College of Medical Sciences, Department of Nursing, Nova Southeastern University, Ft Lauderdale, Florida, USA.
Adv Skin Wound Care. 2009 May;22(5):222-9. doi: 10.1097/01.ASW.0000350839.19477.ce.
Tracking wound size is an essential part of treatment. Because a wound's initial size may affect apparent healing rates, its surface area (S) and its surface area-to-perimeter (S/P) ratio are useful to document healing. Assessments of these parameters can be made by computerized planimetry of digital images using suitable software.
Because different caregivers often evaluate wounds and because measurement time is important, the objective of this study was to determine accuracy, repeatability, and measurement time of S and S/P from measurements of images recorded by digital photography.
Six wound images of various complexities with known areas were measured in triplicate by 20 senior nursing students during 2 sessions 1 week apart. Images included an ellipse, 2 traced venous ulcers, and photographs of a pressure, diabetic plantar, and venous ulcer. Area error was determined as the percentage difference between known and planimetry measured areas. Reliability was assessed from test-retest coefficient of variations (CV%) from which the smallest meaningful percentage change (SMPC) was determined.
Area errors (mean +/- SD) ranged from -2.95% +/- 7.01% to +2.32% +/- 6.04%. For well-defined image margins, area and S/P SMPC values were all less than 3.2%. For borders that were not as well defined, SMPCs were larger, ranging between 6.2% and 10.8%. Wound measurement time decreased from 93.4 +/- 35.1 seconds at session 1 to 67.7 +/- 24.4 at session 2 (P < .001).
: Results based on the specific software used and on the outcomes of the study group indicate that simple computer-based planimetry of digital images can provide rapid, accurate, and reliable estimates of wound area and S/P ratios.
跟踪伤口大小是治疗的重要组成部分。由于伤口的初始大小可能会影响明显的愈合速度，因此其表面积 (S) 和表面积与周长比 (S/P) 很有用，可用于记录愈合情况。这些参数的评估可以通过使用合适软件对数字图像进行计算机化的平面测量来完成。
由于不同的护理人员经常评估伤口，并且测量时间很重要，因此本研究的目的是确定通过数字摄影记录的图像测量时 S 和 S/P 的准确性、可重复性和测量时间。
在两次间隔一周的会议上，由 20 名高级护理学生对具有已知面积的 6 个复杂程度不同的伤口图像进行了三次测量。图像包括一个椭圆、2 个追踪的静脉溃疡以及压力、糖尿病足底和静脉溃疡的照片。面积误差是通过比较已知面积和平面测量面积之间的百分比差异来确定的。可靠性是通过测试-再测试变异系数 (CV%) 来评估的，从中确定了最小有意义的百分比变化 (SMPC)。
面积误差（平均值 +/- SD）范围为 -2.95% +/- 7.01% 至 +2.32% +/- 6.04%。对于定义明确的图像边缘，面积和 S/P SMPC 值均小于 3.2%。对于定义不明确的边界，SMPC 值较大，范围在 6.2%至 10.8%之间。测量时间从第一次会议的 93.4 +/- 35.1 秒减少到第二次会议的 67.7 +/- 24.4 秒（P <.001）。
基于使用的特定软件和研究组的结果，简单的数字图像计算机化平面测量可以提供快速、准确、可靠的伤口面积和 S/P 比估计值。
