Department of Dermatology, Caen University Hospital, Caen, France.
Wound Repair Regen. 2010 Jan-Feb;18(1):13-20. doi: 10.1111/j.1524-475X.2009.00555.x.
The purpose of this study was to examine the intra- and interrater reliability of three methods to measure the percentage of fibrin within a wound, hence reflecting wound debridement. The three methods include visual assessment, a portable wound measurement system (PWMS) Visitrak(R), and a computerized planimetry software Canvas(R). The main objective was to compare the computerized planimetry with visual analysis. For each wound, a series of two repeated recordings of fibrin percentage based on the same Day 1 photograph at Day 8 and Day 15, respectively, was assessed by four evaluators using the two methods. Additional objectives consisted in the assessment of the inter-rater reliability of computerized planimetry and PWMS to assess fibrin percentage and total surface area. Twenty-four patients were included for a total of 31 wounds. Intraclass correlation coefficient revealed improved reproducibility and repeatability of computerized planimetry. The reproducibility of computerized planimetry was better than PWMS when measuring the percentage of fibrin and total wound area. Because average visual estimations were very close to the computerized planimetry, bedside evaluation of fibrin percentage and wound debridement was considered as reliable, and consequently a valid technique for daily practice. PWMS proved to be less convenient, owing to difficulties in identifying fibrin margins. The higher intra and interrater reliability of computerized planimetry probably reflected the fact that subjective clinical assessment and objective calculation of percentages were mandatory for correct wound evaluation. Therefore, digital image analysis was considered as an accurate method for double-blind and multicentric trials.
本研究旨在评估三种测量伤口内纤维蛋白百分比的方法（反映伤口清创程度）的组内和组间可靠性。这三种方法包括肉眼评估、便携式伤口测量系统（PWMS）Visitrak®和计算机化面积测定软件 Canvas®。主要目的是比较计算机化面积测定与肉眼分析。对于每个伤口，分别在第 8 天和第 15 天对同一第 1 天照片进行两次重复的纤维蛋白百分比记录，由四位评估员使用两种方法进行评估。次要目的是评估计算机化面积测定和 PWMS 评估纤维蛋白百分比和总表面积的组间可靠性。共纳入 24 例患者，总计 31 个伤口。组内相关系数显示，计算机化面积测定的重复性和可再现性得到了改善。当测量纤维蛋白百分比和总伤口面积时，计算机化面积测定的可再现性优于 PWMS。由于平均肉眼估计值非常接近计算机化面积测定，因此床边评估纤维蛋白百分比和伤口清创被认为是可靠的，并且是日常实践中的有效技术。PWMS 由于难以识别纤维蛋白边缘而证明不太方便。计算机化面积测定的组内和组间可靠性较高，可能反映了主观临床评估和客观百分比计算对于正确的伤口评估是强制性的事实。因此，数字图像分析被认为是双盲和多中心试验的一种准确方法。
