Wendelken Martin E, Berg William T, Lichtenstein Philip, Markowitz Lee, Comfort Christopher, Alvarez Oscar M
Center for Curative and Palliative Wound Care, Calvary Hospital, Bronx NY; Email:
Center for Curative and Palliative Wound Care, Calvary Hospital, Bronx NY.
Wounds. 2011 Sep;23(9):267-75.
Traditional wound tracing technique consists of tracing the perimeter of the wound on clear acetate with a fine-tip marker, then placing the tracing on graph paper and counting the grids to calculate the surface area. Standard wound measurement technique for calcu- lating wound surface area (wound tracing) was compared to a new wound measurement method using digital photo-planimetry software ([DPPS], PictZar® Digital Planimetry).
Two hundred wounds of varying etiologies were measured and traced by experienced exam- iners (raters). Simultaneously, digital photographs were also taken of each wound. The digital photographs were downloaded onto a PC, and using DPPS software, the wounds were measured and traced by the same examiners. Accuracy, intra- and interrater reliability of wound measurements obtained from tracings and from DPPS were studied and compared. Both accuracy and rater variability were directly related to wound size when wounds were measured and traced in the tradi- tional manner.
In small (< 4 cm2), regularly shaped (round or oval) wounds, both accuracy and rater reliability was 98% and 95%, respectively. However, in larger, irregularly shaped wounds or wounds with epithelial islands, DPPS was more accurate than traditional mea- suring (3.9% vs. 16.2% [average error]). The mean inter-rater reliabil- ity score was 94% for DPPS and 84% for traditional measuring. The mean intrarater reliability score was 98.3% for DPPS and 89.3% for traditional measuring. In contrast to traditional measurements, DPPS may provide a more objective assessment since it can be done by a technician who is blinded to the treatment plan. Planimetry of digital photographs allows for a closer examination (zoom) of the wound and better visibility of advancing epithelium.
Measurements of wounds performed on digital photographs using planimetry software were simple and convenient. It was more accurate, more objective, and resulted in better correlation within and between examiners. .
传统的伤口测量技术是用细尖记号笔在透明醋酸纤维纸上描绘伤口的周长，然后将描绘图放在方格纸上并计算方格数量以计算表面积。将用于计算伤口表面积的标准伤口测量技术（伤口描绘）与使用数字照片平面测量软件（[DPPS]，PictZar®数字平面测量）的新伤口测量方法进行了比较。
由经验丰富的检查人员（评分者）对200个病因各异的伤口进行测量和描绘。同时，也为每个伤口拍摄数字照片。将数字照片下载到个人电脑上，使用DPPS软件，由相同的检查人员对伤口进行测量和描绘。研究并比较了从描绘图和DPPS获得的伤口测量的准确性、评分者内和评分者间的可靠性。当以传统方式对伤口进行测量和描绘时，准确性和评分者变异性都与伤口大小直接相关。
在小的（<4平方厘米）、形状规则（圆形或椭圆形）的伤口中，准确性和评分者可靠性分别为98%和95%。然而，在较大的、形状不规则的伤口或有上皮岛的伤口中，DPPS比传统测量更准确（平均误差分别为3.9%和16.2%）。DPPS的评分者间可靠性平均得分为94%，传统测量为84%。DPPS的评分者内可靠性平均得分为98.3%，传统测量为89.3%。与传统测量相比，DPPS可能提供更客观的评估，因为它可以由对治疗方案不知情的技术人员进行。数字照片的平面测量允许对伤口进行更仔细的检查（放大），并能更好地观察上皮的进展情况。
使用平面测量软件对数字照片上的伤口进行测量简单方便。它更准确、更客观，并且在检查人员内部和之间产生更好的相关性。
