title: 3D finite compartment modeling of formation and healing of bruises may identify methods for age determination of bruises.
abstract: Simulating the spatial and temporal behavior of bruises may identify methods that allow accurate age determination of bruises to assess child abuse. We developed a numerical 3D model to simulate the spatial kinetics of hemoglobin and bilirubin during the formation and healing of bruises. Using this model, we studied how skin thickness, bruise diameter and diffusivities affect the formation and healing of circular symmetric bruises and compared a simulated bruise with a natural inhomogeneous bruise. Healing is faster for smaller bruises in thinner and less dense skin. The simulated and natural bruises showed similar spatial and temporal dynamics. The different spatio-temporal dynamics of hemoglobin and bilirubin allows age determination of model bruises. Combining our model predictions with individual natural bruises may allow optimizing our model parameters. It may particularly identify methods for more accurate age determination than currently possible to aid the assessment of child abuse.
authors.affiliation: Biomedical Engineering and Physics, Academic Medical Centre, Amsterdam, The Netherlands. b.stam@amc.nl
authors.forename: Barbara
authors.initials: B
authors.lastname: Stam
authors.forename: Martin J C
authors.initials: MJ
authors.lastname: van Gemert
authors.forename: Ton G
authors.initials: TG
authors.lastname: van Leeuwen
authors.forename: Maurice C G
authors.initials: MC
authors.lastname: Aalders
mesh_terms: D001663:Bilirubin / Q000097:blood; D002648:Child; D002649:Child Abuse / Q000175:diagnosis*; D003288:Contusions / Q000175:diagnosis* / Q000209:etiology; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D008954:Models, Biological; D010781:Photography; D013997:Time Factors; D014945:Wound Healing / Q000502:physiology*
chemical_list: D006454:Hemoglobins; D001663:Bilirubin