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Clinical Research Res.
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Experience with digital photograph planimetry (DPP) for wound measurement, quantitative wound assessment, and charting First Author: Paul Kogan Authors: Paul Kogan, Martin Wendelken, DPM, RN, Lee Markowitz, DPM, Linda Waltrous, RN, BSN, CWCN, Oscar M. Alvarez, PhD For decades, the gold standard for measuring wounds has been tracing and planimetry (tracing the perimeter of the wound on transparent acetate with a fine-tip marker, then calculating the surface area by counting grids manually, or with a digitized pad). A wound measurement method using DPP software* was compared to standard tracings (measured manually and with a digitized pad**) in more than 200 wounds of all shapes and sizes. Accuracy, intra-rater and inter-rater reliability of wound measurements obtained from tracings and from DPP were studied and compared. Both accuracy and rater variability was directly related to wound size and shape when wounds were traced in the traditional manner. In small (<4cm2), regularly shaped (round or oval) wounds both accuracy and rater reliability was 98¡Ó2% and 95¡Ó3.5% respectively with tracings (manual and digital pad) or PDP. However, in larger, irregularly shaped wounds, or wounds with epithelial islands, traditional and digital measurements were less accurate than PPD (8-45% standard error). The mean inter-rater reliability score was 80% for traditional measurements, 84% for digitized pad planimetry and 94% for PPD P<0.05). In addition to the obvious advantages (handling the tracing, and difficulty seeing the wound edges clearly), planimetry of digital photographs allows for a closer examination of the wound and better visability of advancing epithelium. It also permits accurate quantitation of other wound assessment parameters such as granulation, nonviable tissue, erythema and maceration. PPD was more accurate, more objective and resulted in better correlation within and between examiners. With PPD, wounds may be archived and studied serialy, plus wound measurement data can be exported to the chart or other software programs such as StatSoft, SPSS, Word or Excel for tabulation and analysis. *PictZarTM-CDM, BioVisual Technologies, LLC, Engelwood, NJ) **VisitrakTM Smith and Nephew Inc, Largo FL |
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