title: ﻿﻿﻿﻿﻿﻿﻿Wounds measured from digital photographs using photodigital planimetry software: validation and rater reliability.
abstract: ﻿﻿﻿﻿﻿﻿ 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).
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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. ﻿﻿﻿.
authors: ﻿Center for Curative and Palliative Wound Care, Calvary Hospital, Bronx NY; Email: drmew@optonline.net.
authors: Martin E
authors: ME
authors: Wendelken
authors: Center for Curative and Palliative Wound Care, Calvary Hospital, Bronx NY.
authors: William T
authors: WT
authors: Berg
authors: Center for Curative and Palliative Wound Care, Calvary Hospital, Bronx NY.
authors: Philip
authors: P
authors: Lichtenstein
authors: Center for Curative and Palliative Wound Care, Calvary Hospital, Bronx NY.
authors: Lee
authors: L
authors: Markowitz
authors: Center for Curative and Palliative Wound Care, Calvary Hospital, Bronx NY.
authors: Christopher
authors: C
authors: Comfort
authors: Center for Curative and Palliative Wound Care, Calvary Hospital, Bronx NY; Department of Medicine, New York Medical College, Valhalla, NY.
authors: Oscar M
authors: OM
authors: Alvarez