Authors (including presenting author) :
Mak MY, Lo WS, Tam KYG, Po Y, Kng C
Affiliation :
Community Healthcare Services, Hong Kong East Cluster
Introduction :
In HKEC Community Healthcare Services (CHS), the yearly wound care deliverable is over 48,000 within which over 70% is chronic wounds. With the burden of chronic wounds continues to grow due to ageing and increasing incidence of chronic diseases, accurate wound measurement techniques will help monitoring of wound progress, evaluating the effect of care and facilitating tele-medicine which will indirectly help improving quality of care. Traditionally, nurses focus on paper ruler measurement techniques or photograph for wound documentation and communication. Measuring the wound area with the greatest head-to-toe length by the perpendicular greatest width using simple ruler is considered as an easy, practical and low cost method. However, it was accurate in rectangular wounds without irregularities and likely overestimates the area besides its poor inter-rater reliability. Recently, various 3D techniques for measuring wound area, volume, and classifying wound tissues has been proposed and made it possible to objectively tracking of wound healing process.
Objectives :
This study aimed to compare the difference between the ruler and 3D measurement on chronic wounds over time and to explore the feasibility of integrating the 3D technology with CMS documentation.
Methodology :
A prospective cohort design was adopted in CHS to monitor the chronic wound healing using the 3D wound camera and the simple ruler method at baseline, weeks 2, 4, 6, 8, 10 and 12. Compared with the 3D camera method, the averaged relative error for ruler distance and area measurement was assessed. One-way analysis of variance (ANOVA) was used to analyze the variance between two groups of measurement. In addition, the visual quality differences were used to compare the wound healing tracking for a 12-week duration.
Result & Outcome :
For wound distance and area measurement, a total of 36 randomly selected chronic wounds were included in the study, and 32 were followed for 12 weeks from July to November 2021. Results showed the ruler method has 14.77%, 18.05% and 47.9% relative errors for wound length, width and area measurement respectively. The repeated wound area measure analysis over time demonstrated no statistically significant differences in the ruler and 3D measurement method (F = 2.63 and p > .11). However, the wound healing tracking had an inconsistent and larger increase in ruler areas compared with 3D measurements over time. Conclusion: The finding highlights the potential benefit of 3D camera for monitoring chronic wound healing. With the increasing trend of using photograph for wound documentation in CMS and multidisciplinary communication, integrate the 3D measurement technology with hospital iPad device can facilitate remote wound monitoring and tele-medicine besides improving the consistency of measured values while maintaining quality of care. Further studies are required to explore the reliability and user acceptance of using the device across clinical settings.
