title: A study of the utility and equivalency of 2 methods of wound measurement: digitized tracing versus digital photography.
abstract: OBJECTIVE
  To examine agreement between digitized tracing and digital photography methods in measuring wound area and healing rate, and to compare and contrast the 2 methods on feasibility and utility in patient care and research settings.
  
  
  METHODS
  Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada.
  
  
  METHODS
  A total of 20 subjects aged 18 years or older with a spinal cord injury and pressure ulcers that were Stage II or higher, and who had received in- or outpatient wound care at the hospital for at least 3 consecutive weeks.
  
  
  METHODS
  Wound area was measured at weekly intervals. One assessor calculated wound area from a digitized tracing. A second assessor calculated wound area using a wound photograph. Both assessors used Image-J software. The 2 methods were compared for differences in weekly wound area and weekly healing rate.
  
  
  RESULTS
  Methods were different for wound area (P < .0001), whereas there was no difference between methods in weekly healing rate (P = .9429).
  
  
  CONCLUSIONS
  The 2 methods are in agreement on the important parameter of healing rate. Both methods are feasible in clinical settings. Wound photography may be more useful than digitized tracings because it simultaneously captures wound appearance.
authors.affiliation: Sharon Gabison, MSc, PT, is a Lecturer, Department of Physical Therapy, University of Toronto, Ontario, Canada. Colleen McGillivray, MD, FRCP(C), is Assistant Professor, Department of Medicine, University of Toronto, and Consultant, Physical Medicine and Rehabilitation, University Health Network-Toronto Rehab Lyndhurst, Spinal Cord Rehab Program, Toronto, Ontario, Canada. Sander L. Hitzig, PhD, is Senior Research Associate, University of Toronto, Faculty of Medicine, Institute for Life Course & Aging, Toronto, Ontario, Canada. Ethne Nussbaum, PhD, PT, is Adjunct Associate Professor, MClSC Program, School of Physical Therapy, Faculty of Health Sciences, Western University, London, Ontario, Canada. The authors have disclosed they have no financial relationships related to this article. Acknowledgment: This study was funded by the Ontario Neurotrauma Foundation. Travel support to Dr Nussbaum was provided by Mount Sinai Hospital, Toronto, Ontario, Canada. Additional support was provided by the Toronto Rehabilitation Institute, which receives funding under the Provincial Rehabilitation Research Program from the Ministry of Health and Long-Term Care in Ontario. The authors thank the patients, physicians, physical therapists, nurses, and occupational therapists at the Toronto Rehabilitation Institute for supporting this project. Submitted September 10, 2013; accepted in revised form December 16, 2013.
authors.forename: Sharon
authors.initials: S
authors.lastname: Gabison
authors.forename: Colleen
authors.initials: C
authors.lastname: McGillivray
authors.forename: Sander L
authors.initials: SL
authors.lastname: Hitzig
authors.forename: Ethne
authors.initials: E
authors.lastname: Nussbaum
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D010781:Photography; D003668:Pressure Ulcer / Q000000981:diagnostic imaging* / Q000209:etiology / Q000532:radiotherapy; D013119:Spinal Cord Injuries / Q000150:complications; D014467:Ultraviolet Therapy; D014945:Wound Healing