Wound Measurement Methods in wound care - wound clinic

wound measurement method

1. Wound Measurement Methods (based on review entitled ‘Methods to assess area and volume of wounds – a systematic review’ by Line Bisgaard Jørgensen1, Jens A Sørensen2, Gregor BE Jemec3 & Knud B Yderstræde1 - 2015 Presented By ; Dr Rabiatul Adawiyah Hasnan Medical Officer, Wound Care Unit, Hospital Putrajaya

2. Reasons to measure wounds Monitor healing progress Monitor rate of healing Can predict which wounds are unlikely to heal with conventional treatment Can help set wound care goals Monitor effectiveness of treatment Identify delayed healing/static wounds and prompt reassessment of the patient Provide positive feedback to the patient, helping with motivation and concordance

3. Methods of Wound Measurement simple ruler method mathematical models manual planimetry digital planimetry SPG digital imaging

4. simple ruler method consists of multiplying the greatest length and width of the wound to determine the surface area low cost method and easy to use However, it is accurate only in perfectly rectangular wounds and does not take into account wound irregularities. It is thus likely to overestimate the area. Rogers et al. found that the simple ruler method overestimated the wound area by an average of 41% compared with digital planimetry. Similarly, Shetty et al. reported 29–43% overestimation by the simple ruler method compared with manual planimetry.

5. Mathematical Models based on the assumption that most wounds are spherical or elliptical in nature, and the area can therefore be calculated using standard mathematical formula. The most common approach is the elliptical method, in which the area is calculated by multiplying 𝜋 (𝜋 =3⋅14) by the shortest and longest radii of the wound. mathematical models are fast, easy to use and non-invasive, but inaccurate in wounds with an irregular shape.

6. Planimetric measurement can be manual or electronic In the manual method , a transparent film is placed on top of the wound and the margin of the wound is traced with a pen. The tracing is subsequently placed on a metric grid and wound area is determined by counting the number of squares in the grid covered by the traced area. In digital planimetry , the margin of the wound is retraced onto a tablet computer that performs the same calculations Manual planimetric methods are relatively easy to learn and are accurate and reliable. A drawback is the need for contact with the wound, which carries a risk of contamination. Digital planimetry is slightly more accurate and reliable than manual planimetry

7. Stereophotogrammetry Anon-contact method in which a stereographical camera linked to a computer captures an image of the wound . The image is downloaded to the computer, and the wound perimeter is simply traced by moving the cursor on the monitor. The computer software calculates the wound area, length and width . Wound size can be measured in both two and three dimensions SPG method is an accurate, non-contact method , which reduces the risk of wound contamination, but it is also time-consuming and expensive .

8. wound measurement with a three-camera vision system The stereoscopic light method takes multiple photos at the same angle and under different lighting conditions to reconstruct a 3D model. The simplest stereoscopic light method uses three light sources to illuminate the object in three different directions, opening only one light source at a time. It uses three comprehensive photos and the perfect diffuse to work out the gradient on the surface of the object. Then the 3D model is obtained after integrating the vector field

9. Digital Imaging In the digital imaging method, an image of the wound is captured and transferred to a computer. The margin of the wound is traced on the screen using a pointing device and the software uses a scale near the wound on the photo to estimate the area. i.e ARANZ Medical silhouette https://youtu.be/_7tiDPwJM3A digital imaging is a non-contact method that is equally accurate and reliable as planimetric methods. However, it is also time-consuming and can be affected by the illumination, location and size of the wound.

10. CONCLUSION Wound measurement methods need to be accurate, reliable and feasible if they are to be useful in evaluating the wound healing process. It is recommended to use digital planimetry or digital imaging if measurement accuracy is required (e.g. for a clinical trial), but the methods can also be time-consuming for everyday clinical practice. When requiring a fast method ( i.e for daily clinical works), simple area measurement method for circumferential wounds is recommended. Methods that measure wound volume have the potential to assess wound healing using all the dimensions of a wound and are therefore useful for large and deep wounds. However, volume measurement techniques are not yet sufficiently validated, and further studies are needed to confirm their accuracy and reliability

11. Tips for measuring wounds Ensure the patient is in the same position each time Use the same method for each re-measurement; Methods are not interchangeable Include a ruler in any photograph to give perspective and try to ensure the same distance on each subsequent photograph Measure separately any areas of devitalised tissue, bone, tendon, etc , within the wound bed; these can be marked on a tracing.