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day) suffering each year from burn injuries that necessitate medi­cal attention, cause extended absences from work or school, or even result in death [3]. In contrast, the incidence of burn injuries is higher than the combined incidence of tuberculosis and human immunodeciency virus (HIV/AIDS), and it is close to the inci­dence of all malignant neoplasms [4].

This chapter will discuss on the knowledge of burn wound evaluation, various methods of burn determination, the limitation of burn depth determination, and a thorough review of the devel­opment, fundamentals, and evidence base for using ICGA precise marking for burn wound evaluation and excision in clinical practice.

Burn wounds are categorized based on the depth of tissue injury, which determines the burn management to be either con­servative or operative. Burn depth is classied into four catego­ries: epidermal, supercial partial-thickness, deep partial-thickness, and full-thickness skin loss [14, 15]. Epidermal burns involve only the epidermis. The typical etiology is sunburn. The wounds appear erythematous, painful, and blanch with pres­sure. Supercial partial-thickness burns affect the supercial part of the dermis, with scald burn being the most frequent etiology. These wounds are erythematous and tender, and blisters can appear up to 24h after the injury. Deep partial-thickness burns involve the deep part of the dermis, where hair follicles and glan­dular tissue are located. This kind of burn wound is not painful unless the burn area is pressured with signicant force. These wounds contain variously mottled colorization from patchy white to red, and they were not blanched with the pressure. Finally, full­thickness burns, the deepest degree, involve the epidermis and all layers of the dermis. A diverse wound color can be observed, such as waxy white, leathery gray, charred, and dark black. The wound is dry, inelastic, and painless. It does not blanched with pressure.

Infection can also impair burn wound healing [20]. The skin is a vital organ, which serves as a barrier to protect the external envi­ronment, maintain body temperature and homeostasis, provide sensory detection, and provide metabolic and immunological sup­port. Destruction of this vital organ damages the innate immuno­logical response and increases the risk of infection [20]. Therefore, burn patients are certainly at a higher risk of infection [21]. When burn patients are hospitalized long enough to get infected by drug-resistant organisms, the infection process prolongs the hos­pital stay, delays the wound healing, increases hospital cost, and increases mortality [22, 23].

Nutrition contributes to proper burn wound healing [24]. Minimizing the consequence of hypermetabolism and supplying adequate nutritional support are the main components that contrib­ute to the appropriate wound healing process and recovery [25].

The following health factors can also impact burn severity and the burn recovery process: diabetes, obesity, and geriatric status. Diabetes mellitus signicantly affects burn patients [26]. It impairs the body’s ability to deal with stress due to glucose- related cell, end-organ, and vascular damage, which deteriorates clinical out­comes in admitted patients [27]. The hyperglycemic state injures the immune cells causing their function to be impaired. This dis­tinctly leads to a greater risk of infection in diabetic patients [28], which is one of the lethal complications in burns [20].