Noninvasive Broadband Terahertz Assessment of Burn Severity

 描述（由申请人提供）：美国烧伤协会报告称，每年约有450，000例烧伤在美国接受医疗治疗。皮肤烧伤在分诊期间分为4个严重程度等级，这反过来又决定了其不同的临床治疗过程。例如，浅表的部分皮层烧伤可以在2至3周的时间内自愈，而深的部分皮层烧伤和全皮层烧伤则需要切除和外科植皮手术。然而，目前用于区分烧伤等级的临床评估技术的准确率仅限于64- 70%，通常需要在治疗过程中为每位患者进行多次植皮手术。对烧伤创面进行非侵入性和高度准确的评估可以改变治疗过程，缩短住院时间，改善烧伤患者的整体康复，同时还可以降低护理成本。基于我们先前对相干太赫兹（THz）时域光谱对组织含水量的敏感性以及对正常皮肤结构密度的散射的经验观察，我们提出了以下新假设：在2-3周内自发愈合的部分厚度烧伤的太赫兹特征与不愈合的伤口显著不同。我们将从以下方法来解决这个假设：1。我们将使用标准化的猪烧伤模型来确定太赫兹模式在烧伤表征中与组织学测定的功效。2.鉴于深层真皮结构在皮肤再生过程中的重要作用，我们将使用活力测定来量化每个烧伤的毛囊和汗腺附近负责上皮再生的细胞的完整性和生物活性。我们将测试皮肤再生的组织学测量与太赫兹时域光谱测量之间的统计相关性，以确定基于早期THz预测的烧伤愈合可能性的潜在关系。3.我们将在正常猪皮肤模型中进行剂量测定和安全性研究，以确定暴露于太赫兹光对人体研究是安全的。4.在与哈博维尤区域烧伤中心在华盛顿大学的合作，我们将进行一项试点人体研究，以调查在烧伤后早期阶段的太赫兹模式的效用评估。

 DESCRIPTION (provided by applicant): The American Burn Association has reported that each year approximately 450,000 burn injuries receive medical treatment in the U.S. Skin burns are classified into 4 grades of severity during triage, which in turn determines their distinct course of clinical treatment. For example, superficial partial-thickness burns can heal spontaneously over a 2- to 3-week period, whereas deep partial-thickness and full-thickness burns require excision and surgical skin grafting procedures. However, the accuracy rate of the current clinical assessment technique used to differentiate between burn grades is limited to 64-70%, often necessitating several skin grafting operations per patient over the course of treatment. Non-invasive and highly-accurate assessment of burn wounds can alter the management course, reduce the length of hospital stay and improve the overall recovery of the burn patient, while also reducing the cost of care. Based on our previous empirical observations of the sensitivity of the coherent terahertz (THz) time-domain spectroscopy to the water content of the tissue, as well as to scattering by the density of normal skin structures, we propose the following novel hypothesis: Partial-thickness burns that heal spontaneously in 2-3 weeks will differ significantly in their terahertz signatures from wounds that do not heal. We will address this hypothesis from the following approaches: 1. We will use standardized porcine burn models to determine the efficacy of the THz modality in burn characterization against histological assays. 2. Given the important role of deep dermal structures in the skin regeneration process, we will quantify the intactness and biological viability of cells that are responsible for reepithelialization in the vicinity of hair follicles and sweat glands of each burn using vitality assays. We will test the statistical correlation between this histological measure of skin regeneration and the terahertz time-domain spectroscopy measurements to determine a potential relationship for burn healing likelihood based on early THz predictions. 3. We will conduct dosimetry and safety studies in normal porcine skin models to establish that exposure to terahertz light is safe for human studies. 4. In collaboration with the Harborview Regional Burn Center at the University of Washington, we will conduct a pilot human study in order to investigate the utility of the terahertz modality in burn assessment during the early post-injury period.