Hypertrophic scarring is a form of scar caused by injury to the deep layers of the skin. It is commonly seen in patients who are injured by burns. There is no proven effective standard treatment for this condition. This is largely secondary to lack of concise and object measurements of scar character. In the absence of measure scar changes, treatments cannot be appropriately tested and evaluated. In this project we outline a plan to develop a novel imaging device that has the potential to evaluate scar in a non- invasive manner. We then describe how we wil utilize these non-invasive methods to test whether pressure (a currently used treatment) effects scar character. This worked will be performed in an organized fashion with three arms.
Aim 1) Development of the system to quantify the extent of scar roughness using polarimetric and structured illumination techniques (SPOS - Spectro-Polarimetric Optical System);
Aim 2) Development of the swine model for hypertrophic scarring, controlling for wound size, severity, and depth;
and Aim 3) Quantification of the influence of two different pressures on phenotype and genotype of scars and correlate findings with SPOS and perfusion measurements. We expect that polarimetric and structural illumination measurements will correlate with histological, as well as perfusion and molecular findings. Hypertrophic scaring is still a poorly understood and devastating morbidity following injury, particularly thermal trauma with prevalence reported as high as 67%. Scar contractures can lead to significant reduction in function and inhibit patients from returning to work, participating in leisure activities and even render them unable to provide care for themselves. In addition these patients suffer great psycho-social setbacks due to their disfigured apearance. There is a continued ned for beter assessment techniques to diagnose and treat patients with scar. This is underscored by the fact that greater than 30% of the respondents to an American Burn Association Rehabilitation committee's survey on research needs in burn care indicate that scar management should be a priority. This project specifically focuses on addressing this clinical gap to provide a better tool for assessment and treatment development for patients with these lesions.

Public Health Relevance

The overall goal of the proposed research is to develop instrumentation and data processing algorithms to provide quantitative estimates of hypertrophic scar formation. Hypertrophic scarring is a form of scar caused by injury to the deep layers of the skin. It is commonly seen in patients who are injured by burns. There is no proven effective standard treatment for this condition. This is largely due to lack of concise and object measurements of scar character. We expect that this research will provide a means of predicting several variables of interest in scar formation including height, vascularity, and pigmentation, and will lead to improved clinical outcomes through elucidation of the etiology of scar formation and management of treatment.

Agency
National Institute of Health (NIH)
Institute
National Institute of Biomedical Imaging and Bioengineering (NIBIB)
Type
Academic Research Enhancement Awards (AREA) (R15)
Project #
1R15EB013439-01
Application #
8103423
Study Section
Medical Imaging Study Section (MEDI)
Program Officer
Erim, Zeynep
Project Start
2011-06-01
Project End
2013-09-30
Budget Start
2011-06-01
Budget End
2013-09-30
Support Year
1
Fiscal Year
2011
Total Cost
$359,107
Indirect Cost
Name
Catholic University of America
Department
Engineering (All Types)
Type
Schools of Engineering
DUNS #
041962788
City
Washington
State
DC
Country
United States
Zip Code
20064
Tejiram, Shawn; Zhang, Jenny; Travis, Taryn E et al. (2016) Compression therapy affects collagen type balance in hypertrophic scar. J Surg Res 201:299-305
Ghassemi, Pejhman; Moffatt, Lauren T; Shupp, Jeffrey W et al. (2016) A new approach for optical assessment of directional anisotropy in turbid media. J Biophotonics 9:100-8
Travis, Taryn E; Ghassemi, Pejhman; Ramella-Roman, Jessica C et al. (2015) A multimodal assessment of melanin and melanocyte activity in abnormally pigmented hypertrophic scar. J Burn Care Res 36:77-86
Travis, Taryn E; Mino, Matthew J; Moffatt, Lauren T et al. (2015) Biphasic presence of fibrocytes in a porcine hypertrophic scar model. J Burn Care Res 36:e125-35
Ghassemi, Pejhman; Shupp, Jeffrey W; Travis, Taryn E et al. (2015) A portable automatic pressure delivery system for scar compression therapy in large animals. Rev Sci Instrum 86:015101
Nguyen, Thu T A; Ramella-Roman, Jessica C; Moffatt, Lauren T et al. (2013) Novel application of a spatial frequency domain imaging system to determine signature spectral differences between infected and noninfected burn wounds. J Burn Care Res 34:44-50