Autofluorescence of skin burns detected by fiber-optic confocal imaging: evidence that cool water treatment limits progressive thermal damage in anesthetized hairless mice

BACKGROUND: Although full-thickness burns present no difficulty to clinical judgment, accurate assessment of burn depth immediately after injury in partial thickness burns has always been difficult. METHODS: Thermal burns (applied by a 3-mm-diameter brass rod heated to 50 degrees--80 degrees C for 20 seconds) were induced on the skin of anesthetized hairless mice. Anesthesia was maintained throughout all experiments. Both burns and normal skin were investigated noninvasively in vivo using fiber-optic confocal imaging (FOCI) microscopy (excitation, 488 nm; detection, 505 nm). RESULTS: Autofluorescence was detected in burned skin, and the depth of the autofluorescent region was found to correlate with the intensity of heat applied. Cool water treatment (for 20 minutes immediately after burn induction) significantly reduced the progressive increase in autofluorescence in deeper layers of the skin over the 4-hour postburn observation period. Histology showed burn-associated changes at a lower temperature than that at which autofluorescence was first detected in vivo by FOCI. However, there was a good correlation (r = 0.78) between depth of damage revealed by FOCI compared with that by histology. CONCLUSION: These results suggest that FOCI may be used to provide an index of burn depth.