A novel and accurate technique of photographic wound measurement

Integrating Point-of-Care Bacterial Fluorescence Imaging-Guided Care with Continued Wound Measurement for Enhanced Wound Area Reduction Monitoring

AIM

This prospective observational study investigated wound area reduction (WAR) outcomes in a complex wound population composed of non-healing acute and chronic wounds. The relationship between bacterial autofluorescence signals and WAR was investigated. Area measurements were collected both manually and digitally, and both methods were compared for accuracy.

METHODS

Twenty-six participants with 27 wounds of varying etiologies were observed twice weekly for two weeks. Digital wound measurement, wound bacterial status assessment, and targeted debridement were performed through a point-of-care fluorescence imaging device (MolecuLight® i: X, MolecuLight Inc, Toronto, Canada). The wound area reduction (WAR) rate was calculated using baseline and last visit measurements. Statistical analyses, including t-tests, Fisher exact tests, the Wilcoxon signed rank test for method comparison, and ANOVA for bacterial subgroups, were applied as pertinent.

RESULTS

The overall average WAR was -3.80 cm2, or a decrease of 46.88% (manual measurement), and -2.62 cm2, or a 46.05% decrease (digital measurement via MolecuLight® device). There were no statistically significant differences between the WAR of acute and chronic wounds (p = 0.7877). A stepwise correlation between the WAR and bacterial status classification per fluorescence findings was observed, where persistent bacteria resulted in worse WAR outcomes. An overestimation of wound area by manual measurement was 23% on average.

CONCLUSION

Fluorescence imaging signals were linked to WAR outcome and could be considered predictive. Wounds exhibiting bacterial loads that persisted at the end of the study period had worse WAR outcomes, while those for which management was able to effectively remove them demonstrated greater WAR. Manual measurement of the wound area consistently overestimated wound size when compared to digital measurement. However, if performed by the same operator, the overestimation was uniform enough that the WAR was calculated to be close to accurate. Notwithstanding, single wound measurements are likely to result in overestimation.

The importance of length and area estimate for forensic medicine without using a measurement tool

Background/aim

Accurately measuring and recording the length or area of lesions affects the judgement of the forensic report, surgical wound management and, in some countries, the billing of health care services. The aim of this study was to determine whether the length and area of lesions described by physicians by estimation are accurate.

Materials and methods

This study was designed as a cross-sectional descriptive study and was conducted with 494 participants consisting of internists and physicians at Ondokuz Mayıs University, Faculty of Medicine. The participants were asked to estimate the lengths or areas of 6 different shapes in the questionnaire form without using a measuring instrument.

Results

Of the participants, 216 (43.7%) were interned physicians and 278 (56.3%) were physicians. Most 122 people (24.7%) answered the curved line shape with a length of 4 cm as "exact value". The average of the values given by the internists to each shape was higher than the average of the values given by the physicians to each shape and was found to be further away from the true value. It was determined that more than half of the participants gave values above the actual length and area values of the shapes. It was observed that the rate of correct estimation of line shapes was higher than the rate of correct estimation of area shapes both as exact values and with ±10% margin of error. For line shapes, it was observed that the number of those who gave exact values decreased as the line length increased.

Conclusion

When preparing forensic reports, determining surgical wound management and billing, estimated data should not be used in lesion description. It would also be useful to develop tools that will enable physicians to make measurements in terms of easy use.

Estimation of wound surface area: an evaluation of medical professionals' assessment in a plastic surgery unit

The percentage of skin graft take following the resurfacing of burn injuries is routinely calculated in a subjective fashion, in order to make management decisions. Given the gravity of decisions made based on this clinical assessment of graft check, it is notable that limited research has been carried out on this subject. No standardised subjective assessment tools exist to measure surface area of graft take in a manner similar to that of Wallace's Rule of Nines or Lund and Browder. This study set out to examine the accuracy of visual assessments of graft take within the multidisciplinary team regularly making assessments of newly grafted burn wounds. A total of 15 digitally drawn images were used to assess 36 staff members' estimations of percentage of surface area. The results showed a wide variation in estimation in all staff types, including senior burns surgeons, who were found to underestimate surface area by as much as 30%. The British Burns Association has removed 'healing time' as an outcome measurement from its guidance, as it recognises how hard it is to make a standardised assessment of wound healing. This study demonstrates the difficulty in subjectively assessing surface area and makes some suggestions for further research and clinical applications of technology to aid assessment.

Comparison of Digital Planimetry and Ruler Methods for the Measurement of Extraction Socket Wounds

Background and objectives: The purpose of the study was to evaluate and compare ruler and digital planimetry methods to measure extraction socket wounds. Materials and Methods: In total, 41 extraction socket wounds were selected for assessment of wound area by ruler and digital planimetry methods. In the simple ruler method, the periodontal probe was utilized to measure the length and breadth of the extraction wound, whereas in the digital planimetry technique, Pictzar software was used. Data were analyzed using R software version 4.1.1 and Excel. For intergroup comparisons of wound surface area, Welch t-tests were used, and paired t-tests were used for intragroup comparisons. Intra-class correlation coefficients (ICC) and 95% confidence intervals (CIs) were used to evaluate the inter-method reliabilities of surface area. Results: Both ruler and digital planimetry techniques showed post-operative reductions in surface area. A significant difference was reported between the two techniques; however, the ruler method measurements were overestimated compared to those obtained with digital planimetry. Conclusions: This study concludes that digital planimetry techniques provide more accurate results when compared with the simple ruler method.

A clinimetric assessment of the validity and reliability of 3D technology for scar surface area measurement

INTRODUCTION

The quality of scars has become an important outcome of burn care. Objective scar assessment through scar surface area measurement enables quantification of scar formation and evaluation of treatment efficacy. 3D technology has proven valid and reliable but often remains cumbersome, expensive, and time-consuming. 3D technology with depth sensors on mobile devices has become available and might surpass these limitations. This study provides a clinimetric assessment of the validity and reliability of a 3D system with a depth sensor for scar surface area measurement.

METHODS

A technology involving a depth sensor mounted on a mobile device was used. Images and analyses were made with a custom-made software application. A standardized one-keyframe image capturing procedure was followed. To assess validity, stickers with predefined dimensions (8.01 cm² - 77.70 cm²) were imaged in a single observer setting on various body parts of healthy volunteers. To assess reliability, hypertrophic scars, keloids, and normotrophic scars were imaged and rated by two observers independently. Data are expressed as mean (+/-SD), Coefficient of Variation (CV), Intraclass Correlation Coefficients (ICC), and Limits of Agreements (LoA).

RESULTS

Eighty stickers placed on 20 healthy volunteers showed validity with CV between 0.62%- 1.67% for observer A and 0.75%- 1.19% for observer B. For the reliability study, 69 scars on 36 patients were included. Mean scar surface area ranged from 0.83 cm² to 155.59 cm². Mean scar surface area measurement was 13.83 cm² (SD 23.06) for observer A and 13.59 cm² (SD 23.31) for observer B. Adjusted interobserver CV for trained observers is estimated as 5.59%, with corresponding LoA = 0 ± 0.15 x mean surface area. Interobserver ICCs were 0.99-1.00.

CONCLUSION

This 3D technology with a depth sensor for measuring scar surface area provides valid and reliable data and thereby surpasses expensive and time-consuming 3D cameras.

A Pilot Study to Explore a Correlation between Inflammatory Markers and the Wound Healing Rate in Diabetic Patients

Background and objectives: We examined whether there is a significant correlation between inflammatory markers and the wound healing rate (WHR) in diabetic patients. Materials and Methods: A total of 60 patients were divided into two groups depending on the completion of wound healing (WH) at 5 weeks: the early WH group (period of WH < 5 weeks; n = 27) and the late WH group (period of WH > 5 weeks; n = 33). The baseline characteristics and wound measurements were compared between the two groups. To identify the correlation between inflammatory markers (e.g., white blood cell counts (WBCs), serum C-reactive protein (CRP) levels and erythrocyte sedimentation rate (ESR)) and WHR, we performed a Pearson correlation analysis. Results: The WHR was 8.06 ± 4.02 mm2/day in the early WH group and 2.71 ± 0.88 mm2/day in the late group. This difference reached statistical significance (p < 0.001). Moreover, WBC counts were significantly higher and serum levels of CRP and ESR were significantly lower in the early WH group than in the late group (p = 0.027, 0.036 and 0.043, respectively). Conclusions: Our results indicate that WBC as well as serum CRP and ESR levels have a significant correlation with WHR in diabetic patients.

Software-Based Method for Automated Segmentation and Measurement of Wounds on Photographs Using Mask R-CNN: a Validation Study

In clinical routine, wound documentation is one of the most important contributing factors to treating patients with acute or chronic wounds. The wound documentation process is currently very time-consuming, often examiner-dependent, and therefore imprecise. This study aimed to validate a software-based method for automated segmentation and measurement of wounds on photographic images using the Mask R-CNN (Region-based Convolutional Neural Network). During the validation, five medical experts manually segmented an independent dataset with 35 wound photographs at two different points in time with an interval of 1 month. Simultaneously, the dataset was automatically segmented using the Mask R-CNN. Afterwards, the segmentation results were compared, and intra- and inter-rater analyses performed. In the statistical evaluation, an analysis of variance (ANOVA) was carried out and dice coefficients were calculated. The ANOVA showed no statistically significant differences throughout all raters and the network in the first segmentation round (F = 1.424 and p > 0.228) and the second segmentation round (F = 0.9969 and p > 0.411). The repeated measure analysis demonstrated no statistically significant differences in the segmentation quality of the medical experts over time (F = 6.05 and p > 0.09). However, a certain intra-rater variability was apparent, whereas the Mask R-CNN consistently provided identical segmentations regardless of the point in time. Using the software-based method for segmentation and measurement of wounds on photographs can accelerate the documentation process and improve the consistency of measured values while maintaining quality and precision.

Evaluation of three different techniques for measuring wound area in diabetic foot ulcers: a reproducibility study

OBJECTIVE

Wound surface area can be measured with several assessment tools, including a manual planimetric method, ImageJ software and three-dimensional wound measurement (3DWM) methods. This study aimed to determine the advantages of each method as well as the concordance between them.

METHOD

This reproducibility study included adult patient volunteers with diabetic foot ulcers (DFUs). Wounds with ambiguous borders were excluded. All included wounds were sequentially assessed with each of the three measurement methods, and the time for each measurement was recorded with a chronometer. SPSS and MedCalc package software were used for all statistical analyses.

RESULTS

A total of 20 patients with 20 DFUs took part in the study. According to the measurement method, the average wound area was 6.41cm² by the manual planimetric method, 6.53cm² by ImageJ and 6.32cm² by 3DWM. Correlation analyses revealed correlation coefficients of 0.997 between the manual planimetric method and ImageJ, 0.929 between the manual planimetric method and 3DWM, and 0.929 between ImageJ and 3DWM. Bland-Altman analysis was used to determine whether these three measurement methods could be used interchangeably. There was no significant difference between the three measurement methods and, therefore, it was concluded that they could be used interchangeably. Wound area measurement times were 173.35±19.38 seconds by the manual planimetric method, 61.60±9.21 seconds by ImageJ and 36.90±6.91 seconds by the 3DWM method.

CONCLUSION

The three measurement methods studied can be used interchangeably, as each method is highly concordant with the other two. The fastest method was 3DWM and the manual planimetric method was the slowest.

The UTrack framework for segmenting and measuring dermatological ulcers through telemedicine

Chronic dermatological ulcers cause great discomfort to patients, and while monitoring the size of wounds over time provides significant clues about the healing evolution and the clinical condition of patients, the lack of practical applications in existing studies impairs users' access to appropriate treatment and diagnosis methods. We propose the UTrack framework to help with the acquisition of photos, the segmentation and measurement of wounds, the storage of photos and symptoms, and the visualization of the evolution of ulcer healing. UTrack-App is a mobile app for the framework, which processes images taken by standard mobile device cameras without specialized equipment and stores all data locally. The user manually delineates the regions of the wound and the measurement object, and the tool uses the proposed UTrack-Seg segmentation method to segment them. UTrack-App also allows users to manually input a unit of measurement (centimeter or inch) in the image to improve the wound area estimation. Experiments show that UTrack-Seg outperforms its state-of-the-art competitors in ulcer segmentation tasks, improving F-Measure by up to 82.5% when compared to superpixel-based approaches and up to 19% when compared to Deep Learning ones. The method is unsupervised, and it semi-automatically segments real-world images with 0.9 of F-Measure, on average. The automatic measurement outperformed the manual process in three out of five different rulers. UTrack-App takes at most 30 s to perform all evaluation steps over high-resolution images, thus being well-suited to analyze ulcers using standard mobile devices.

Diabetic foot ulcer care: a concept analysis of the term integrated into nursing practice

BACKGROUND

Diabetic foot ulcer care demonstrates a beneficial approach to overcoming problems in patients with diabetes. This approach is frequently given but is not always successfully implemented due to its fragmentation amid healthcare providers. What's more, there are a number of different understandings, interchangeable languages and an absence of uniformity overlapping terminologies of meaning for diabetic foot ulcer care. Therefore, analysing the concept of diabetic foot ulcer care is important to provide a wider nursing knowledge, synthesise a greater theoretical model and drive more effective care of diabetic foot ulcer.

OBJECTIVE

This article aimed to analyse how the concept of diabetic foot ulcer care is clearly defined in the relevant evidence as it has several implications in nursing practice.

METHOD

Walker and Avant's (1995) method of concept analysis was systematically used in this study.

FINDINGS

Three critical attributes of diabetic foot ulcer care were determined consisting of assessment, intervention and evaluation. Constructed cases are also presented to differentiate the concept of diabetic foot ulcer care from other concepts. This concept analysis results in the critical attributes of diabetic foot ulcer care, defines an operational definition and describes common goals that improve clarity, consistency and understanding of the concept amid healthcare professionals along with researchers.

CONCLUSION

Effective implementation of the concept of DFU care into clinical nursing practice may undoubtedly improve patient outcomes and prevent the complexities of DFU in the years to come. Future research needs to be developed for evaluating the current use of this concept.

ImageJ: A Free, Easy, and Reliable Method to Measure Leg Ulcers Using Digital Pictures

Wound measurement to document the healing course of chronic leg ulcers has an important role in the management of these patients. Digital cameras in smartphones are readily available and easy to use, and taking pictures of wounds is becoming a routine in specialized departments. Analyzing digital pictures with appropriate software provides clinicians a quick, clean, and easy-to-use tool for measuring wound area. A set of 25 digital pictures of plain foot and leg ulcers was the basis of this study. Photographs were taken placing a ruler next to the wound in parallel with the healthy skin with the iPhone 6S (Apple Inc, Cupertino, CA), which has a camera of 12 megapixels using the flash. The digital photographs were visualized with ImageJ 1.45s freeware (National Institutes of Health, Rockville, MD; http://imagej.net/ImageJ ). Wound area measurement was carried out by 4 raters: head of the department, wound care nurse, physician, and medical student. We assessed intra- and interrater reliability using the interclass correlation coefficient. To determine intraobserver reliability, 2 of the raters repeated the measurement of the set 1 week after the first reading. The interrater model displayed an interclass correlation coefficient of 0.99 with 95% confidence interval of 0.999 to 1.000, showing excellent reliability. The intrarater model of both examiners showed excellent reliability. In conclusion, analyzing digital images of leg ulcers with ImageJ estimates wound area with excellent reliability. This method provides a free, rapid, and accurate way to measure wounds and could routinely be used to document wound healing in daily clinical practice.

Using AutoCAD software to measure venous leg ulcers: a reproducibility assessment study

OBJECTIVE

To assess the reproducibility of using AutoCAD software to measure the area of venous leg ulcers (VLUs).

METHOD

Data from patients with VLUs were collected between March and July 2015, using data collection forms and photographing the different ulcers. A researcher and five nurses collected the data. The wounds were measured using AutoCAD software. Data were analysed using intraclass correlation coefficient (ICC), concordance correlation coefficient (CCC) and Bland-Altman analysis.

RESULTS

A total of 21 patients with 36 VLUs were included in the study. A statistically significant difference (p<0.05) was observed between the areas of VLUs measured by the researcher and the evaluators. There was an excellent agreement when analysing the ICC [p=0.98; 95% CI (0.97-0.99); p <0.05] and the CCC [CCC=CI 0.97; 95% (0.95-0.98)]. There was no difference between the measurements of VLUs ≤10 cm² (p=0.49) and those with an area >10cm² (p=0.22).

CONCLUSION

The use of AutoCAD software is appropriate for measuring VLUs and appears to be more accurate when used to measure VLUs with an area >10cm².

Quantitative image analysis of the shape and size of circular wound sites generated by vertically stamped scratches

A protocol for quantitative image analysis of wound generation is important to better understand the integrative process of wound healing and the closure mechanism. Here, we present a method for quantitative analysis of microscopic images of circular wound sites generated by vertically stamped scratches. To demonstrate proof-of-concept validation, we used two types of mechanical stamping tools, a mechanical pencil lead (type 1; brittle) and polydimethylsiloxane (PDMS) pillars (type 2; ductile), to create circular wound sites. We also present a method for analysis of microscopic images of the generated wound sites by suggesting new parameters, such as controlled area transfer ratio, modified shape factor, and roundness index, specifically to investigate the shape and size of wounds via house-coded image processing. We believe that this approach can be potentially useful by providing a better way of studying vertical wound generation for future skin wound generation and care applications compared with its counterpart, conventional horizontal wound generation.

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.

DISCUSSION

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.

Nontraditional Methods to Evaluate Wound Healing

BACKGROUND

Traditional evaluation of wound healing is sometimes subjective. It is necessary to develop qualitative and quantitative methods to enable more efficient and accurate evaluation of wounds. Recently, new techniques have been introduced and the correspondence between these techniques and clinician judgment is critical.

OBJECTIVE

Some nontraditional techniques that analyze wound healing were reviewed, which include measurements of the wound area, tissue color, skin barrier function, skin humidity, and keratinocyte morphology.

METHODS

This review article is based on medical research that focuses on the evaluation of wound healing.

RESULTS

Software-based and advanced device-based techniques generally provide more accurate and precise results than traditional ones, such as the ruler-based technique. Measurement of tissue color can also help to identify the type of tissue. Evaluation of skin barrier function can assist clinicians to analyze functional restoration of skin, whereas skin humidity demonstrates the exudate production status of the wound. In addition, keratinocyte morphology in the wound bed indicates quality of wound healing and side effects of treatment.

CONCLUSION

There is no gold standard method for qualitative and quantitative evaluation of wound healing. It is important to understand the type of wound, sample size, results obtained, advantages, and limitations of each technique.

Three-dimensional imaging: a novel, valid, and reliable technique for measuring wound surface area

PURPOSE

The aim of this study was to investigate the validity and reliability of a novel three-dimensional imaging technique using Artec MHT^™ 3D Scanner for measuring the wound surface area.

METHODS

The validity was tested by measuring the surface area of 60 stickers (gold standard) on 20 volunteers. Stickers with standardized areas of 2590, 7875, and 15,540 mm² were applied on the thorax, forearm, and thigh, respectively. For the reliability test, 58 burn wounds on 48 patients were assessed twice by two different observers with the Artec MHT^™ 3D Scanner. Scanning, post-processing, and surface area measurements were performed by two clinicians.

RESULTS

The results for the validity analysis showed an intraclass correlation coefficient of 0.99 and coefficient of variation of the thorax, forearm, and thigh were 1.1%, 0.9%, and 0.6%, respectively. The reliability analysis showed an intraclass correlation coefficient of 0.99, a coefficient of variation of 6.3%, and limits of agreement between measurements of two observers were calculated at 0 ± 0.17 × mean surface area.

CONCLUSION

Three-dimensional imaging using the Artec MHT^™ 3D Scanner is a valid and reliable method for measuring the wound surface area.

Wound Area Measurement with Digital Planimetry: Improved Accuracy and Precision with Calibration Based on 2 Rulers

Introduction

In the treatment of chronic wounds the wound surface area change over time is useful parameter in assessment of the applied therapy plan. The more precise the method of wound area measurement the earlier may be identified and changed inappropriate treatment plan. Digital planimetry may be used in wound area measurement and therapy assessment when it is properly used, but the common problem is the camera lens orientation during the taking of a picture. The camera lens axis should be perpendicular to the wound plane, and if it is not, the measured area differ from the true area.

Results

Current study shows that the use of 2 rulers placed in parallel below and above the wound for the calibration increases on average 3.8 times the precision of area measurement in comparison to the measurement with one ruler used for calibration. The proposed procedure of calibration increases also 4 times accuracy of area measurement. It was also showed that wound area range and camera type do not influence the precision of area measurement with digital planimetry based on two ruler calibration, however the measurements based on smartphone camera were significantly less accurate than these based on D-SLR or compact cameras. Area measurement on flat surface was more precise with the digital planimetry with 2 rulers than performed with the Visitrak device, the Silhouette Mobile device or the AreaMe software-based method.

Conclusion

The calibration in digital planimetry with using 2 rulers remarkably increases precision and accuracy of measurement and therefore should be recommended instead of calibration based on single ruler.

Methods to assess area and volume of wounds - a systematic review

Wound measurement is important in monitoring the healing process of chronic wounds and in evaluating the effect of treatment. The objective of this systematic review was to evaluate evidence from the literature on accuracy, agreement, reliability and feasibility of wound measurement techniques described since 1994. Studies were identified by searching the electronic databases PubMed, Embase and Cochrane Library. Of the 12 013 studies identified, 43 were included in the review. A total of 30 papers evaluated techniques for measuring wound area and 13 evaluated techniques for measuring wound volume. The six approaches for measuring wound area were simple ruler method (10 papers), mathematical models (5 papers), manual planimetry (10 papers), digital planimetry (16 papers), stereophotogrammetry (2 papers) and digital imaging method (20 papers). Of these studies, 10 evaluated accuracy, 15 agreement, 17 reliability and 25 mentioned feasibility. The number of wounds examined in the studies was highly variable (n = 3-260). Studies evaluating techniques for measuring wound volume included between 1 and 50 wounds and evaluated accuracy (4 studies), agreement (6 studies), reliability (8 studies) and feasibility (12 studies). Digital planimetry and digital imaging were considered the most accurate and reliable methods for area measurement, particularly in larger and irregularly shaped wounds. None of the three-dimensional technologies have so far had a major impact, because of their low accuracy, high cost and complexity in handling the system set-up.

3D photography is as accurate as digital planimetry tracing in determining burn wound area

BACKGROUND

In the paediatric population careful attention needs to be made concerning techniques utilised for wound assessment to minimise discomfort and stress to the child.

AIM

To investigate whether 3D photography is a valid measure of burn wound area in children compared to the current clinical gold standard method of digital planimetry using Visitrak™.

METHOD

Twenty-five children presenting to the Stuart Pegg Paediatric Burn Centre for burn dressing change following acute burn injury were included in the study. Burn wound area measurement was undertaken using both digital planimetry (Visitrak™ system) and 3D camera analysis. Inter-rater reliability of the 3D camera software was determined by three investigators independently assessing the burn wound area.

RESULTS

A comparison of wound area was assessed using intraclass correlation co-efficients (ICC) which demonstrated excellent agreement 0.994 (CI 0.986, 0.997). Inter-rater reliability measured using ICC 0.989 (95% CI 0.979, 0.995) demonstrated excellent inter-rater reliability. Time taken to map the wound was significantly quicker using the camera at bedside compared to Visitrak™ 14.68 (7.00)s versus 36.84 (23.51)s (p<0.001). In contrast, analysing wound area was significantly quicker using the Visitrak™ tablet compared to Dermapix(®) software for the 3D Images 31.36 (19.67)s versus 179.48 (56.86)s (p<0.001).

CONCLUSION

This study demonstrates that images taken with the 3D LifeViz™ camera and assessed with Dermapix(®) software is a reliable method for wound area assessment in the acute paediatric burn setting.