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Laboratory Research
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PDA-based, portable laser scanner measurement of wound size: accuracy and reproducibility Rachelle Salter, MBChB, BHB, Hamish Love, MBChB, BSc(hons), Mark Nixon, MBChB, Richard Fright, PhD(Eng) The accurate quantification of changes in the area and depth of chronic ulcers is an important part of the treatment process. While promising new technologies are being investigated, current methods usually rely on hand-tracing over onlay grids to estimate surface area, with probes inserted into the wound to estimate depth. These techniques are less than ideal due to their invasive nature and large inter- and intra-observer variability. A portable, hand-held laser scanner device has been developed for the assessment of chronic ulcers. The scanner consists of a wand containing two lasers and a camera; attached to a hand-held computer or personal digital assistant (PDA). Embedded software calculates the surface area and depth profile of the ulcer. This data is organized into a patient file containing clinical photos, graphs showing changes in ulcer surface area and depth over time, together with clinical notes This study was designed to assess the accuracy of the scanner and the inter- and intra-observer variability. Its usability in the clinical setting was also assessed. Vascular ulcer gel models were scanned by three practitioners. Measurements of area and depth obtained were compared to measurements obtained from multi-slice computed tomography (CT) three-dimensional reconstructions of the models and measurements performed using manual techniques. The laser scanner was accurate to within 2% in surface area and depth measurement compared with multi-slice CT. Overall accuracy, inter- and intra-observer variability was found to be significantly better than results found with manual techniques. This novel technology has significant promise in wound care management. Clinical trials are currently underway. Flanagan M. Improving accuracy of wound measurement in clinical practice. Ostomy Wound Manage. 2003;49(10):28Ð40 Goldman RJ, Salcido R. More than one way to measure a wound: an overview of tools and techniques. Adv Skin Wound Care. 2002;15:236Ð245. Johnson JD. Using ulcer surface area and volume to document wound size. J Am Podiatr Med Assoc. 1995;85(2):91Ð95. Jones TD, Plassmann P. An active contour model for measuring the area of leg ulcers. IEEE Trans Med Imaging. 2000;19(12):1202Ð1210 Langemo DK, Melland H, Hanson D, Olson B, Hunter S, Henly SJ. Two-dimensional wound measurement: comparison of 4 techniques. Adv Skin Wound Care. 1998;11(7):337Ð343 Marjanovic D, Dugdale RE, Vowden P, Vowden KR. Measurement of the volume of a leg ulcer using a laser scanner. Physiol Meas. 1998;19(4):535Ð543 Smith RB, Rogers B, Tolstykh GP, et al. Three-dimensional laser imaging system for measuring wound geometry. Lasers Surg Med. 1998;23(2):87Ð93. Thawer HA, Houghton PE, Woodbury G, Keast D, Campbell K. A comparison of computer-assisted and manual wound size measurement. Ostomy Wound Manage. 2002;48(10):46Ð53. |
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