Polychrome Bone Fluorescence: A Valuable Diagnostic Tool for Fourth-Degree Calvarial Burns. A Case Report

Abstract

Fourth-degree calvarial burns are complex in management with regard to determining bone vitality and subsequent choice of defect coverage. Distinguishing viable and nonviable bone can be challenging. Tetracycline bone fluorescence is well described and in common use in maxillofacial patients with bisphosphonate osteonecrosis and has been reported in septic orthopedic surgery specifically periprosthetic joint infection. On the basis of viable bone fluoresces, the concept of polychrome fluorescence was extrapolated as a diagnostic tool for calvarial burns. Bone fluorescence presents an efficient, non-invasive, and cost-effective diagnostic tool delineating exact necrotic margins in fourth-degree burns ensuring targeted bone-sparing debridement. This report describes the use of polychrome bone fluorescence as an intraoperative tool including a single-center case report with fourth-degree calvarial burns.

Keywords: calvarial burns; case report; fluorescent-guided bone resection; fourth-degree burns; polychrome bone fluorescence; tetracycline bone labeling.