Evaluation of a Novel Three-Dimensional Wound Measurement Device for Assessment of Diabetic Foot Ulcers

Guilherme Pena; Beatrice Kuang; Zygmunt Szpak; Prue Cowled; Joseph Dawson; Robert Fitridge

doi:10.1089/wound.2019.0965

Evaluation of a Novel Three-Dimensional Wound Measurement Device for Assessment of Diabetic Foot Ulcers

Adv Wound Care (New Rochelle). 2020 Nov;9(11):623-631. doi: 10.1089/wound.2019.0965. Epub 2019 Oct 23.

Authors

Guilherme Pena^{1

2}, Beatrice Kuang^{1

2}, Zygmunt Szpak³, Prue Cowled², Joseph Dawson^{1

2}, Robert Fitridge^{1

2}

Affiliations

¹ Department of Vascular and Endovascular Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
² Discipline of Surgery, The University of Adelaide, Adelaide, South Australia, Australia.
³ School of Computer Science, Australian Institute for Machine Learning, The University of Adelaide, Adelaide, South Australia, Australia.

Abstract

Objective: The initial wound measurement and regular monitoring of diabetic foot ulcers (DFU) is critical to assess treatment response. There is no standardized, universally accepted, quick, reliable, and quantitative assessment method to characterize DFU. To address this need, a novel topographic imaging system has been developed. Our study aims at assessing the reliability and practicality of the WoundVue^® camera technology in the assessment of DFU. Approach: The WoundVue system is a prototype device. It consists of two infrared cameras and an infrared projector, and it is able to produce a three-dimensional (3D) reconstruction of the wound structure. Fifty-seven diabetic foot wounds from patients seen in a multidisciplinary foot clinic were photographed from two different angles and distances by using the WoundVue camera. Wound area, volume, and maximum depth were measured for assessment of reliability. Thirty-one of these wounds also had area calculated by using the established Visitrak™ system, and a correlation between the area obtained by using both systems was assessed. Results: WoundVue images analysis showed excellent agreement for area (intraclass correlation coefficient [ICC]: 0.995), volume (ICC: 0.988), and maximum depth (ICC: 0.984). Good agreement was found for area measurement by using the WoundVue camera and Visitrak system (ICC: 0.842). The average percentage differences between measures obtained by using the WoundVue from different angles for assessment of different sizes and shapes of wounds were 2.9% (95% confidence interval [CI]: 0.3-5.4), 12.9% (95% CI: 9.6-35.7), and 6.2% (95% CI: 2.3-14.7) for area, maximum depth, and volume, respectively. Innovation: This is the first human trial evaluating this novel 3D wound measurement device. Conclusion: The WoundVue system is capable of recreating a 3D model of DFU and produces consistent data. Digital images are ideal for monitoring wounds over time, and the WoundVue camera has the potential to be a valuable adjunct in diabetic foot wound care.

Keywords: chronic wounds; devices; diabetes.

Publication types

Evaluation Study

MeSH terms

Diabetic Foot / diagnostic imaging
Diabetic Foot / pathology*
Humans
Imaging, Three-Dimensional / instrumentation*
Imaging, Three-Dimensional / standards*
Photogrammetry / instrumentation*
Photogrammetry / standards*
Reproducibility of Results
Skin Physiological Phenomena
Wound Healing / physiology