Assessment Study Of Computer-aided Three-Dimensional Wound Evaluation System

BackgroundAccurate estimation of the burn area is crucial to on-site first aid,resuscitation,surgical options,nutritional support,wound care and prognosis.The widely used burn area estimation methods in clinical practice are ‘Lund & Browder chart’,‘Rule of Nines’ and ‘Rule of Palms’,which are two-dimensional evaluation methods,lacking age,sex,ethnicity,body mass,physical deformities,physiological status and other relevant influencing factors.Meanwhile,different assessors have subjective differences.These defects will impact on the diagnosis,treatment and prognosis.Our research group designed and developed a portable,efficient and accurate wound 3D scanning system,BurnCalc,which could establish 3D wound model individually,accurately and quickly calculate the human body surface area for wound model area and percentage evaluation.There is a lot of wound area evaluation technology in clinical practice.The wound tracing method and NIH ImageJ method were more commonly used by physicians.The wound tracing method is economic,convenient,intuitive,accurate and repeatable,but it must contact with the wound directly,which may increase the risk of pain and infection.NIH ImageJ method is quick,easy and non-contact with the wound,but there is a certain error with the use of it.On the basis of the original BurnCalc system,the hardware and software of the scanning system is further upgraded for WoundCleverCalc system.WoundCleverCalc avoid to contact with the wound directly.Furthermore,WoundCleverCalc is a 3D scanning system,which does not need a fixed height and angle.This research aimed to study WoundCleverCalc scanning system in measurement of burn wound area,chronic wound area and the application of the measurement of wound depth and volume.Part 1: Assessment Study of computer-aided Individual Three-dimensional BurnArea EvaluationObjective To validate WoundCleverCalc scanning system for burn area assessment.Methods First of all,wounds were measured by three physicians individually with WoundCleverCalc 3D body scanning system.Compare the difference between the data of three physicians to evaluate the stability of WoundCleverCalc scanning system.Secondly,by using the wound tracing method as the gold standard,wounds were measured and compared in three groups,each group has 12 cases.Each group is measured with the wound tracing method,NIH ImageJ method,and WoundCleverCalc method.Time required for those methods measuring wound was recorded and compared.Data were analyzed with the randomized block analysis of variance and Bonferroni test.Results 1.There is no statistical difference in the same wound area measured by three physicians.It is proved that WoundCleverCalc scanning system has high stability.2.There is no statistical difference in wound area of limbs measured with the wound tracing method and WoundCleverCalc scanning system.It is proved that WoundCleverCalc scanning system has good accuracy in the measurement of burn wound area.NIH ImageJ method has a good accuracy in the measurement of the front torso wound area,but it is less than that of the other two methods in the measurement of the extremity and side torso.3.The time required for WoundCleverCalc scanning system is significantly less than the time required for the wound tracing method.Part 2: Assessment Study of computer-aided Individual Three-dimensional Chronic Wound Area EvaluationObjective To verify the accuracy of WoundCleverCalc scanning system for the evaluation of chronic ulcer wound area.Methods According to the inclusion and exclusion criteria,30 cases of chronic ulcer wounds were included.By using the wound tracing method,NIH ImageJ method and WoundCleverCalc method,the area of chronic ulcer wound was measured.Verify the accuracy of WoundCleverCalc scanning system for the assessment of chronic ulcer wound area.Results The results show that there is no significant difference between the area of WoundCleverCalc scanning method and the other two methods.It is proved that WoundCleverCalc scanning system can measure chronic ulcer wound area accurately.Part 3: Assessment Study of computer-aided Individual Three-dimensional Wound depth and volume EvaluationObjective To evaluate the function of WoundCleverCalc system to calculate wound depth and volume.Methods 1.16 cylindrical wounds were made in the back of Bama miniature pig by using punch.Firstly,compare the difference between the depth of the WoundCleverCalc method and the method of ruler.Secondly,compare the difference between the volume of WoundCleverCalc method and filling method.To verify the accuracy for assessment of the wound depth and volume.2.Make 16 simulated wounds with plasticine.Compare the difference between the depth and volume measured by WoundCleverCalc method with the actual value.Verify the accuracy of the WoundCleverCalc system for measurement for the depth and volume of the wound model.Results The wound depth and volume calculated by WoundCleverCalc method is larger than real value.Conclusions1.WoundCleverCalc scanning system can accurately evaluate the area of burn wound and chronic ulcer wound.2.WoundCleverCalc scanning system has good stability.The time consumed by WoundCleverCalc method is shorter than that of the wound tracing method.3.The wound depth and volume calculated by WoundCleverCalc method is larger than real value.