TY - JOUR
T1 - Enhancing the accuracy of surgical wound excision following burns trauma via application of Rapid Evaporative IonisationMass Spectrometry (REIMS)
AU - Yau, Andrew
AU - Fear, Mark W.
AU - Gray, Nicola
AU - Ryan, Monique
AU - Holmes, Elaine
AU - Nicholson, Jeremy K.
AU - Whiley, Luke
AU - Wood, Fiona M.
N1 - Funding Information:
AY is funded by the Perth Children’s hospital foundation , Australia and Fiona Wood Foundation , Australia. MF is funded by the Perth Children’s hospital foundation, Fiona Wood Foundation, Australia and Stan Perron Foundation, Australia. EH is supported by the Australian Research Council as an ARC Laureate Fellow. We thank The Spinnaker Health Research Foundation, WA, Australia, The McCusker Foundation, WA, Australia, The Western Australian State Government, and the Medical Research Futures Fund (MRFF), Australia for funding the Australian National Phenome Centre for this and related work.
Funding Information:
The authors would like to acknowledge the Spinnaker Health Research Foundation, WA, The McCusker Foundation, WA, The Western Australian State Government, and the MRFF for funding support for the Australian National Phenome Centre. We would also like to acknowledge the Fiona Wood Foundation.
Funding Information:
AY is funded by the Perth Children's hospital foundation, Australia and Fiona Wood Foundation, Australia. MF is funded by the Perth Children's hospital foundation, Fiona Wood Foundation, Australia and Stan Perron Foundation, Australia. EH is supported by the Australian Research Council as an ARC Laureate Fellow. We thank The Spinnaker Health Research Foundation, WA, Australia, The McCusker Foundation, WA, Australia, The Western Australian State Government, and the Medical Research Futures Fund (MRFF), Australia for funding the Australian National Phenome Centre for this and related work.
Publisher Copyright:
© 2022 Elsevier Ltd and International Society of Burns Injuries
PY - 2022/11
Y1 - 2022/11
N2 - Background: Surgical wound excision is a necessary procedure for burn patients that require the removal of eschar. The extent of excision is currently guided by clinical judgement, with excess into healthy tissue potentially leading to excessive scar, or inadequate debridement increasing risk of infection. Thus, an objective real-time measure to facilitate accurate excision could support clinical judgement and improve this surgical procedure. This study was designed to investigate the potential use of Rapid evaporative ionisation mass spectrometry (REIMS) as a tool to support data-driven objective tissue excision. Methods: Data were acquired using a multi-platform approach that consisted of both Rapid Evaporative Ionisation Mass Spectrometry (REIMS) performed on intact skin, and comprehensive liquid chromatography-mass spectrometry (LC-MS/MS) lipidomics performed on homogenised skin tissue extracts. Data were analysed using principal components analysis (PCA) and multivariate orthogonal projections to latent squares discriminant analysis (OPLS-DA) and logistic regression to determine the predictability of the models. Results: PCA and OPLS-DA models of the REIMS and LC-MS/MS lipidomics data reported separation of excised and healthy tissue. Molecular fingerprints generated from REIMS analysis of healthy skin tissue revealed a high degree of heterogeneity, however, intra-individual variance was smaller than inter-individual variance. Both platforms indicated high levels of skin classification accuracy. In addition, OPLS-DA of the LC-MS/MS lipidomic data revealed significant differences in specific lipid classes between healthy control and excised skin samples; including lower free fatty acids (FFA), monoacylglycerols (MAG), lysophosphatidylglycerol (LPG) and lysophosphatidylethanolamines (LPE) in excised tissue and higher lactosylceramides (LCER) and cholesterol esters (CE) compared to healthy control tissue. Conclusions: Having established the heterogeneity in the biochemical composition of healthy skin using REIMS and LC-MS/MS, our data show that REIMS has the potential to distinguish between excised and healthy skin tissue samples. This pilot study suggests that REIMS may be an effective tool to support accurate tissue excision during burn surgery.
AB - Background: Surgical wound excision is a necessary procedure for burn patients that require the removal of eschar. The extent of excision is currently guided by clinical judgement, with excess into healthy tissue potentially leading to excessive scar, or inadequate debridement increasing risk of infection. Thus, an objective real-time measure to facilitate accurate excision could support clinical judgement and improve this surgical procedure. This study was designed to investigate the potential use of Rapid evaporative ionisation mass spectrometry (REIMS) as a tool to support data-driven objective tissue excision. Methods: Data were acquired using a multi-platform approach that consisted of both Rapid Evaporative Ionisation Mass Spectrometry (REIMS) performed on intact skin, and comprehensive liquid chromatography-mass spectrometry (LC-MS/MS) lipidomics performed on homogenised skin tissue extracts. Data were analysed using principal components analysis (PCA) and multivariate orthogonal projections to latent squares discriminant analysis (OPLS-DA) and logistic regression to determine the predictability of the models. Results: PCA and OPLS-DA models of the REIMS and LC-MS/MS lipidomics data reported separation of excised and healthy tissue. Molecular fingerprints generated from REIMS analysis of healthy skin tissue revealed a high degree of heterogeneity, however, intra-individual variance was smaller than inter-individual variance. Both platforms indicated high levels of skin classification accuracy. In addition, OPLS-DA of the LC-MS/MS lipidomic data revealed significant differences in specific lipid classes between healthy control and excised skin samples; including lower free fatty acids (FFA), monoacylglycerols (MAG), lysophosphatidylglycerol (LPG) and lysophosphatidylethanolamines (LPE) in excised tissue and higher lactosylceramides (LCER) and cholesterol esters (CE) compared to healthy control tissue. Conclusions: Having established the heterogeneity in the biochemical composition of healthy skin using REIMS and LC-MS/MS, our data show that REIMS has the potential to distinguish between excised and healthy skin tissue samples. This pilot study suggests that REIMS may be an effective tool to support accurate tissue excision during burn surgery.
KW - Burns
KW - Debridement
KW - Mass Spectrometry
KW - Rapid Evaporative Ionisation Mass Spectrometry (REIMS)
KW - Surgery
UR - http://www.scopus.com/inward/record.url?scp=85138146837&partnerID=8YFLogxK
U2 - 10.1016/j.burns.2022.08.021
DO - 10.1016/j.burns.2022.08.021
M3 - Article
C2 - 36116996
AN - SCOPUS:85138146837
VL - 48
SP - 1574
EP - 1583
JO - Burns
JF - Burns
SN - 0305-4179
IS - 7
ER -