Noninvasive Broadband Terahertz Assessment of Burn Severity

 描述(由申请人提供)：美国烧伤协会报告称，在美国，每年约有450,000名烧伤患者接受治疗。皮肤烧伤在分流过程中被分为4个严重等级，这反过来又决定了它们不同的临床治疗过程。例如，浅层部分烧伤可以在2-3周内自然愈合，而深层和全层烧伤需要切除和外科植皮手术。然而，目前用于区分烧伤级别的临床评估技术的准确率仅限于-70%，往往需要每个患者在治疗过程中进行多次植皮手术。对烧伤创面进行无创性和高度准确的评估可以改变治疗过程，减少住院时间，改善烧伤患者的整体康复，同时还可以降低护理成本。基于我们之前对相干太赫兹(THz)时域光谱对组织水分含量以及正常皮肤结构密度散射的敏感性的经验观察，我们提出了以下新的假设：在2-3周内自发愈合的部分厚度烧伤与未愈合的创面的太赫兹信号将显著不同。我们将从以下方法解决这一假设：1.我们将使用标准化的猪烧伤模型来确定THz模式在烧伤特征方面相对于组织学分析的有效性。2.鉴于深层真皮结构在皮肤再生过程中的重要作用，我们将使用活力分析来量化每次烧伤毛囊和汗腺附近负责再上皮化的细胞的完整性和生物学活性。我们将测试这种皮肤再生的组织学测量和太赫兹时域光谱测量之间的统计相关性，以确定基于早期太赫兹预测的烧伤愈合可能性的潜在关系。3.我们将在正常的猪皮肤模型中进行剂量学和安全性研究，以确定暴露在太赫兹光下对人体研究是安全的。4.我们将与华盛顿大学港景地区烧伤中心合作，进行一项试验性人体研究，以调查太赫兹模式在创伤后早期评估中的用途。

 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.