ULTRASONIC ASSESSMENT OF SURGICAL WOUNDS

高达10%的手术患者会出现伤口并发症， 导致医院成本增加和生产力损失， 超过10亿美元。 然而，没有客观的方法， 非侵入性评估影响修复过程的因素，例如： 糖尿病、低氧张力、感染、全身性类固醇、遗传 工程化生长因子、缝合材料或细胞毒性药物。 初始 研究表明，高频超声是一种很有前途的方式， 非常适合在人体中进行这种非侵入性测量。 这项工作的长期目标是开发能够 对材料性能进行客观的无创临床测量 用于外科伤口。 此外，这项工作的结果将提供 关于超声波能量与软质材料相互作用的基本知识 这对组织的发育至关重要 适用于各种连接词的特征化技术 组织中 重要的声学参数将使用一口井进行调查 特征伤口模型。 一种高定量的扫描激光声学 将在10、30和100 MHz下使用显微镜（SLAM）来表征 体外伤口的基本声学特性。 后向散射声学 技术（BAT），直接适用于临床 将在10-40 MHz下使用环境进行体外测量。 将研究早期伤口（1-21天），因为它们非常重要 临床上，我们迄今为止的工作表明， 在该时间段期间预期声学行为。 变化 预期使用最佳可得技术测量的衰减系数将提供 对最终体内临床测量程序的见解 修复评估。 较旧的伤口（50-365天），其中主要 胶原蛋白的变化是三维结构，也将是 研究了 结构尺寸分布的声学测量 （异质性指数和频率依赖性后向散射） 与纤维束大小的变化相关。 此外，我们将 利用特别制备的生物样品（胶原凝胶和 关节软骨模型），以分离 交联和蛋白聚糖的声学性能 愈合伤口 超声技术的发展能够测量 伤口组织中的材料特性应提供临床相关的 一种客观和非侵入性地评估人体创伤的方法 方式

Up to 10% of all surgical patients experience wound complications which result in increased hospital costs and lost productivity amounting to more than a billion dollars per year. Yet no objective method exists for noninvasively evaluating factors affecting the repair process such as: diabetes, low oxygen tension, infection, systemic steroids, genetically engineered growth factors, suture material or cytotoxic drugs. Initial studies have shown that high frequency ultrasound is a promising modality well-suited for making such noninvasive measurements in humans. The long term goal of this work is to develop acoustic methods capable of making objective noninvasive clinical measurements of material properties for surgical wounds. In addition, results of this work will provide basic knowledge regarding the interaction of ultrasonic energy with soft tissues, which is essential for the development of tissue characterization techniques applicable to a wide range of connective tissues. Important acoustic parameters will be investigated using a well characterized wound model. A highly quantitative scanning laser acoustic microscope (SLAM) will be utilized at 10, 30, and 100 MHz to characterize basic acoustic properties of wounds in vitro. Backscatter acoustic techniques (BAT), which are directly applicable to the clinical environment will be utilized at 10-40 MHz for in vitro measurements. Early wounds (1-21 days) will be studied since they are of great interest clinically and our work to date indicates that the greatest change in acoustic behavior is expected during that time period. Changes in attenuation coefficient as measured with BAT are expected to provide insight for clinical measurement procedures for eventual in vivo evaluation of repair. Older wounds (50-365 days), where the principal change in collagen is the three dimensional architecture, will also be studied. Acoustic measures of structural size distribution (heterogeneity index and frequency dependent backscatter) will be correlated with changes in fiber bundle size. Additionally, we will utilize specially prepared biological specimens (collagen gel and articular cartilage models) to isolate the important contribution of cross-linking and proteoglycans to the acoustical properties of the healing wound. Development of ultrasound techniques capable of measuring material properties in wound tissue should provide a clinically relevant method for evaluating human wounds objectively and in a noninvasive manner.