Research into the effect of impact force on the healing 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: Is there a relation between the healing process of the
bruise and the impact force that is used to create the bruise?

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 validate the model based on bruises that
where induced with different forces of impact. Based on previous results we
expect that skin type, thickness of the skin, location on the body, age of the
volunteer and the size of the bruise are able to influence the healing. The
size of the bruise can be influenced by the impact forces. Also thickness of
the skin can have an influence when force is applied on the skin.

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 made using the standard impact force, the other
bruise be applied using a higher or lower impact force. 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.
The total burden will be approximately 2 hours.