title: Monitoring the healing of combat wounds using Raman spectroscopic mapping.
abstract: Soldiers wounded in modern warfare present with extensive and complicated acute wounds, confounded by an overwhelming inflammatory response. The pathophysiology of acute wounds is unknown and timing of wound closure remains subjective. Collagen gene expression profiles are presented for 24 patients. Impaired healing wounds showed a twofold decrease in the up-regulation of COL1A1 and COL3A1 genes in the beginning of the wound healing process, compared with normal healing wounds. By the final debridement, however, collagen gene expression profiles for normal and impaired healing wounds were similar for COL1A1 and COL3A1. In addition, Raman spectroscopic maps were collected of biopsy tissue sections, from the first and last debridements of 10 wounds collected from nine patients. Tissue components obtained for the debridement biopsies were compared to elucidate whether or not a wound healed normally. Raman spectroscopy showed a loss of collagen in five patients, indicated by a negative percent difference in the 1,665/1,445 cm(-1) band area ratios. Four healed patients showed an increased or unchanged collagen content. Here, we demonstrate the potential of Raman spectroscopic analysis of wound biopsies for classification of wounds as normal or impaired healing. Raman spectroscopy has the potential to noninvasively monitor collagen deposition in the wound bed, during surgical wound debridements, to help determine the optimal time for wound closure.
authors.affiliation: Regenerative Medicine Department, Combat Casualty Care, Operational and Undersea Medicine, Naval Medical Research Center, Silver Spring, Maryland 20910, USA.
authors.forename: Nicole J
authors.initials: NJ
authors.lastname: Crane
authors.forename: Trevor S
authors.initials: TS
authors.lastname: Brown
authors.forename: Korboi N
authors.initials: KN
authors.lastname: Evans
authors.forename: Jason S
authors.initials: JS
authors.lastname: Hawksworth
authors.forename: Sean
authors.initials: S
authors.lastname: Hussey
authors.forename: Doug K
authors.initials: DK
authors.lastname: Tadaki
authors.forename: Eric A
authors.initials: EA
authors.lastname: Elster
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D001706:Biopsy; D024042:Collagen Type I / Q000502:physiology; D000090602:Collagen Type I, alpha 1 Chain; D024061:Collagen Type III / Q000502:physiology; D003646:Debridement; D005109:Extracellular Matrix / Q000502:physiology; D005260:Female; D005786:Gene Expression Regulation / Q000502:physiology; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D008889:Military Personnel; D015999:Multivariate Analysis; D013059:Spectrum Analysis, Raman / Q000379:methods*; D018709:Statistics, Nonparametric; D014481:United States; D015854:Up-Regulation / Q000502:physiology; D014857:Warfare; D014945:Wound Healing / Q000502:physiology*; D014950:Wounds, Penetrating / Q000145:classification / Q000473:pathology* / Q000503:physiopathology* / Q000628:therapy
chemical_list: C439971:COL3A1 protein, human; D024042:Collagen Type I; D000090602:Collagen Type I, alpha 1 Chain; D024061:Collagen Type III