Research into the influence of blue light on the healing process of bruises using reflection spectroscopy.

Child abuse is a major problem that is more and more acknowledged by our
society. Research of the incidence of child abuse in the Netherlands in 2010
estimates more than 118.000 cases of child abuse among children in the age of 0
to 18 years old (3% of the total population).

Diagnosis of child abuse by a for example a pediatrician is based on certain
factors. One of these factors is the determining the presence of (multiple)
bruises. Knowledge on the age of the bruise can play a very important role in
the determination whether it is a case of abuse. At this moment in time it is
not possible to objectively and accurately determine the age of a bruise. To
make this possible in the future the department of Biomedical Engineering and
Physics is developing a reliable, patient friendly method for the age
determination of bruises.

Using a spectral camera they perform (non invasive) measurements on a bruise.
This camera measures the absorption of different colors of light and makes it
possible to determine the chemical information of the measured surface per
pixel. This makes it possible to detect the different components in a bruise
(hemoglobin, bilirubin) and determine the area where these components are
present in higher concentrations. For the age determination the change in size
of these areas is essential. Using the specially developed 3D model for the age
determination of bruises the age of the bruise can be determined based on the
size of the areas of hemoglobin and bilirubin.

Previous research: The basis of a similar technique lies in Norway, at
Trondheim University. There tests are performed on volunteers showing that it
is possible to determine the age of a bruise with an accuracy of 1 day.
Researchers in the department of Biomedical Engineering & Physics developed and
improved this method method with which they are able to determine the age of a
bruise with an accuracy of 3 hours.

Research question: Does illumination of the bruise using blue light have an
effect on the healing process?

To determine the accuracy and robustness of this method it is necessary to
validate it. In the past some successful studies have been performed in adult
volunteerd. However we would like to investigate the influence of induced
changes to the healing process. By this we mean that the healing process of the
bruise can be influenced by treating the bruise using methods which are said to
have a possitive or negative effect on the healing of the bruise.

On the internet there is a lot of speculation on the possitive effect of
exposing the bruise to sunlight or tanningbeds to break down the yellow pigment
bilirubine. This idea is based on a method that is applied in the medical field
for the treatment of neonates suffering jaundice. Using the light of a blue
lamp the excess of bilirubin in the skin is broken down and can than be
exported out of the system without hurting the infant. Because the effect of
blue light on the healing process is unclear and might have an influence on the
model for the age determination of bruises we would like to investigate this
into more depth.

In this study research will be performed on healthy volunteers. For every
participant we will make 2 bruises, 1 on each forearm, in a controlled manner.
One of these bruises will be illuminated multiple times during the healing
using a blue light, the other bruise will heal in a normal manner. The bruises
will be measured over time using a spectral camera to get a good insight of the
healing of the bruise

2 bruises will be inflicted. 1 on each forearm.
These bruises will be measured 10 times. Every measurement will take 5-10
minutes and will be spread over 2 weeks.

Furthermore the bruise will have to be illuminated for 7 minutes with a blue
light at the moments of the measurements.
The total burden will be approximately 2,5 hours.