Many military combat injuries involve the head and neck. Often these injuries result in losses of noses, eyes, ears or jaws. These missing facial structures are no longer able to function, and they produce deformities in facial appearance. When lost facial structures cannot be corrected surgically, they are replaced by artificial prostheses. Head and face prostheses should look and feel like natural skin, but unfortunately present-day materials do not always permit a realistic duplication of lost facial structures. Also, many prostheses demonstrate short lifetimes, as they fade and harden, sometimes within a period of only a few months. Consequently, nearly 25% of facial prostheses must be replaced each year. The long-term goal of this research is to develop a new generation of materials that will produce facial prostheses that look and feel like human facial skin. In order to achieve this goal, baseline information is needed to establish "gold standards" towards which future improvements in materials may be targeted. Therefore, the objective of this pilot project is to provide this baseline information by measuring facial skin elasticity in a human population. The project is designed to include equal numbers of participants from four racial groups (asian, black, white, hispanic), both genders and three age groups between 18 and 70 years. Facial skin elasticity (which yields information regarding the feel of skin) will be measured by a device that is placed against the skin and applies suction for 18 seconds. When the suction stops, the device measures how the skin recovers and this provides information regarding the skin's elastic recovery (or feel). Measurements will be made at three locations - forehead, cheek and chin. The results will be analyzed to determine whether skin elasticity is different based on race, age and facial location. Also, a statistical procedure (clustering analysis) will analyze the data to identify certain skin elastic properties that characterize the group of human subjects included in this study. This information is critical for future research designed to improve polymers (plastics) and additives that will better replicate the appearance and feel of human facial skin.
Relevance of Proposed Research to Veterans Healthcare Issues OEF/OIF veterans are returning with disfiguring head injuries caused by explosions, and older veterans undergo disfiguring surgery to treat head and neck cancer. Both groups require facial prostheses to correct these defects. Facial prostheses are critical for elevating self esteem and integrating the veteran back into society. This research will measure facial skin flexibility to provide baseline information critical for developing new facial prosthetic materials that are both life-like and durable. This fully supports RR&D's stated purpose of sponsoring research that "maximizes functional recovery." The project has strong implications for translation into clinical practice through prosthetics, and it focuses on reintegrating veterans into all facets of civilian life. These objectives match those stated by RR&D as being key goals of this funding award.