Application of computational and expert approaches to determining the type of postburn skin scars
Abstract
Difficulties in choosing anti-scarring tactics are one of the topical problems in the management of children with sequels of burn injury. Therapeutic effectiveness can be enhanced, by making a more accurate diagnosis of the type of scar tissue, which allows the determination of an optimal combination of tools and methods for convalescent burn treatment. Despite that there are recent research works dedicated to the practice of unbiased methods, clinical examination is so far the most widespread method for scar assessment, which shows a high percent of medical errors in view of its subjectivity. The authors of this article propose an algorithm of scar type identification via binary regression and expert approach. The data of 109 clinical examinations of scars in 75 children admitted to the G.N. Speransky Children’s Clinical Hospital with burn scar were reviewed. The developed algorithms showed a high efficiency in identifying the type of a scar and were implemented in software that could define the probability of classifying the scar as one of the clinical and morphological types after entering the clinical exam data and scar age. The program is designed for both combustiology professionals and general practitioners.
About the Authors
D. D. Dolotova
Pirogov Russian National Research Medical University
Russian Federation
Russian Federation
L. V. Shurova
Research Clinical Institute of Pediatrics
Russian Federation
Russian Federation
B. A. Kobrinsky
Research Clinical Institute of Pediatrics; Pirogov Russian National Research Medical University
Russian Federation
Russian Federation
L. I. Budkevich
G.N. Speransky City Children’s Clinical Hospital Nine, Moscow
Russian Federation
Russian Federation
References
1. Баиндурашвили А.Г., Соловьева К.С., Залетина А.В. Распространенность ожогов у детей, потребность в стационарном лечении, инвалидность. Российский вестник детской хирургии, анестезиологии и реаниматологии. Приложение. Труды X Всероссийской научно-практической конференции «Актуальные проблемы хирургии детского возраста» 2012; 26—27. (Baindurashvili A.G., Solov'eva K.S., Zaletina A.V. The prevalence of burns in children, the need for hospitalization and disability. The Russian bulletin of children's surgery, anesthesiology and resuscitation. The application. Proceedings of X Russian scientific-practical conference "Actual problems of pediatric surgery" 2012; 26—27.)
2. Соболева И.В. Обоснование тактики лечения детей с послеожоговыми рубцами кожи: Автореф. дис. … канд. мед. наук. М 2007; 24. (Soboleva I.V. Substantiation of management among children with post-burn scars skin. The synopsis of Ph.D. thesis. Moscow 2007; 24.)
3. Трыкова И.А., Шаробаров В.И., Тимина И.Е. и др. Неинвазивная дифференциальная диагностика гипертрофических и келоидных рубцов с помощью высокочастотного ультразвука. Анналы пластической, реконструктивной и эстетической хирургии 2012; 3: 66—71. (Trykova I.A., Sharobarov V.I., Timina I.E. et al. Non-invasive diagnostics of hypertrophic and keloid scars by means of highfrequency ultrasound. Аnnaly plasticheskoj, rekonstruktivnoj i ehsteticheskoj khirurgii 2012; 3: 66—71.)
4. Gulamhuseinwala N., Mackey S., Meagher P. et al. Should excised keloid scars be sent for routine histologic analysis? Ann Plast Surg 2008; 60: 2: 186—187.
5. Biryukov M.L., Belyakova T.N., Dmitriev G.I. The scars caused by burns, their structure, varieties and complications. Acta Chir Plast 1979; 21: 3: 86—95.
6. Tyack Z., Simons M., Spinks A. et al. A systematic review of the quality of burn scar rating scales for clinical and research use. Burns 2012; 38: 1: 6—18.
7. Durani P., McGrouther D.A., Ferguson M.W. Current scales for assessing human scarring: a review. J Plast Reconstr Aesthet Surg 2009; 62: 6: 713—720.
8. Forbes-Duchart L., Marshall S., Strock A. et al. Determination of inter-rater reliability in pediatric burn scar assessment using a modified version of the Vancouver Scar Scale. J Burn Care Res 2007; 28: 3: 460—467.
9. van der Wal M.B., Verhaegen P.D., Middelkoop E. et al. A clinimetric overview of scar assessment scales. J Burn Care Res 2012; 33: 2: 79—87.
10. Гланц С. Медико-биологическая статистика. М: Пра- ктика 1998; 460. (Glanc S. Biomedical Statistics. Moscow: Praktika 1998; 460.)
11. Гаврилова Т.А., Червинская К.Р. Извлечение и структурирование знаний для экспертных систем. М: Радио и связь 1992; 200. (Gavrilova T.A., Chervinskaja K.R. Acquisition and structuring of knowledge for expert systems. Moscow: Radio i svjaz', 1992; 200.)
12. Арндт К.А. Коррекция рубцов. М: Рид Элсивер 2009; 116. (Arndt K.A. Scar revision. Moscow: Rid Jelsiver 2009; 116.)
13. Белоусов А.Е. Рубцы и их коррекция. Ст-Петербург: Командор-SPB 2005; 128. (Belousov A.E. Scars and their revision. SPb.: Komandor-SPB, 2005; 128.)
14. Озерская О.С. Рубцы кожи и их дерматокосметическая коррекция. Ст-Петербург: Искусство России 2007; 224. (Ozerskaja O.S. Scars of skin and dermatocosmetology revision. SPb: Iskusstvo Rossii 2007; 224.)
15. Логвинов С.В., Арий Е.Г., Байтингер В.Ф. Патологические кожные рубцы. Томск: Печатная мануфактура 2004; 140. (Logvinov S.V., Arij E.G., Bajtinger V.F. Abnormal skin scars. Tomsk: Pechatnaja manufaktura, 2004; 140.)
16. Галлямова Ю.А., Кардашова З.З. Гипертрофические и келоидные рубцы. Лечащий врач 2009; 10: 20—23. (Galljamova Ju.A., Kardashova Z.Z. Hypertrophic and keloid scars. Lechashhij vrach 2009; 10: 20—23.)
Review
For citations:
Dolotova D.D., Shurova L.V., Kobrinsky B.A., Budkevich L.I. Application of computational and expert approaches to determining the type of postburn skin scars. Rossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics). 2014;59(1):88-92. (In Russ.)
Views:
537
Email this article 