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

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.

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.

Red and infrared laser therapy inhibits in vitro growth of major bacterial species that commonly colonize skin ulcers.

Low-level laser therapy (LLLT) is used in chronic wounds due to its healing effects. However, bacterial species may colonize these wounds and the optimal parameters for effective bacterial inhibition are not clear. The aim of this study was to analyze the effect of LLLT on bacterial growth in vitro. Bacterial strains including Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa were suspended in saline solution at a concentration of 10(3) cells/ml and exposed to laser irradiation at wavelengths of 660, 830, and 904 nm at fluences of 0 (control), 3, 6, 12, 18, and 24 J/cm(2). An aliquot of the irradiated suspension was spread on the surface of petri plates and incubated at 37 °C for quantification of colony-forming unit after 24, 48, and 72 h. Laser irradiation inhibited the growth of S. aureus at all wavelengths and fluences higher than 12 J/cm(2), showing a strong correlation between increase in fluence and bacterial inhibition. However, for P. aeruginosa, LLLT inhibited growth at all wavelengths only at a fluence of 24 J/cm(2). E. coli had similar growth inhibition at a wavelength of 830 nm at fluences of 3, 6, 12, and 24 J/cm(2). At wavelengths of 660 and 904 nm, growth inhibition was only observed at fluences of 12 and 18 J/cm(2), respectively. LLLT inhibited bacterial growth at all wavelengths, for a maximum of 72 h after irradiation, indicating a correlation between bacterial species, fluence, and wavelength.

Blue Laser Inhibits Bacterial Growth of Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa.

OBJECTIVE: The purpose of this study was to analyze the influence of blue laser on bacterial growth of the main species that usually colonize cutaneous ulcers, as well as its effect over time following irradiation. BACKGROUND DATA: The use of blue laser has been described as an adjuvant therapeutic method to inhibit bacterial growth, but there is no consensus about the best parameters to be used. METHODS: Strains of Staphylococcus aureus ATCC 25923, Pseudomonas aeruginosa ATCC 27853, and Escherichia coli ATCC 25922 were suspended in saline solution at a concentration of 1.5×10(3) colony forming units (CFU)/mL. Next, 300 µL of this suspension was transferred to a microtitulation plate and exposed to a single blue laser irradiation (450 nm) at fluences of 0 (control), 3, 6, 12, 18, and 24 J/cm(2). Each suspension was spread over the surface of a Petri plate before being incubated at 37°C, and counts of CFU were determined after 24 and 48 h. RESULTS: Blue laser inhibited the growth of S. aureus and P. aeruginosa at fluences >6 J/cm(2). On the other hand, E. coli was inhibited at all fluences tested, except at 24 J/cm(2). CONCLUSIONS: Blue laser light was capable of inhibiting bacterial growth at low fluences over time, thus presenting no time-dependent effect.

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.