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Oral Abstracts (Session 5 of 5)
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(Presentation 33.5) Wounds measured from digital photographs using photo-digital planimetry software: validation and rater reliability Oscar Alvarez, PhD, Martin Wendelken, RN, DPM; Lee Markowitz, DPM; Linda Waltrous, RN, BSN, Wound Care Program, Calvary Hospital, Bronx, NY The standard wound measurement technique for calculating wound surface area (wound tracing) was compared to a new wound measurement method using digital photographs and digital planimetry software* (photo-digital planimetry, PDP). Thirty-six wounds of varying etiologies were measured and traced by 5 experienced examiners (raters). Simultaneously, digital photographs were also taken of each wound. The digital photographs were downloaded onto a PC, and using PDP, the wounds were measured and traced by the same examiners. Accuracy and intrarater and interrater reliability of wound measurements obtained from tracings and from PDP were studied and compared. Both accuracy and rater variability were directly related to wound size when wounds were measured and traced in the traditional manner. In small (< 4cm2), regularly shaped (round or oval) wounds, accuracy and rater reliability were 98% and 95%, respectively. However, in larger, irregularly shaped wounds, or wounds with epithelial islands, traditional measuring was significantly less accurate than PDP (16.2% versus 3.9% average error, P < 0.05). The mean inter-rater reliability score was 79.7% for traditional measuring and 92.1% for PDP. 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 (zoom) of the wound and better visibility of advancing epithelium. Wound measurement performed on digital photographs using planimetry software was simple and convenient. It was more accurate and objective and resulted in better correlation within and between examiners. With this software, wounds may be archived and studied serially. Wound measurement data can be retrieved easily and exported to other software programs, such as Microsoft® Excel or Word for analysis and tabulation. *PictZarTM-CDM, BioVisual Technologies, LLC, Engelwood, NJ |
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