Intra- and inter-examiner reliability of digital images of skin donor areas in burns

SUMMARY OBJECTIVE: The main objective of this study was to evaluate intra- and inter-rater reliability in the analysis of digital images of donor areas for skin in burn patients using the CaPAS plugin in the ImageJ®. METHODS: Donor sites were reviewed by two independent reviewers in duplicate. The capture of images was standardized on the same device and distance (with a millimeter ruler), without a flash. The evaluators were trained to capture the images and use the plugin. RESULTS: We selected 70 images from donor areas, from men and women between 18 and 60 years old. In the analysis of intra-examiner reliability, eight of the nine variables exhibited excellent reliability (0.985-0.998) and one (entropy) exhibited good reliability (0.525). The same was true for the inter-examiner analysis: excellent reliability for eight variables (0.824-0.993) and good reliability for entropy (0.501). CONCLUSIONS: The CaPAS plugin has proven to be a reliable tool for use in research in skin donor areas in burns, as demonstrated by its excellent intra- and inter-examiner reliability values. This is a pioneering study in the quantitative assessment of skin donor areas in burn patients using the CaPAS plugin.

Efeitos da galvanopuntura no tratamento das estrias atróficas / Galvanic-puncture effects in stretch marks treatment

A estria é definida como uma atrofia tegumentar adquirida, representada por adelgaçamento, pregueamento, secura, menor elasticidade da pele e rarefação dos pêlos. Sua etiologia básica ainda é desconhecida, mas sabe-se que dentre os possíveis fatores causais, o fator endocrinológico é o principal determinante. Este trabalho teve como objetivo avaliar os efeitos obtidos no tratamento da estria através da galvanopuntura, verificando possível reparação do tecido e melhora da aparência estética da área afetada. Para isso, foi realizado um estudo de caso em um voluntário do sexo feminino, 25 anos, apresentando estrias atróficas, de coloração branca, na região externa do quadril e da coxa. Foi realizada biópsia da pele estriada, antes e após o tratamento, a fim de verificar possíveis alterações histológicas decorrentes do estímulo oferecido pela associação da corrente contínua filtrada e o estímulo físico da agulha. Os resultados obtidos através de microscopia ótica mostraram uma epiderme mais espessa, maior quantidade de fibroblastos, fibras colágenas e elásticas, e maior número de vasos. Conclui-se, portanto, que houve reparação da pele após o tratamento, com conseqüente melhora do aspecto cutâneo da região.

The stretch mark is defined as an acquired atrophy of the skin, characterized by thinning, wrinkling, dryness, flaccidness and loss of hair. Its basic etiology is still not completely known, but it is understood that, among the causes, the endocrinous activity is a determined factor. This study had the objective to evaluate the effects obtained by the galvanic-puncture, observing the possibility of tissue repairing and esthetic appearance improvement of the affected area. To observe this a case study was made on a feminine volunteer, 25 years old, presenting white stretch marks in the external area of hips and thighs. A biopsy of the stretched skin was made, before and after the treatment with the galvanic-puncture, verifying possible histological alterations resulting from the impulse of the direct current in association with the needle’s physical impulse. The obtained results, viewed by optical microscopy, showed a dense epidermis, higher quantity of fibroblasts, collagen and elastic fibers, and more blood vessels. Thence it follows that there is a repairing of the skin after treatment, with improvement of the aspect of the skin.