Developing clinical protocols for objective assessment of burn scars with optical coherence tomography

Yih Miin Liew

    Research output: ThesisDoctoral Thesis

    514 Downloads (Pure)

    Abstract

    [Truncated abstract] Abnormal scarring is a common pathological outcome after a burn injury. This scarring often causes cosmetic and functional problems for patients. Various scar management techniques have been developed in the past three decades for scar prevention and reduction. However, the efficacy of many of these techniques has not been sufficiently validated by large-scale controlled studies. This is due, in part, to a lack of suitable objective techniques to assess scar progression. The overarching goal of this thesis is to incorporate a 3D, micrometer-resolution biomedical imaging modality, known as optical coherence tomography (OCT), into clinical usage to improve the assessment of burn scars in vivo. The research reported in this thesis is divided into two areas: the mitigation of image artefacts; and the development of a means of vascular assessment. This thesis reports two types of image artefacts, referred to as morphological and intensity artefacts, which are induced by the tissue sample and are associated with non-contact skin imaging protocols (i.e. where the OCT light beam passes directly from air into the tissue, without any additional buffering media). These artefacts were demonstrated both in novel skin-mimicking phantoms and normal human skin in vivo. Imaging protocols were defined to mitigate these artefacts through the use of two refractive index-matching media (glycerol and ultrasound gel), and to quantify the impact of these techniques. Both media were shown to be effective in reducing image artefacts, improving the ability to visualise subsurface structures such as blood vessels, and reducing morphological distortions. We also found that these media induced a temporary thickening of the epidermis and, thus, would be inappropriate in studies focused on assessing epidermal thickness...
    Original languageEnglish
    QualificationDoctor of Philosophy
    Publication statusUnpublished - 2013

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