Emerging technologies for burn depth assessment: a comprehensive review
Keywords:
burns; diagnostic imaging; nanotechnology; virtual reality; artificial intelligence.Abstract
Abstract
Introduction: In routine medical practice, the diagnosis of burn depth is subjective, based solely on three degrees according to skin layers. However, skin has several layers, and the extent of burn involvement is difficult to establish, limiting the prognosis of the injury. This could be better differentiated with the use of technology. Given that, to our knowledge, no objective, accurate, and non-invasive method for diagnosing burn depth, monitoring evolution, and determining prognosis has been described, this literature review was conducted. Objective: To evaluate emerging technologies in the diagnosis of burn depth. Method: A literature review was conducted in PubMed, Elsevier, Google Scholar, Google Research, and SciELO; articles in English and Spanish were included. Results: Of the 165 sources found, 41 were selected based on the inclusion criteria. More than 75% were in English, and the articles were published between 2006 and 2025. Conclusion: The high rate of diagnostic error necessitates objective tools that provide complementary data, and their combination will improve the assessment. Most are still in the research phase and are not yet clinically standardized. The future points toward AI-integrated systems for predictive diagnoses and personalized treatments.
Keywords: burns, diagnostic imaging, nanotechnology, virtual reality, artificial intelligence
Downloads
References
Referencias bibliográficas
1. Payne R, Glassman E, Turman ML, Cancio LC. Pathophysiology and Treatment of Burns. J Spec Oper Med. 2022;22(2):87-92. DOI: 10.55460/BGGY-2LFL
2. Keshri VR, Peden M, Singh P, Norton R, Abimbola S, Jagnoor J. Health systems research in burn care: an evidence gap map. Inj Prev. 2023;29(5):446-53. DOI: 10.1136/ip-2023-044963
3. Barreiro Ramos H, Barreiro Peñaranda A, Viera Fernández E, Marrero Martín O. Quemaduras y etiología medicolegal. Rev Cubana Med Gen Integr. 2006;22(4). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-21252006000400007&lng=es.
4. Karim AS, Shaum K, Gibson ALF. Indeterminate-Depth Burn Injury-Exploring the Uncertainty. J Surg Res. 2020;245:183-97. DOI: 10.1016/j.jss.2019.07.063.
5. Rajkumar J, Chandan N, Lio P, Shi V. The Skin Barrier and Moisturization: Function, Disruption, and Mechanisms of Repair. Skin Pharmacol Physiol. 2023;36(4):174-85. DOI: 10.1159/000534136
6. Gutowska I, Żwierełło W, Piorun K, Skórka Majewicz M, Maciejewska Markiewicz D, Kupnicka P, et al. The Extent of Burn Injury Significantly Affects Serum Micro- and Macroelement Concentrations in Patients on the First Day of Hospitalisation. Nutrients. 2022;14(20):4248. DOI: 10.3390/nu14204248
7. Ramírez CE, Ramírez C, González LF, Ramírez N, Vélez K. Fisiopatología del paciente quemado. Universidad Rev. Ind. Santander. 2010;42(1):55-65. Disponible en: http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0121-08072010000100007&lng=en.
8. Savage N, Doherty Z, Singer Y, Menezes H, Cleland H, Goldie SJ. A Review of Petrol Burns in Australia and New Zealand. J Burn Care Res. 2023;44(5):1162-8. DOI: 10.1093/jbcr/irad008
9. Toppi J, Cleland H, Gabbe B. Severe burns in Australian and New Zealand adults: Epidemiology and burn centre care. Burns. 2019;45(6):1456-61. DOI: 10.1016/j.burns.2019.04.006.
10. Atwell K, Bartley C, Cairns B, Charles A. The epidemiologic characteristics and outcomes following intentional burn injury at a regional burn center. Burns. 2020;46(2):441-6. DOI: 10.1016/j.burns.2019.08.002
11. Watson RE Jr, Tesfaldet M, Warren J, Hoff MN. MR Imaging Safety Events: Analysis and Improvement. Magn Reson Imaging Clin N Am. 2020;28(4):593-600. DOI: 10.1016/j.mric.2020.07.004
12. Dang J, Lin M, Tan C, Pham CH, Huang S, Hulsebos IF. Use of Infrared Thermography for Assessment of Burn Depth and Healing Potential: A Systematic Review. J Burn Care Res. 2021:108. DOI: 10.1093/jbcr/irab108.
13. Carrière ME, de Haas LEM, Pijpe A, Meij de Vries A, Gardien KLM, van Zuijlen PPM, et al. Validity of thermography for measuring burn wound healing potential. Wound Repair Regen. 2020;28(3):347-54. DOI: 10.1111/wrr.12786.
14. Pedrosa R, Souza Martins L, Freire RM, et al. Precisión de la evaluación mediante termografía infrarroja en la cicatrización de heridas por quemaduras: una revisión sistemática y un metanálisis. J Wound Care. 2024;33(Sup4a):cxviii-cxxix. doi:10.12968/jowc.2024.33.Sup4a.cxviii.
15. Rahman S, Ogilvie T, Okonski D, et al. Una revisión exhaustiva del uso de dispositivos de termografía infrarroja en el punto de atención para evaluar varios tipos de heridas. Int Wound J. 2025;22(8):e70741. doi:10.1111/iwj.70741.
16. Owoso T, Kankam HKN, Abdulsalam A, Lewis D. The Use of Laser Doppler Imaging in Nitric Acid Burns: A Case Report and Literature Review. J Burn Care Res. 2023;44(6):1440-4. DOI: 10.1093/jbcr/irad044.
17. Goel J, Nizamoglu M, Tan A, Gerrish H, Cranmer K, El-Muttardi N, et al. A prospective study comparing the FLIR ONE with laser Doppler imaging in the assessment of burn depth by a tertiary burns unit in the United Kingdom. Scars Burn Heal. 2020;6:2059513120974261. DOI: 10.1177/2059513120974261
18. Mekonnen T, Lin X, Zevallos Delgado C, Singh M, Aglyamov SR, Coulson Thomas VJ, et al. Longitudinal assessment of the effect of alkali burns on corneal biomechanical properties using optical coherence elastography. J Biophotonics. 2022;15(8):e202200022. DOI: 10.1002/jbio.202200022
19. DeJong H, Abbott S, Zelesco M, Spilsbury K, Ziman M, Kennedy BF, et al. Objective quantification of burn scar stiffness using shear-wave elastography: Initial evidence of validity. Burns. 2020;46(8):1787-98. DOI: 10.1016/j.burns.2020.05.009.
20. Dijkstra A, Guven G, van Baar ME, Trommel N, Hofland HWC, Kuijper TM, et al. Laser speckle contrast imaging, an alternative to laser doppler imaging in clinical practice of burn wound care derivation of a color code. Burns. 2023;49(8):1907-15. DOI: 10.1016/j.burns.2023.04.009
21. Wang Q, Gong P, Afsharan H, Joo C, Morellini N, Fear M, et al. In vivo burn scar assessment with speckle decorrelation and joint spectral and time domain optical coherence tomography. J Biomed Opt. 2023;28(12):126001. DOI: 10.1117/1.JBO.28.12.126001
22. Liu K, Chen Z, Zhou W, Xing D. Towards quantitative assessment of burn based on photoacoustic and optical coherence tomography. J Biophotonics. 2020;13(10):e202000126. DOI: 10.1002/jbio.202000126
23. McUmber H, Dabek RJ, Bojovic B, Driscoll DN. Burn Depth Analysis Using Indocyanine Green Fluorescence: A Review. J Burn Care Res. 2019;40(4):513-6. doi: 10.1093/jbcr/irz054.
24. Wongkietkachorn A, Surakunprapha P, Jenwitheesuk K, Eua-Angkanakul K, Winaikosol K, Punyavong P, et al. Indocyanine Green Angiography Precise Marking for Indeterminate Burn Excision: A Prospective, Multi-centered, Double-blinded Study. Plast Reconstr Surg Glob Open. 2021;9(4):e3538. DOI: 10.1097/GOX.0000000000003538
25. Kim YH, Paik SH, Kim Y, Yoon J, Cho YS, Kym D, et al. Clinical application of functional near-infrared spectroscopy for burn assessment. Front Bioeng Biotechnol. 2023;11:1127563. DOI: 10.3389/fbioe.2023.1127563
26. Mihara K, Shindo H, Mihara H, Ohtani M, Nagasaki K, Katoh N. Early depth assessment of local burns by dermoscopy: a new frontier of dermoscopic evaluation. Arch Dermatol. 2012:E1. DOI: 10.1001/archdermatol.2012.418.
27. Li AT, Moussa A, Gus E, Paul E, Yii E, Romero L, et al. Biomarkers for the Early Diagnosis of Sepsis in Burns: Systematic Review and Meta-analysis. Ann Surg. 2022;275(4):654-62. DOI: 10.1097/SLA.0000000000005198
28. Jiang X, Li F, Chi Y, Chen X, Luo Y, Ye Q, et al. Application of contrast-enhanced ultrasound in the diagnosis of burn depth. Ann Transl Med. 2021;9(16):1315. DOI: 10.21037/atm-21-3715
29. Taib BG, Karwath A, Wensley K, Minku L, Gkoutos GV, Moiemen N. Artificial intelligence in the management and treatment of burns: A systematic review and meta-analyses. J Plast Reconstr Aesthet Surg. 2023;77:133-61. DOI: 10.1016/j.bjps.2022.11.049
30. Moura FS, Amin K, Ekwobi C. Artificial intelligence in the management and treatment of burns: a systematic review. Burns Trauma. 2021;9:022. DOI: 10.1093/burnst/tkab022
31. Handa M, Maharana SK, Pal K, Shukla R. Biocompatible Nanomaterials for Burns. Curr Pharm Biotechnol. 2022;23(12):1514-26. DOI: 10.2174/1389201023666220413091055
32. Ujjwal RR, Yadav A, Tripathi S, Krishna ST. Polymer-based Nanotherapeutics for Burn Wounds. Curr Pharm Biotechnol. 2022;23(12):1460-82. DOI: 10.2174/1389201022666210927103755
33. Bermo MS, Patterson D, Sharar SR, Hoffman H, Lewis DH. Virtual Reality to Relieve Pain in Burn Patients Undergoing Imaging and Treatment. Top Magn Reson Imaging. 2020;29(4):203-8. DOI: 10.1097/RMR.0000000000000248
34. Hoffman HG, Chambers GT, Meyer WJ 3rd, Arceneaux LL, Russell WJ, Seibel EJ, et al. Virtual reality as an adjunctive non-pharmacologic analgesic for acute burn pain during medical procedures. Ann Behav Med. 2011;41(2):183-91. DOI: 10.1007/s12160-010-9248-7
35. Tan P, Ravulapalli K, Lewis CJ. Una revisión sistemática de los avances en el uso de imágenes espectrales en la evaluación de la profundidad de las quemaduras. Burns. 2025;51(3):107401. doi: 10.1016/j.burns.2025.107401.
36. Wang S, Gu M, Zhang M, Tan X. Investigación sobre un método de detección de gravedad de quemaduras basado en imágenes hiperespectrales. Sensors (Basilea, Suiza). 2025;25(5):1330. doi:10.3390/s25051330.
37. Rangaiah PKB, Kumar BPP, Huss F, Augustine R. Diagnóstico de precisión de lesiones por quemaduras mediante imágenes y modelos predictivos para aplicaciones clínicas. Sci Rep. 2025;15(1):7604. doi:10.1038/s41598-025-92096-4.
38. Núñez J, Mironov S, Wan B, et al. Nuevas imágenes infrarrojas de onda corta multiespectrales para la evaluación de la profundidad de las quemaduras humanas. Wound Repair Regen. 2024;32(6):979-991. doi:10.1111/wrr.13221.
39. Parque YR, Eom JB. Fotopletismografía de imágenes de múltiples longitudes de onda para la evaluación no invasiva y sin contacto de la gravedad de las quemaduras. Sci Rep. 2025;15(1):16586. doi:10.1038/s41598-025-01707-7.
40. Perusseau-Lambert A, Akram M, Frew Q, Barnes D. Comparación entre imágenes multiespectrales e imágenes láser Doppler para predecir los requisitos de las heridas por quemaduras para cirugía. Burns. 2025;51(8):107650. doi: 10.1016/j.burns.2025.107650.
41. Chen, Y., Huang, S., & Pickwell-MacPherson, E. (2021). A prospective study of using terahertz pulsed imaging to predict the healing of burns. Optica, 8(9), 1155-1158. doi: https://doi.org/10.1364/OPTICA.431511
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Olga Rodríguez S´´anchez, Alicia María Tamayo Carbón, Luz Marina Miquet Romero, Diana Katherine Cuastumal Figueroa
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Aquellos autores/as que tengan publicaciones con esta revista, aceptan los términos siguientes:
- Los autores/as conservarán sus derechos de autor y garantizarán a la revista el derecho de primera publicación de su obra, el cuál estará simultáneamente sujeto a la Licencia de reconocimiento de Creative Commons que permite a terceros compartir la obra siempre que se indique su autor y su primera publicación esta revista.
- Los autores/as podrán adoptar otros acuerdos de licencia no exclusiva de distribución de la versión de la obra publicada (p. ej.: depositarla en un archivo telemático institucional o publicarla en un volumen monográfico) siempre que se indique la publicación inicial en esta revista.
- Se permite y recomienda a los autores/as difundir su obra a través de Internet (p. ej.: en archivos telemáticos institucionales o en su página web) antes y durante el proceso de envío, lo cual puede producir intercambios interesantes y aumentar las citas de la obra publicada. (Véase El efecto del acceso abierto).
