Background Numerous patients suffer from chronic wounds and wound infections nowadays. Until now, the care for wounds after surgery still remain a tedious and challenging work for the medical personnel and patients. As a result, with the help of the hand-held mobile devices, there is high demand for the development of a series of algorithms and related methods for wound infection early detection and wound self monitoring. Methods This research proposed an automated way to perform (1) wound image segmentation and (2) wound infection assessment after surgical operations. The first part describes an edge-based self-adaptive threshold detection image segmentation method to exclude nonwounded areas from the original images. The second part describes a wound infection assessment method based on machine learning approach. In this method, the extraction of feature points from the suture area and an optimal clustering method based on unimodal Rosin threshold algorithm that divides feature points into clusters are introduced. These clusters are then merged into several regions of interest (ROIs), each of which is regarded as a suture site. Notably, a support vector machine (SVM) can automatically interpret infections on these detected suture site. Results For (1) wound image segmentation, boundary-based evaluation were applied on 100 images with gold standard set up by three physicians. Overall, it achieves 76.44% true positive rate and 89.04% accuracy value. For (2) wound infection assessment, the results from a retrospective study using confirmed wound pictures from three physicians for the following four symptoms are presented: (1) Swelling, (2) Granulation, (3) Infection, and (4) Tissue Necrosis. Through cross-validation of 134 wound images, for anomaly detection, our classifiers achieved 87.31% accuracy value; for symptom assessment, our classifiers achieved 83.58% accuracy value. Conclusions This augmentation mechanism has been demonstrated reliable enough to reduce the need for face-to-face diagnoses. To facilitate the use of this method and analytical framework, an automatic wound interpretation app and an accompanying website were developed. Trial registration 201505164RIND , 201803108RSB .

The importance of effective surgical wound care cannot never be underestimated. Poorly managing surgical wounds may cause many serious complications. Thus, it raises the necessity to develop a patient-friendly self-care system which can help both patients and medical professionals to ensure the state of the surgical wounds without any special medical equipment. In this paper, a surgical wound assessment system for self-care is proposed. The proposed system is designed to enable patients capture surgical wound images of themselves by using a mobile device and upload these images for analysis. Combining image-processing and machine-learning techniques, the proposed method is composed of four phases. First, images are segmented into superpixels where each superpixel contains the pixels in the similar color distribution. Second, these superpixels corresponding to the skin are identified and the area of connected skin superpixels is derived. Third, surgical wounds will be extracted from this area based on the observation of the texture difference between skin and wounds. Lastly, state and symptoms of surgical wound will be assessed. Extensive experimental results are conducted. With the proposed method, more than 90% state assessment results are correct and more than 91% symptom assessment results consistent with the actual diagnosis. Moreover, case studies are provided to show the advantage and limitation of this system. These results show that this system could perform well in the practical self-care scenario.Index Terms-Artificial intelligence (AI), classification, health care service systems.

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