An Optical Tomography-Based Score to Assess Pediatric Hand Burns

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Interesting study and new technique on assessing burn depths.

How long on average did it take to scan a whole hand?  As most patients were very young < 2 years of age is there a problem of movement artefact? How does the practical use of the device compare to the Laser Doppler?

It seems only a very small area is scanned (6 x 6 mm) per burn? How was this area chosen?

in line 260 it is stated:'' Our score predicts skin grafting in 56% however the decision to perform skin grafting is also influenced by the size of the wound and the families''.  How do families influence whether or not to skin graft? 

In the discussion as well as briefly in the introduction one should review the available devices for measuring burn depth and of course the Laser Doppler has been the Gold standard for many years now. Some comparison between the 2 devices should be made regarding ease of use and accuracy.

Also the use of AI and big data / machine learning could be mentioned in a little more detail.

Comments on the Quality of English Language

There could a little improvement made to the english language

Author Response

Dear Reviewer 1 

Please find our answers in the letter atached.

Thank you very much

 

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

Thank you for the opportunity to review this paper. I think it is well written, although requires a proof read (have noted some typos below). Overall, this is a useful research study that can translate to clinical practice.

Abstract

Line 12 – typo: t

Line 14 – rephrase sentence so it doesn’t start with a number ie Overall, 67 hand burns…

Introduction

Line 32 – you could comment here about 1) that children’s skin is thinner than adults, and also 2) that palms and fingers are highly innervated and these types of burns are particularly impactful because the burns are so painful.

Line 34 typo: relevant. Although ‘compromising’ might work better in the sentence if I am interpreting it correctly

Line 35 – typo: a

Line 52 – typo: ..

Line 54 – typo: plexus.he.  Should this be papillary plexus under the skin?

Line 60 typo

The three research questions are clear, well-defined and logical. Well done.

Materials and Methods

Beware of starting your sentences with a number (eg line 75)

Lines 77-78 – sentence needs rewriting for clarity

Line 83 – why adjacent or contralateral? Why not stick to one or the other for consistency?

Line 84 – ‘to save time’ was this to reduce patient burden?

Line 98 – is 2mm deep enough to assess these wounds?

Line 122 – Because they are defining features… etc ( ie plural). Perhaps move this sentence that reports on the presence of surface irregularity and epidermal loss to the beginning of the result section, because effectively this answers research question 1.

Results

For median results, please report IQR not SD. Suggest median and IQR are reported for the number of dressing changes, and length of stay.

I think it is appropriate to repeat the photos that are described in parts 3.1, 3.2, 1.3 of the results section, and the scoring image in Table 3. Makes the findings clear, and then shows how this can be translated to practice with a visual scale.

Discussion

This is a logical discussion which lays out the reasoning effectively.

General feedback:

·         There are a lot of very short paragraphs and it would be better to combine some of these together.

·         Directly answer each of the three research questions in turn, with at least one paragraph for each.

·         A paragraph about the practicalities of using this in a clinical setting (eg cost, time taken, staff training) would give a useful perspective.

·         Proofread for typos ( eg lines 236, 250, 268, 271)

Good luck with your resubmission.

Author Response

Dear Reviewer 2

Please find our comments in the document attached

Thank you very much

 

Author Response File: Author Response.pdf