Continuous, Portable, Non-Perfusion Based 'Short Wave Assessment Tool' (SWAT) Improves Burn Care

Ultimate Applicability of Research: We foresee this research improving the care of Soldiers, Veterans, and civilians with burn injuries. Through this proposal we will validate a novel point-of-care, portable imaging device that provides objective information about burn depth and guides more targeted treatments to improve patient outcomes. Currently, first responders and medical professionals lack an objective way to assess wounds and instead rely on subjective visual inspection, a measure that varies widely based on expertise. Through the creation of an analytic system to objectively evaluate burn injury based on tissue moisture, we can revolutionize the care of patients with burn injuries, improving their short-term outcomes and long-term function.

FY17 Topic Area: This proposal aligns with the need to support clinical research studies with the potential to have a major impact on the prevention, treatment, and mitigation of debilitating burn scars that are relevant to military personnel. The specific intent is to improve functional outcomes and/or assess clinical efficacy and safety of treatment modalities, e.g., photonics.

Current Standard of Care: Surgeon physical exam, which is only accurate 60% of the time.

Proposed Solution: Short Wave Assessment Tool (SWAT) creating objective measurement of viability based on tissue moisture, with accuracy greater than 90%.

Impact on Topic Area Addressed: The findings from this proposal will change the current paradigm for burn assessment through the development of a novel imaging device that can guide wound care and surgery by predicting the potential for delayed wound healing. Rather than depending on a medical provider's subjective visual assessment of a wound, we will validate a portable, easily deployed camera that provides objective information to guide clinical decisions and improve wound care.

Potential Clinical Applications, Benefits, and Risks: This small, portable, and durable camera can be used to provide a pre-operative assessment of burn wound depth to determine whether a wound requires surgical excision for proper healing. Once this determination is made, this same technology can be used intra-operatively to guide the extent of surgical intervention. Because our camera assesses tissue viability, we can also apply this technology to traumatic wounds, diabetic wounds, and spinal cord injury wounds, in addition to burn wounds. Because this is an external camera resembling a typical point-and-shoot camera, there is no risk associated with this technology. The benefits of this device include improved assessment of wounds, more directed wound care, and improved short-term wound healing and long-term functional outcomes. The outcomes of interest include improved time to wound closure and decreased wound failure and complications.

Projected Timeline: This project will be completed over the course of three years. During the first year, we will demonstrate that our short wave assessment tool is more accurate at assessing burn wound depth than currently available imaging technologies and surgeon assessment. During the second two years we will enroll burn patients at military (San Antonio Military Medical Center) and civilian (University of Michigan) burn centers and demonstrate the ability of our SWAT to improve patient outcomes including time to burn wound healing.

Benefit to Service Members and/or U.S. Veterans Who Sustained Burn Injuries, as well as Their Families, Caregivers, and the General Public: Given the large number of Wounded Warriors, Veterans, and civilians with burn injuries and a lack of accurate, objective modalities to guide care, a substantial need exists to improve and standardize burn wound depth analysis. Whereas other disease states such as cardiac disease and diabetes have objective criteria that guide treatment, burn care still depends on subjective decisions made by clinicians with differing opinions and expertise. We plan to change burn care by designing a device that can objectively assess the extent of a burn wound thus allowing for accurate and standardized pre-operative and intra-operative decisions. Specifically, patients with burn injuries often undergo unnecessary surgery for superficial wounds or develop wound complications as a result of incorrect assessment of the initial depth of tissue injury. Through validation of our camera device, we will provide clinicians and first responders with an objective tool to help guide decision-making and improve burn patient outcomes.