ULTRASONIC ASSESSMENT OF SURGICAL WOUNDS

高达10%的外科患者经历过伤口并发症， 导致医院成本增加和生产力损失 每年超过10亿美元。然而，目前还没有客观的方法来确定 非侵入性地评估影响修复过程的因素，例如： 糖尿病、低氧分压、感染、全身性类固醇，遗传性 基因工程生长因子、缝合材料或细胞毒性药物。首字母 研究表明，高频超声波是一种很有前途的检查方式。 非常适合在人类身上进行这样的非侵入性测量。 这项工作的长期目标是开发能够 对材料性能进行客观、无创的临床测量 用来治疗手术创伤。此外，这项工作的结果将提供 关于超声能量与软体相互作用的基本知识 组织，这是组织发育所必需的 适用于多种连接词的表征技术 纸巾。 重要的声学参数将使用一口井进行研究 特征化的创伤模型。一种高定量扫描激光声学 将使用10、30和100 MHz的显微镜(SLAM)来表征 体外创面的基本声学特性。背向散射声学 技术(BAT)，直接适用于临床 将利用10-40兆赫的环境进行体外测量。 早期伤口(1-21天)将被研究，因为它们是非常重要的 临床上和我们到目前为止的工作表明， 在这段时间内，声学行为是预期的。中的更改 用BAT测量的衰减系数有望提供 对最终体内临床测量程序的洞察力 对修复的评估。较老的伤口(50-365天)，其中主要 胶原蛋白的变化是三维的，也会是 学习。结构尺寸分布的声学测量 (异质性指数和依赖于频率的后向散射)将 与纤维束大小的变化相关。此外，我们还将 利用专门准备的生物标本(胶原胶和 关节软骨模型)分离出的重要贡献 交联剂和蛋白多糖对声学特性的影响 愈合的伤口。可测量的超声技术的发展 伤口组织中的材料特性应该提供临床上相关的 一种客观、非侵入性评价人体创伤的方法 举止。

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.