Burn depth assessment — laser Doppler imaging

Overview¶

Burn depth is the determinant that drives almost every downstream decision in the first week of care, yet it is one of the hardest things to read by eye. Reliable assessment of burn wound depth and healing potential is essential to treatment decision-making, to prognosis, and to comparing studies across treatment modalities ^[30]. The problem is that the eye is a poor perfusion sensor: clinical assessment of burn depth has been shown to be accurate in only 60-75% of cases, even when performed by an experienced burn surgeon ^[12]. A more recent appraisal puts partial-thickness clinical accuracy at 67% and notes that clinical assessment nonetheless remains the most consistent standard of practice ^[42]. The quoted accuracy of 64% to 76% among senior burn surgeons is itself the argument for an objective adjunct ^[16].

Laser Doppler imaging (LDI) is the most studied of the optical adjuncts developed to close that gap ^[16]. The depth of a burn wound and its healing potential are the most important determinants of therapeutic management and of residual morbidity or scarring ^[12], and across the literature LDI is described as the most objective and accurate diagnostic tool for measuring blood flow and its associated healing potential ^[35]. It is the one technique shown to predict wound outcome with a large weight of evidence ^[12], and it has been cleared for burn depth assessment by regulatory bodies including the FDA ^[12]. The clinical question on a given wound is rarely "what does LDI say" in isolation; it is "does the perfusion reading, read at the right time and interpreted alongside the wound's appearance, change whether this patient goes to the operating room." This page covers how LDI and its laser-based relatives (laser Doppler flowmetry and laser speckle contrast imaging) measure perfusion, when in the post-burn course the reading is trustworthy, how accurate it is against the 21-day healing standard, and how it does and does not change management.

Pathophysiology¶

LDI does not see burn depth directly. It sees blood flow, and infers depth from it. The technology provides an estimate of perfusion through the burn wound, on the assumption that lower perfusion correlates with a deeper wound and therefore a longer time to heal ^[16]. That assumption rests on a real microvascular substrate: reduced blood flow to various levels in thermally damaged dermis is related to the depth of the burn ^[1]. The deeper the thermal injury, the more of the dermal vascular plexus is occluded, and the lower the measured perfusion.

The relationship is quantitative. An inverse relationship exists between burn depth and the laser Doppler perfusion index ^[9], and absolute perfusion values track depth: in one early flowmetry series the mean value of superficial second-degree burns was 194.6 perfusion units (PU), deep second-degree burns measured 59.7 PU, and third-degree burns measured 5.1 PU ^[5]. This perfusion gradient is what the colour-coded LDI palette encodes.

Burn wounds are not static, which is why timing is load-bearing for any perfusion measurement. Wounds show a progressive decline in perfusion and a progressive increase in the depth of injury over the first 72 hours ^[9], and the burn wound has been shown experimentally to progress in depth over that same window ^[21].

Assessment¶

Technique and color palette¶

LDI scans the wound with a laser beam in a raster pattern and produces a perfusion image of dermal blood flow ^[2]. The output is converted into a clinically usable color map. In the widely used Pape colour code, high healing potential (under 14 days) is coded red at greater than 600 PU, intermediate (14-21 days) yellow at 260-440 PU, and low healing potential (over 21 days) blue at under 200 PU, with pink and green overlap regions between them ^[19]. The laser Doppler imager therefore classifies burns into three healing-potential categories: high (under 14 days), intermediate (14-21 days), and low (over 21 days) ^[25]. The 21-day mark matters because it is the threshold beyond which spontaneous healing is associated with worse scarring, making it the operative dividing line for excision decisions.

Timing¶

The single most important practical fact about LDI is that its accuracy depends on when the scan is taken. Measurement of perfusion is an established method to evaluate burn depth, but high accuracy is only achievable more than 48 hours after injury ^[33]. The day-by-day curve is steep: in one cohort, LDI accuracy on the day of burn and on post-burn days 0, 1, 3, 5, and 8 was 54%, 79.5%, 95%, 97%, and 100%, compared with clinical accuracies of 40.6%, 61.5%, 52.5%, 71.4%, and 100% respectively ^[13]. LDI accuracy was significantly higher than clinical accuracy on day 3 and day 5 ^[13]. The practical window where LDI adds the most over the clinical eye is roughly days 3 to 5 post-burn, after the wound has declared its perfusion but before clinical signs have caught up.

Accuracy against clinical assessment¶

Head-to-head studies consistently favor LDI over the clinical eye in the indeterminate-depth window. An early audit of intermediate-depth burns scanned at 48-72 hours reported LDI accuracy of 97%, against 60-80% for established clinical methods ^[6]. In a pediatric series, clinical examination correctly determined 66% of deep partial or full-thickness burns between 36 and 72 hours compared with 90% for LDI, and LDI was also more specific, correctly diagnosing 96% of superficial partial-thickness burns versus 71% clinically ^[8]. A prospective comparison found LDI and clinical accuracies of 90.21% and 81.52% respectively, with LDI sensitivity 92.75% versus 81% clinically at equal 82% specificity ^[27]. A study comparing modalities on post-burn days 0 and 3 found LDI accuracies of 80.8% and 92.3%, against 55.8% and 71.2% for thermal imaging and 62.5% and 71.6% for photographic clinical assessment ^[28].

Pooled diagnostic accuracy¶

The meta-analytic picture is strong. In a meta-analysis and systematic review of 14 studies covering 1,818 patients, the overall LDI sensitivity for burn depth was 91% (95% CI 86-95%) and specificity was 96% (95% CI 92-98%), with an overall positive likelihood ratio of 20.35 and negative likelihood ratio of 0.09 ^[32]. The summary ROC area under the curve was 0.98 ^[32]. A separate systematic review and meta-analysis found pooled sensitivity and specificity that were similarly high, while cautioning that careful clinical assessment should still be performed alongside LDI in patients with deep burns ^[26]. A systematic review of measurement-technique quality found strong evidence for adequate construct validity of LDI ^[30].

Where LDI sits among the modalities¶

Across reviews, LDI is the reference adjunct against which others are measured. It is described as currently the most objective and accurate diagnostic tool for measuring blood flow and its associated healing potential, the main predictor of a patient's long-term functional and aesthetic outcome ^[35]. It is a fast, non-contact, single-measurement tool that can scan large burned areas with 96% accuracy ^[35]. It is described as universally considered the most evidence-based method for objective burn depth assessment ^[37], and as the only modality shown to be reliable where infrared thermography and spectrophotometric intracutaneous analysis have proven less accurate ^[38]. By contrast, single-point laser Doppler flowmetry (LDF), the predecessor technique, requires direct contact with numerous points on the wound bed and serial measurements over several days ^[35].

Management¶

LDI changes management chiefly by changing the timing and confidence of the excision decision. In a survey of burn centers, final treatment decisions were based on the combination of LDI and clinical assessment in 74% of centers, and 70% almost never operated on burns reading LDI-red while almost always operating on LDI-blue burns ^[37]. For indeterminate burns, decisions are described as a combination of human interpretation and machine measurement ^[37]; when clinical assessment and LDI disagree, 41% of centers relied more on clinical diagnosis, 25% delayed the decision to operate, and 16% re-scanned the next day ^[37]. The reading reduces the number of clinically indeterminate-depth burns ^[37].

The decision-acceleration effect is reproducible. In a blinded prospective trial, when the LDI scan median flux indicated need for excision it was 100% accurate (7 of 7), and LDI allowed for earlier objective determination of the need to operate ^[10]. In a pediatric cohort, mean time from injury to the grafting decision was 8.9 days with an LDI scan versus 11.6 days with clinical observation alone, a statistically significant difference ^[18]. The presence of LDI-blue is itself an operative signal: % TBSA blue was more than four times higher in the operated group (0.48% versus 0.11%) and was significantly related to the decision to operate ^[39].

The clinical aim of these earlier, more confident decisions is to avoid unnecessary surgery on wounds that would have healed and to avoid delay on wounds that will not. A multicenter cohort that stratified wounds by LDI healing-potential category found that scar quality was strongly related to the healing-potential category, with low-healing-potential wounds having significantly lower scar quality ^[25]; in that cohort, no positive effect on scar quality or healing time was found from operating earlier on intermediate-healing-potential wounds, a result the authors framed as favoring a conservative approach for that group ^[25].

Outcomes¶

The prognostic core of LDI is that perfusion early after burn predicts who heals without surgery. Wounds that healed spontaneously in fewer than 21 days showed higher average perfusion than those that required excision and grafting or were unhealed at day 21 ^[3], and laser Doppler flowmetry had a positive predictive value of 100% for nonhealing wounds on post-burn days 1 and 3 ^[3]. Among 129 wounds with admission laser Doppler readings below 1.4, 127 were ultimately classified as deep second- or third-degree and required excision; the positive predictive value of a low reading was 98.4% ^[1]. Perfusion below 10 PU correctly predicted a third-degree burn in 100% of cases ^[5].

The randomized-trial evidence on patient-level outcome is more measured. A cost-effectiveness randomized controlled trial in the Dutch burn centers found that on the day of randomization clinicians decided significantly more often on operative or nonoperative treatment in the LDI group, instead of postponing the choice ^[24]. Across the whole cohort, mean time to wound healing was 14.3 days in the LDI group versus 15.5 days with standard care, a non-significant difference ^[24]; in the subgroup of admitted patients requiring surgery, LDI was associated with an earlier decision for surgery, a shorter healing time, and a potential cost saving of 875 euro per scanned patient ^[24]. A later appraisal of Dutch burn care noted that although LDI led to faster operative decisions, this did not translate into shorter wound healing time or cost savings overall ^[29]. A practical secondary benefit is on the patient experience: after LDI information was discussed with patients, anxiety dropped significantly ^[34].

Special Considerations¶

Pediatric burns. LDI is well validated in children. Laser Doppler flowmetry is a useful tool for burn wound assessment in pediatric patients ^[4], and LDI is accurate and effective in a pediatric population using a low-resolution fast-scan setting ^[14]. LDI predicts burn wound outcome in children, including within 48 hours of injury; in one series, sensitivity and specificity for patients scanned within 48 hours were 78% and 74%, versus 75% and 85% for those scanned later, a non-significant difference ^[17]. The technology is not uniform across mechanisms, however: LDI is a less reliable predictor of outcome for friction burns than for other mechanisms of injury in children, predicting outcome accurately in only 64% of one mixed pediatric cohort ^[20].

Chemical burns. The evidence base is thin outside thermal injury. There is no clear evidence for the use of LDI in chemical burns, though limited experimental animal studies suggest similar validity ^[40]; one review describes LDI as accurate for thermal burns and an area of future interest for chemical burns ^[36].

Controversies and Evidence Gaps¶

Why a validated, FDA-cleared tool is still not standard. The most striking gap is the distance between the evidence and the adoption. For unclear reasons, LDI is still not routinely used in burn centers worldwide ^[35]. In the United States, clinical assessment continues to dominate despite a literature supporting more accurate modalities such as LDI ^[22], and burn-center directors name the leading barriers as cost (72%), availability (63%), and limited supporting evidence (35%) ^[22]. Adoption is described as hampered by high costs, long scan times, and limited portability ^[28]. Centers with the most LDI experience, by contrast, consider it an indispensable diagnostic tool ^[37], suggesting the barrier is as much the learning curve and capital cost as the underlying evidence.

Whether the trial evidence supports the diagnostic-accuracy enthusiasm. The diagnostic-accuracy literature is strongly positive, but the patient-outcome trial evidence is more equivocal. The Dutch randomized controlled trial showed faster decisions but no whole-cohort reduction in healing time ^[24], and a subsequent appraisal of Dutch practice concluded the faster decisions did not yield shorter healing or cost savings ^[29]. The signal for benefit is concentrated in the surgical subgroup rather than across all scanned patients.

Methodological quality of the older literature. A critical clinimetric evaluation found a lack of standardization across studies and significant methodological problems affecting the validity of findings, and concluded that until those were resolved laser Doppler should remain a research tool ^[11]. That appraisal predates the larger validation cohorts and meta-analyses, but the standardization concern about scan protocols and interpretation persists.

Technical artifacts and detection-depth limits. Perfusion imaging is sensitive to acquisition conditions. Scanning distance, tissue curvature, dressing thickness, and the pathophysiological effects of skin colour, blisters, and wound fluids all significantly affect the laser Doppler signal, though most can be adjusted for if the examiner knows them ^[7]. Scanning-beam devices are slow, causing patient discomfort and imaging artifacts ^[15]. There is also a physical ceiling: perfusion values measured by LDI correlate less well at higher burn temperatures, attributable to the limited depth at which light produces a measurable Doppler shift ^[23].

Laser speckle contrast imaging as the emerging alternative. Laser speckle contrast imaging (LSCI) offers instant, full-field perfusion measurement and has been proposed as an alternative to LDI. Derived LSCI cut-offs discriminated 14-day and 21-day healing potential with ROC areas around 0.89 ^[41], and lower LSCI perfusion values are associated with longer healing and care periods ^[31]. A critical validation study, however, found LSCI positive predictive values as low as 50.8% and 68.2% for the intermediate and 21-day healing-potential categories, and concluded that LSCI failed to detect deep dermal blood flow and overestimated burn severity ^[43]. LSCI is not yet a settled replacement.

Low-cost adjuncts for resource-limited settings. Because LDI is expensive and not portable, cheaper tools are under study for settings where LDI is unavailable, including a portable thermal camera that produced diagnostic-accuracy results comparable to LDI for superficial partial-thickness burns in a pediatric pilot ^[44]. These remain early-stage.

References¶

[1] O'Reilly TJ, Spence RJ, Taylor RM, Scheulen JJ. "Laser Doppler flowmetry evaluation of burn wound depth." The Journal of burn care & rehabilitation 1989. PMID: 2646302. ↩

[2] Niazi ZB, Essex TJ, Papini R, Scott D, McLean NR, Black MJ. "New laser Doppler scanner, a valuable adjunct in burn depth assessment." Burns : journal of the International Society for Burn Injuries 1993. PMID: 8292231. ↩

[3] Atiles L, Mileski W, Purdue G, Hunt J, Baxter C. "Laser Doppler flowmetry in burn wounds." The Journal of burn care & rehabilitation 1995. PMID: 8582917. ↩

[4] Atiles L, Mileski W, Spann K, Purdue G, Hunt J, Baxter C. "Early assessment of pediatric burn wounds by laser Doppler flowmetry." The Journal of burn care & rehabilitation 1995. PMID: 8582936. ↩

[5] Park DH, Hwang JW, Jang KS, Han DG, Ahn KY, Baik BS. "Use of laser Doppler flowmetry for estimation of the depth of burns." Plastic and reconstructive surgery 1998. PMID: 9583481. ↩

[6] Pape SA, Skouras CA, Byrne PO. "An audit of the use of laser Doppler imaging (LDI) in the assessment of burns of intermediate depth." Burns : journal of the International Society for Burn Injuries 2001. PMID: 11311516. ↩

[7] Droog EJ, Steenbergen W, Sjöberg F. "Measurement of depth of burns by laser Doppler perfusion imaging." Burns : journal of the International Society for Burn Injuries 2001. PMID: 11525849. ↩

[8] Holland AJ, Martin HC, Cass DT. "Laser Doppler imaging prediction of burn wound outcome in children." Burns : journal of the International Society for Burn Injuries 2002. PMID: 11834324. ↩

[9] Riordan CL, McDonough M, Davidson JM, Corley R, Perlov C, Barton R, et al. "Noncontact laser Doppler imaging in burn depth analysis of the extremities." The Journal of burn care & rehabilitation 2003. PMID: 14501410. ↩

[10] Jeng JC, Bridgeman A, Shivnan L, Thornton PM, Alam H, Clarke TJ, et al. "Laser Doppler imaging determines need for excision and grafting in advance of clinical judgment: a prospective blinded trial." Burns : journal of the International Society for Burn Injuries 2003. PMID: 14556723. ↩

[11] Chatterjee JS. "A critical evaluation of the clinimetrics of laser Doppler as a method of burn assessment in clinical practice." Journal of burn care & research : official publication of the American Burn Association 2006. PMID: 16566554. ↩

[12] Monstrey S, Hoeksema H, Verbelen J, Pirayesh A, Blondeel P. "Assessment of burn depth and burn wound healing potential." Burns : journal of the International Society for Burn Injuries 2008. PMID: 18511202. ↩

[13] Hoeksema H, Van de Sijpe K, Tondu T, Hamdi M, Van Landuyt K, Blondeel P, et al. "Accuracy of early burn depth assessment by laser Doppler imaging on different days post burn." Burns : journal of the International Society for Burn Injuries 2009. PMID: 18952377. ↩

[14] Mill J, Cuttle L, Harkin DG, Kravchuk O, Kimble RM. "Laser Doppler imaging in a paediatric burns population." Burns : journal of the International Society for Burn Injuries 2009. PMID: 19500913. ↩

[15] van Herpt H, Draijer M, Hondebrink E, Nieuwenhuis M, Beerthuizen G, van Leeuwen T, et al. "Burn imaging with a whole field laser Doppler perfusion imager based on a CMOS imaging array." Burns : journal of the International Society for Burn Injuries 2010. PMID: 19716237. ↩

[16] Jaskille AD, Ramella-Roman JC, Shupp JW, Jordan MH, Jeng JC. "Critical review of burn depth assessment techniques: part II. Review of laser doppler technology." Journal of burn care & research : official publication of the American Burn Association 2010. PMID: 20061851. ↩

[17] Nguyen K, Ward D, Lam L, Holland AJ. "Laser Doppler Imaging prediction of burn wound outcome in children: is it possible before 48 h?." Burns : journal of the International Society for Burn Injuries 2010. PMID: 20171012. ↩

[18] Kim LH, Ward D, Lam L, Holland AJ. "The impact of laser Doppler imaging on time to grafting decisions in pediatric burns." Journal of burn care & research : official publication of the American Burn Association 2010. PMID: 20182369. ↩

[19] Pape SA, Baker RD, Wilson D, Hoeksema H, Jeng JC, Spence RJ, et al. "Burn wound healing time assessed by laser Doppler imaging (LDI). Part 1: Derivation of a dedicated colour code for image interpretation." Burns : journal of the International Society for Burn Injuries 2012. PMID: 22115981. ↩

[20] Menon S, Ward D, Harvey JG, Hei EL, Holland AJ. "Friction burns in children: does laser Doppler imaging have a role?." Journal of burn care & research : official publication of the American Burn Association 2012. PMID: 22878493. ↩

[21] Xiao M, Li L, Li C, Zhang P, Hu Q, Ma L, et al. "Role of autophagy and apoptosis in wound tissue of deep second-degree burn in rats." Academic emergency medicine : official journal of the Society for Academic Emergency Medicine 2014. PMID: 24730400. ↩

[22] Resch TR, Drake RM, Helmer SD, Jost GD, Osland JS. "Estimation of burn depth at burn centers in the United States: a survey." Journal of burn care & research : official publication of the American Burn Association 2014. PMID: 25144808. ↩

[23] Ida T, Iwazaki H, Kawaguchi Y, Kawauchi S, Ohkura T, Iwaya K, et al. "Burn depth assessments by photoacoustic imaging and laser Doppler imaging." Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society 2016. PMID: 26487320. ↩

[24] Hop MJ, Stekelenburg CM, Hiddingh J, Kuipers HC, Middelkoop E, Nieuwenhuis MK, et al. "Cost-Effectiveness of Laser Doppler Imaging in Burn Care in The Netherlands: A Randomized Controlled Trial." Plastic and reconstructive surgery 2016. PMID: 26710049. ↩

[25] Goei H, van der Vlies CH, Hop MJ, Tuinebreijer WE, Nieuwenhuis MK, Middelkoop E, et al. "Long-term scar quality in burns with three distinct healing potentials: A multicenter prospective cohort study." Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society 2016. PMID: 27102976. ↩

[26] Shin JY, Yi HS. "Diagnostic accuracy of laser Doppler imaging in burn depth assessment: Systematic review and meta-analysis." Burns : journal of the International Society for Burn Injuries 2016. PMID: 27215151. ↩

[27] Jan SN, Khan FA, Bashir MM, Nasir M, Ansari HH, Shami HB, et al. "Comparison of Laser Doppler Imaging (LDI) and clinical assessment in differentiating between superficial and deep partial thickness burn wounds." Burns : journal of the International Society for Burn Injuries 2018. PMID: 28918904. ↩

[28] Wearn C, Lee KC, Hardwicke J, Allouni A, Bamford A, Nightingale P, et al. "Prospective comparative evaluation study of Laser Doppler Imaging and thermal imaging in the assessment of burn depth." Burns : journal of the International Society for Burn Injuries 2018. PMID: 29032974. ↩

[29] Legemate CM, Hop MJ, Nieuwenhuis MK, Middelkoop E, van Baar ME, van der Vlies CH. "[Determining depth of burns using laser Doppler imaging]." Nederlands tijdschrift voor geneeskunde 2018. PMID: 29629853. ↩

[30] Jaspers MEH, van Haasterecht L, van Zuijlen PPM, Mokkink LB. "A systematic review on the quality of measurement techniques for the assessment of burn wound depth or healing potential." Burns : journal of the International Society for Burn Injuries 2019. PMID: 29941159. ↩

[31] Elmasry M, Mirdell R, Tesselaar E, Farnebo S, Sjöberg F, Steinvall I. "Laser speckle contrast imaging in children with scalds: Its influence on timing of intervention, duration of healing and care, and costs." Burns : journal of the International Society for Burn Injuries 2019. PMID: 30827850. ↩

[32] Wang R, Zhao J, Zhang Z, Cao C, Zhang Y, Mao Y. "Diagnostic Accuracy of Laser Doppler Imaging for the Assessment of Burn Depth: A Meta-analysis and Systematic Review." Journal of burn care & research : official publication of the American Burn Association 2020. PMID: 31872859. ↩

[33] Mirdell R, Farnebo S, Sjöberg F, Tesselaar E. "Using blood flow pulsatility to improve the accuracy of laser speckle contrast imaging in the assessment of burns." Burns : journal of the International Society for Burn Injuries 2020. PMID: 32299641. ↩

[34] Hartlief GA, Niemeijer AS, Lamberts KF, Nieuwenhuis MK. "The impact of early information concerning the surgical operations on anxiety in patients with burns." Burns : journal of the International Society for Burn Injuries 2021. PMID: 32978010. ↩

[35] Claes KEY, Hoeksema H, Vyncke T, Verbelen J, De Coninck P, De Decker I, et al. "Evidence Based Burn Depth Assessment Using Laser-Based Technologies: Where Do We Stand?." Journal of burn care & research : official publication of the American Burn Association 2021. PMID: 33128377. ↩

[36] Nguyen ATM, Chamberlain K, Holland AJA. "Paediatric chemical burns: a clinical review." European journal of pediatrics 2021. PMID: 33403450. ↩

[37] Claes KEY, Hoeksema H, Robbens C, Verbelen J, Dhooghe N, De Decker I, et al. "The LDI Enigma Part II: Indeterminate depth burns, man or machine?." Burns : journal of the International Society for Burn Injuries 2021. PMID: 34696950. ↩

[38] Schulz T, Marotz J, Seider S, Langer S, Leuschner S, Siemers F. "Burn depth assessment using hyperspectral imaging in a prospective single center study." Burns : journal of the International Society for Burn Injuries 2022. PMID: 34702635. ↩

[39] Shahid S, Duarte MC, Zhang J, Markeson D, Barnes D. "Laser doppler imaging - the role of poor burn perfusion in predicting healing time and guiding operative management." Burns : journal of the International Society for Burn Injuries 2023. PMID: 35221157. ↩

[40] Owoso T, Kankam HKN, Abdulsalam A, Lewis D. "The Use of Laser Doppler Imaging in Nitric Acid Burns: A Case Report and Literature Review." Journal of burn care & research : official publication of the American Burn Association 2023. PMID: 36987869. ↩

[41] 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 : journal of the International Society for Burn Injuries 2023. PMID: 37863755. ↩

[42] Lee JJ, Abdolahnejad M, Morzycki A, Freeman T, Chan H, Hong C, et al. "Comparing Artificial Intelligence Guided Image Assessment to Current Methods of Burn Assessment." Journal of burn care & research : official publication of the American Burn Association 2025. PMID: 38918900. ↩

[43] De Mey K, De Decker I, Gush R, Hoeksema H, Verbelen J, De Coninck P, et al. "Validity of laser speckle contrast imaging for predicting wound healing potential in burns: A critical examination." Burns : journal of the International Society for Burn Injuries 2025. PMID: 40112657. ↩

[44] van de Warenburg MS, Wieringa M, Ulrich DJO, Hummelink S, Vehmeijer-Heeman MLAW. "The use of the FLIR ONE Pro thermal camera for paediatric burn wound depth assessment: A pilot study." Burns : journal of the International Society for Burn Injuries 2026. PMID: 41780415. ↩