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.
