 © 2003 Elsevier Ltd and ISBI. All rights reserved. doi:10.1016/j.burns.2003.10.016