Pioneers in patient care: consultants leading change
North East
Innovation: Use of Laser Doppler Imaging to assess burn depth and avoid patients having unnecessary skin graft operations
Mrs Sarah Pape
Royal Victoria Infirmary, Newcastle upon Tyne
Job title: Consultant plastic surgeon
Speciality: Plastic surgery
Sixteen thousand people are admitted to UK hospitals every year having sustained a burn. Laser Doppler Imaging (LDI) is a non-invasive method for measuring skin blood flow which consultant plastic surgeon Sarah Pape and her team at Newcastle’s Royal Victoria Infirmary use to measure burn depth.
Mrs Pape says: “By using this method we have been able to reduce the number of burns needing skin grafts by 30 per cent which means fewer people are having operations. That has to be good for patients. It has also resulted in more appropriate decision making, less scarring and shorter hospital stays for patients as well as reduced workload and costs.
“We run a low energy laser beam over the skin which gives us a picture of the burn and looks rather like a thermal image. A red, warm image means the blood flow is high, the burn is superficial and surgery isn’t required. A cold, blue image indicates low blood levels, where the burns are deeper and surgery is needed. It’s like a map of what needs doing and what doesn’t and we are now confident that all our patients who have surgery genuinely need it.
“We have been using the technique clinically since 1997 and have the largest clinical experience in the world. The accuracy of this method is 97 per cent compared with 60-70 per cent using clinical assessment alone. In particular, we have been able to show that even experienced clinicians may over estimate the depth of a burn. My accuracy is 73 per cent and I’ve been assessing burns for 14 years – the machine is nearly 100 per cent.”
The equipment costs £38,000 which is why it is only used in very few UK hospitals, says Mrs Pape. She believes if it were used routinely by the NHS, thousands of patients would benefit and in several years the cost would be recovered and savings made. In her hospital alone, 200 patients benefit from LDI every year.
“I am unable to identify any area where increased Government spending has had an impact on my unit or hospital. Medicine should be a very fulfilling career but it isn’t at the moment. It wouldn’t take an awful lot of effort to make it worthwhile again, so perhaps today’s medical students will be happier when they become consultants than we are at the moment.”