Spectroscopic burn injury evaluation apparatus and method

• US 5,701,902 A
• Filed: 09/14/1994
• Issued: 12/30/1997
• Est. Priority Date: 09/14/1994
• Status: Expired due to Fees

• Current Assignee: Cedars-Sinai Medical Center (Cedars Sinai Health System)
• Original Assignee: Cedars-Sinai Medical Center (Cedars Sinai Health System)
• Inventors: Vari, Sandor G., Maarek, Jean-Michel I.
• Primary Examiner(s): Smith, Ruth S.
• Application Number:
  US08/306,118
• Time in Patent Office: 1,203 Days
• Field of Search: 128/633, 128/634, 128/664, 128/665
• US Class Current: 600/473
• CPC Class Codes: A61B 5/0059 using light, e.g. diagnosis by transillumination, diascopy, fluorescence A61B5/0093, A61B5/1455, A61B5/02416 and A61B5/0261 take precedence
• CPC Class Codes: A61B 5/0071 by measuring fluorescence emission
• CPC Class Codes: A61B 5/0075 by spectroscopy, i.e. measuring spectra, e.g. Raman spectroscopy, infrared absorption spectroscopy A61B5/0071 takes precedence
• CPC Class Codes: A61B 5/445 Evaluating skin irritation or skin trauma, e.g. rash, eczema, wound, bed sore

Abstract

A burn evaluation apparatus and related method, that allows a surgeon to make a quick evaluation of the extent and depth of a skin burn injury by employing induced ultraviolet or blue light fluorescence spectroscopy and visible and infrared reflectance spectroscopy. The apparatus monitors the condition of the structural and metabolic constituents in the injured skin. The apparatus includes a plurality of light sources, a sensor, a microprocessor, and several optical fiber bundles. The light sources emit excitation light at predetermined wavelengths, and when each is activated, the sensor measures the amount return light received within several wavelength bands of interest. A side fiber bundle spaced about a centimeter from a main fiber bundle assists in detecting tissue water below the burn area. By optically evaluating the skin at the burn site, the apparatus prevents the unnecessary removal of viable skin that will heal spontaneously within a few weeks, thereby reducing the amount of skin that must be surgically grafted.

Claims

1. Apparatus for evaluating the condition of burned skin at the site of the burn injury to the skin, comprising:

a plurality of light sources, each emitting excitation light having a predetermined wavelength, that is directed at the burn site to produce return light, wherein at least one light source is characterized by a wavelength of sufficient energy to cause fluorescence of certain chemical constituents of the skin and the return light includes fluorescent light produced by constituents present within the skin;

a sensor, responsive to the return light corresponding to each light source, that monitors the return light and generates a plurality of electrical signals based on the intensity of return light within predetermined wavelength bands; and

a processor associated with the sensor, that processes the plurality of electrical signals and determines the condition of the skin at the site of the burn injury.

2. Apparatus for evaluating a burn injury to skin as defined in claim 1, wherein the plurality of light sources include a first light source that emits narrow band excitation light having a wavelength between 300 nanometers and 480 nanometers.

3. Apparatus for evaluating a burn injury to skin as defined in claim 2, wherein the plurality of light sources includes a first light source that emits excitation light having a wavelength of 405 nanometers, a second light source that emits excitation light having a wavelength of 452 nanometers, a third light source that emits excitation light having a wavelength of 775 nanometers, a fourth light source that emits excitation light having a wavelength of 810 nanometers, a fifth light source that emits excitation light having a wavelength of 904 nanometers, and a sixth light source that emits excitation light having a wavelength of 980 nanometers.

4. Apparatus for evaluating a burn injury to skin as defined in claim 3, wherein each of the plurality of light sources includes a diode laser that generates the respective excitation light.

5. Apparatus for evaluating a burn injury to skin as defined in claim 3, wherein the plurality of light sources include a first light source producing light within a first wavelength band between 450 to 460 nanometers, a second light source producing light within a second wavelength band between 480 and 490 nanometers, a third light source producing light within a third wavelength band between 520 and 530 nanometers, a fourth light source producing light within a fourth wavelength band between 550 and 560 nanometers, a fifth light source producing light within a fifth wavelength band between 770 and 780 nanometers, a sixth light source producing light within a sixth wavelength band between 805 and 815 nanometers, a seventh light source producing light within a seventh wavelength band between 900 and 910 nanometers, and an eighth light source producing light within an eighth wavelength band between 970 and 990 nanometers.

6. Apparatus for evaluating a burn injury to skin as defined in claim 1, further comprising:

a first optical fiber bundle that includes

a plurality of excitation optical fibers, each excitation optical fiber associated with a respective light source to transmit excitation light from the light source to the site of the burn injury; and

one or more return optical fibers that transmit the return light from the site of the burn injury to the sensor.

7. Apparatus for evaluating a burn injury to skin as defined in claim 6, further comprising a second optical fiber bundle of one or more optical fibers that collect return light, the second bundle being located at a distance of approximately one centimeter from the first optical fiber bundle, during the evaluation of the burn injury.

8. Apparatus for evaluating a skin burn injury as defined in claim 1, wherein:

the plurality of light sources includes;

a first light source that emits excitation light having a wavelength not greater than about 480 nanometers to cause fluorescence of certain metabolic and structural constituents in the skin, and

a second light source that emits excitation light having a wavelength of at least about 772 nanometers to illuminate the hemoglobin at the burn injury site;

the return light includes light reflected by the hemoglobin present in the skin; and

the processor determines the potential viability of the skin at the site of the burn injury.

9. Apparatus for evaluating a skin burn injury as defined in claim 8, further comprising a display that provides an image that indicates the potential viability of the skin at the site of the burn injury.

10. Apparatus for evaluating a skin burn injury as defined in claim 8, wherein the plurality of light sources further includes a third light source having a wavelength of at least 980 nanometers to illuminate the water content of the skin and the return light includes light reflected by water present within the skin.

11. Apparatus for evaluating a skin burn injury as defined in claim 1, wherein:

the plurality of light sources includes a light source that emits, at a first location, excitation light having a wavelength of about 980 nanometers;

the sensor further monitors the return light at a second location situated approximately one centimeter from the first location and generates a first electrical signal based on the intensity of return light within a relatively based on the intensity of return light within a relatively narrow wavelength band centered at about 980 nanometers; and

the processor further processes the first electrical signal to evaluate the water content of the skin and tissues below the site of the burn injury.

12. Apparatus for evaluating a skin burn injury as defined in claim 1, wherein:

the sensor includes an optical probe for monitoring the reflectance of infrared light from below a surface of the skin at the site of the burn injury, the optical probe comprising;

a main optical fiber bundle that directs infrared light toward the surface, and

a side optical fiber bundle that is located approximately one centimeter from the main fiber bundle and that collects infrared light reflected from below the surface.

13. Apparatus for evaluating a skin burn injury as defined in claim 1, wherein:

the processor provides a database that associates, for a particular skin type, the fluorescence and spectroscopic characteristics of different degrees of burn injury occurring to the skin of the particular skin type; and

the processor determines the condition of the skin at the site of the burn injury by

determining the fluorescence and spectroscopic characteristics of the injured individual'"'"'s normal skin,

comparing the fluorescence and spectroscopic characteristics of the injured individual'"'"'s normal skin with the fluorescence and spectroscopic characteristics of normal skin for the particular skin types in the database and selecting the closest match between the individual'"'"'s skin type and the skin types provided in the database,

obtaining from the database, information regarding the fluorescence and spectroscopic characteristics associated with different degrees of burn injury for the selected skin type for use in evaluating the degree of the individual'"'"'s burn injury;

determining the fluorescence and spectroscopic characteristics of the injured individual'"'"'s burned skin;

comparing the information obtained from the database for the selected skin type with the characteristics of the injured individual'"'"'s burned skin to estimate the degree of burn injury of the burned skin; and

indicating the estimated degree of burn injury of the injured individual'"'"'s burned skin.

14. Apparatus for evaluating a skin burn injury as defined in claim 1, wherein:

the plurality of light sources includes;

a first light source that emits excitation light having a wavelength between 300 and 480 nanometers to cause fluorescence of certain metabolic and structural constituents in the skin, and

a second light source that emits excitation light having a wavelength at about 775, 810 or 904 nanometers to illuminate the hemoglobin at the burn injury site;

the return light includes light reflected by the hemoglobin present in the skin; and

the processor determines the potential viability of the skin at the site of the burn injury.

15. Apparatus for evaluating a skin burn injury as defined in claim 14, wherein the plurality of light sources further includes a third light source having a wavelength of about 980 nanometers to illuminate the water content of the skin and the return light includes light reflected by water present within the skin.