[A comparison of digital planimetry and transparency tracing based methods for measuring diabetic cutaneous ulcer surface area].
OBJECTIVE
To assess the reliability of diabetic cutaneous ulcer surface area (DCUSA) measurement using digital planimetry method (A) and transparency tracing method (B).


METHODS
Images of diabetic cutaneous ulcers from 35 inpatients with diabetic skin ulcers from September 2005 to April 2007 were taken by a digital camera once a week or twice a week over a period of 12 weeks, resulting in 305 photographs; the ulcers were traced on a grid with acetate wound tracings, simultaneously. A total of 305 pairs of DCUSA which were calculated respectively throughout digital camera combined with Image J medical imaging software and transparency tracing with grid sheet by two independent observers sequentially were obtained. The intraclass correlation coefficients (ICCs, one-way random effect model) was used as an indicator of chance-corrected agreement to estimate the relative reliability for the interobserver data. Multiple linear regression analysis was also used to measure the relationship of these two methods.


RESULTS
DCUSA obtained from method A and obtained from method B was (4.84 +/- 7.73) cm2 and (5.03 +/- 7.89) cm2, respectively; no significant difference was found (P > 0.05). ICCs was high (ICCs = 0.949 for method B and 0.965 for method A), indicating that the relative reliability for the interobserver was excellent. The method A were highly correlated with measurements obtained from method B (r = 0.957, P < 0.05).


CONCLUSIONS
The digital planimetry method described in this study represents a simple, practical, without any wound damage and contamination, and inexpensive technique to accurately evaluate the areas of diabetic cutaneous ulcers. The photographic technique combined with Image J medical imaging software should be considered for wound measurement.
Wang
Yan
Y
Diabetic Foot Care Center, Department of Endocrinology, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P. R. China.
Liu
Guanjian
G
Yuan
Nanbing
N
Ran
Xingwu
X
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017719:Diabetic Foot / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011856:Radiographic Image Enhancement / Q000379:methods; D012883:Skin Ulcer / Q000473:pathology*; D012984:Software