title: An assessment of the accuracy and usability of a novel optical wound measurement system.
abstract: OBJECTIVE
  Measurement of wound size can predict healing and provide information to guide treatment. This study assesses a novel optical wound imaging system that creates a three-dimensional image of the ulcer.
  
  
  METHODS
  Using a new camera-based digital system and traditional elliptical wound measurements, 36 foot ulcers from 31 patients (aged 44-94 years, median 70 years) were examined during a 12-week period at two centres. Median diabetes duration was 18 years (range 6-56 years). Seventeen percent had Type 1 diabetes, 93% had peripheral neuropathy and 57% had peripheral artery disease. Twenty-five were reviewed consecutively, resulting in 76 ulcer examinations. Median ulcer size was 94 mm(2), with size ranging from 3.1 to 2195 mm(2).
  
  
  RESULTS
  Pearson, Spearman and Kendall rank coefficients showed a strong correlation (in all cases P < 0.001) between digital measurements of wounds against traditional hand-measured estimates. Intra-observer variation of wound length using digital elliptical measurement (DEM) gave a coefficient of variation of < 3.0%. Interobserver variation of wound length using DEM was < 6.5%. Variation from a standard known-size wound area was < 8.0% across 30 trials.
  
  
  CONCLUSIONS
  This study shows a strong correlation between digital and traditional measurement techniques. The system can be easily deployed in routine clinical practice, providing an objective visual record, allowing remote in-depth analysis.
authors.affiliation: Manchester Diabetes Centre, Manchester, UK. frank.bowling@manchester.ac.uk
authors.forename: F L
authors.initials: FL
authors.lastname: Bowling
authors.forename: L
authors.initials: L
authors.lastname: King
authors.forename: H
authors.initials: H
authors.lastname: Fadavi
authors.forename: J A
authors.initials: JA
authors.lastname: Paterson
authors.forename: K
authors.initials: K
authors.lastname: Preece
authors.forename: R W
authors.initials: RW
authors.lastname: Daniel
authors.forename: D J
authors.initials: DJ
authors.lastname: Matthews
authors.forename: A J M
authors.initials: AJ
authors.lastname: Boulton
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology; D017719:Diabetic Foot / Q000503:physiopathology*; D003929:Diabetic Neuropathies / Q000503:physiopathology; D016523:Foot Ulcer / Q000473:pathology*; D006801:Humans; D008875:Middle Aged; D015588:Observer Variation; D010781:Photography / Q000379:methods*; D012016:Reference Values; D015203:Reproducibility of Results; D012815:Signal Processing, Computer-Assisted / Q000295:instrumentation*; D014945:Wound Healing / Q000502:physiology*; D014947:Wounds and Injuries / Q000473:pathology*