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使用计算机辅助方法在门诊诊所进行基于图像的伤口面积自动评估:一项开发与验证研究。

Automated Image-Based Wound Area Assessment in Outpatient Clinics Using Computer-Aided Methods: A Development and Validation Study.

作者信息

Li Kuan-Chen, Lee Ying-Han, Lin Yu-Hsien

机构信息

Division of Plastic Surgery, Department of Surgery, Shin Kong Wu Ho-Su Memorial Hospital, No. 95, Wenchang Road, Shilin District, Taipei 111, Taiwan.

Department of General Medicine, Shin Kong Wu Ho-Su Memorial Hospital, No. 95, Wenchang Road, Shilin District, Taipei 111, Taiwan.

出版信息

Medicina (Kaunas). 2025 Jun 17;61(6):1099. doi: 10.3390/medicina61061099.


DOI:10.3390/medicina61061099
PMID:40572787
Abstract

Traditionally, we evaluate the size of a wound by using Opsite Flexigrid transparent film dressing, placing it over the wound, tracing the edges of the wound, and then calculating the area. However, this method is both time-consuming and subjective, often leading to varying results depending on the individual performing the assessment. In this study, our goal is to provide an objective method to calculate the wound size and solve variations in photo-taking distance caused by different medical practitioners or at different times, as these can lead to inaccurate wound size assessments. To evaluate this, we employed K-means clustering and used a QR code as a reference to analyze images of the same wound captured at varying distances, objectively quantifying the areas of 40 wounds. This study aims to develop an objective method for calculating the wound size, addressing variations in photo-taking distance that occur across different medical personnel or time points-factors that can compromise measurement accuracy. By improving consistency and reducing the manual workload, this approach also seeks to enhance the efficiency of healthcare providers. We applied K-means clustering for wound segmentation and used a QR code as a spatial reference. Images of the same wounds taken at varying distances were analyzed, and the wound areas of 40 cases were objectively quantified. We employed K-means clustering and used a QR code as a reference to analyze wound photos taken by different medical practitioners in the outpatient consulting room. K-means clustering is a machine learning algorithm that segments the wound region by grouping pixels in an image according to their color similarity. It organizes data points into clusters based on shared features. Based on this algorithm, we can use it to identify the wound region and determine its pixel area. We also used a QR code as a reference because of its unique graphical pattern. We used the printed QR code on the patient's identification sticker as a reference for length. By calculating the ratio of the number of pixels within the square area of the QR code to its actual area, we applied this ratio to the detected wound pixel area, enabling us to calculate the wound's actual size. The printed patient identification stickers were all uniform in size and format, allowing us to apply this method consistently to every patient. The results support the accuracy of our algorithm when tested on a standard one-cent coin. The paired -test comparing the first and second photos shot yielded a -value of 0.370, indicating no significant difference between the two. Similarly, the -test comparing the first and third photos shot produced a -value of 0.179, also showing no significant difference. The comparison between the second and third photos shot resulted in a -value of 0.547, again indicating no significant difference. Since all -values are greater than 0.05, none of the test pairs show statistically significant differences. These findings suggest that the three randomly taken photo shots produce consistent results and can be considered equivalent. Our algorithm for wound area assessment is highly reliable, interchangeable, and consistently produces accurate results. This objective and practical method can aid clinical decision-making by tracking wound progression over time.

摘要

传统上,我们通过使用Opsite Flexigrid透明薄膜敷料来评估伤口大小,将其覆盖在伤口上,描绘伤口边缘,然后计算面积。然而,这种方法既耗时又主观,常常因进行评估的个体不同而导致结果各异。在本研究中,我们的目标是提供一种客观的方法来计算伤口大小,并解决不同医生或在不同时间拍摄距离不同所导致的问题,因为这些因素可能导致伤口大小评估不准确。为了对此进行评估,我们采用了K均值聚类,并使用二维码作为参考来分析在不同距离拍摄的同一伤口的图像,客观地量化了40个伤口的面积。本研究旨在开发一种客观的伤口大小计算方法,解决不同医务人员或时间点出现的拍摄距离差异问题——这些因素可能影响测量准确性。通过提高一致性并减少人工工作量,这种方法还旨在提高医护人员的效率。我们将K均值聚类应用于伤口分割,并使用二维码作为空间参考。分析了在不同距离拍摄的同一伤口的图像,客观地量化了40例患者的伤口面积。我们采用K均值聚类并使用二维码作为参考,分析门诊咨询室中不同医生拍摄的伤口照片。K均值聚类是一种机器学习算法,通过根据图像中像素的颜色相似性对像素进行分组来分割伤口区域。它根据共享特征将数据点组织成簇。基于该算法,我们可以用它来识别伤口区域并确定其像素面积。我们还使用二维码作为参考,因为它具有独特的图形模式。我们将患者识别标签上打印的二维码用作长度参考。通过计算二维码正方形区域内像素数量与其实际面积的比值,并将该比值应用于检测到的伤口像素面积,我们能够计算出伤口的实际大小。打印的患者识别标签在尺寸和格式上都是统一的,这使我们能够将此方法一致地应用于每个患者。在标准的一分硬币上进行测试时,结果支持了我们算法的准确性。比较第一次和第二次拍摄照片的配对t检验得出的t值为0.370,表明两者之间无显著差异。同样地,比较第一次和第三次拍摄照片的t检验得出的t值为0.179,也表明无显著差异。第二次和第三次拍摄照片的比较结果得出的t值为0.547,再次表明无显著差异。由于所有t值均大于0.05,所有测试对均未显示出统计学上的显著差异。这些发现表明,随机拍摄的三张照片产生了一致的结果,可以认为是等效的。我们用于伤口面积评估的算法高度可靠、可互换,并且始终能产生准确的结果。这种客观实用的方法可以通过跟踪伤口随时间的进展来辅助临床决策。

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本文引用的文献

[1]
Non-invasive techniques for wound assessment: A comprehensive review.

Int Wound J. 2024-11

[2]
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BMC Med Res Methodol. 2024-9-16

[3]
A QR code-enabled framework for fast biomedical image processing in medical diagnosis using deep learning.

BMC Med Imaging. 2024-8-1

[4]
Evaluation of a Semi-Automated Wound-Halving Algorithm for Split-Wound Design Studies: A Step towards Enhanced Wound-Healing Assessment.

J Clin Med. 2024-6-20

[5]
Usability and outcomes of self-monitored surgical wound healing using a smartphone-based application by patients following neurosurgery.

J Hosp Infect. 2024-6

[6]
Implementation of a patient-centered remote wound monitoring system for management of diabetic foot ulcers.

Front Endocrinol (Lausanne). 2023

[7]
AI-Assisted Assessment of Wound Tissue with Automatic Color and Measurement Calibration on Images Taken with a Smartphone.

Healthcare (Basel). 2023-1-16

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Wound Image Quality From a Mobile Health Tool for Home-Based Chronic Wound Management With Real-Time Quality Feedback: Randomized Feasibility Study.

JMIR Mhealth Uhealth. 2021-7-30

[9]
The UTrack framework for segmenting and measuring dermatological ulcers through telemedicine.

Comput Biol Med. 2021-7

[10]
Technical and Medical Aspects of Burn Size Assessment and Documentation.

Medicina (Kaunas). 2021-3-5

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