Simulated Wound Assessment Using Digital Planimetry versus Three-Dimensional Cameras: Implications for Clinical Assessment.
BACKGROUND
Clinical management of wounds can benefit from objective measures of response to treatment. Wound surface area and volume are objective measures of wound healing. Using a synthetic wound model, we compare the accuracy and reproducibility of 2 commercially available 3-dimensional (3D) cameras against planimetry and water displacement.


METHODS
Twelve ulcers of various sizes and colors were reproduced in modeling clay and cured. Five naive observers used digital planimetry, water displacement, Eykona camera (Fuel 3D, UK), and Silhouette camera (ARANZ, New Zealand) to measure the wounds.


RESULTS
When compared with traditional planimetry, wound surface area measurement with Eykona and Silhouette tended to underestimate wounds by 1.7% and 3.7%, respectively. Spearman correlation coefficients were 0.94 (Eykona) and 0.92 (Silhouette). Intraclass correlations for planimetry and the 2 cameras were all 1. Eykona and Silhouette tended to underestimate wound volumes when compared with water displacement by 58% and 23%, respectively. Spearman correlation coefficients were 0.92 (Eykona) and 0.72 (Silhouette). Intraclass correlations for water displacement and the two cameras were all 1.


CONCLUSIONS
Serial accurate objective area measurements are feasible as part of ongoing clinical assessment of wounds. 3D cameras are reliable but have not shown superior accuracy to manual planimetry, and financial concerns and IT integration may limit general clinical usage. Volume measurements of wounds are practicable as part of clinical care.
Section of Surgery, Charing Cross Hospital, Imperial College London, London, UK.
Katherine J
KJ
Williams
Section of Surgery, Charing Cross Hospital, Imperial College London, London, UK.
Viknesh
V
Sounderajah
Section of Surgery, Charing Cross Hospital, Imperial College London, London, UK.
Brahman
B
Dharmarajah
Section of Surgery, Charing Cross Hospital, Imperial College London, London, UK.
Ankur
A
Thapar
Section of Surgery, Charing Cross Hospital, Imperial College London, London, UK. Electronic address: a.h.davies@imperial.ac.uk.
Alun H
AH
Davies
D005240:Feasibility Studies; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008953:Models, Anatomic; D015588:Observer Variation; D010781:Photography / Q000379:methods*; D011237:Predictive Value of Tests; D016628:Replica Techniques; D012883:Skin Ulcer / Q000473:pathology / Q000628:therapy*; D016896:Treatment Outcome; D014945:Wound Healing