Reliability of a Three-Dimensional Wound Camera and Correlation With Routine Ruler Measurement in Diabetes-Related Foot Ulceration

Abstract

Background: In an era of increasing technology and telehealth utilization, three-dimensional (3D) wound cameras promise reliable, rapid, and touch-free ulceration measurements. However, reliability data for commercially available devices in the diabetes foot service setting is lacking. We aimed to evaluate the reliability of diabetes-related foot ulceration measurement using a 3D wound camera in comparison to the routinely used ruler and probe. Method: Participants were prospectively recruited from a tertiary interdisciplinary diabetes foot service. Ulcerations were measured at each visit by two blinded observers, first by ruler and probe, and then using a 3D wound camera twice. Reliability was evaluated using intraclass correlation coefficients (ICC). Measurement methods were compared by Pearson correlation. Results: Sixty-three ulcerations affecting 38 participants were measured over 122 visits. Interobserver reliability of ruler measurement was excellent for estimated area (ICC 0.98, 95% CI 0.97-0.98) and depth (ICC 0.93, 95% CI 0.90-0.95). Intraobserver and interobserver reliability of the 3D wound camera area was excellent (ICC 0.96, 95%CI 0.95-0.97 and 0.97 95% CI 0.96-0.98, respectively). Depth was unrecordable in over half of 3D wound camera measurements, and reliability was inferior to probe measurement. Area correlation between methods was good ( R = 0.88 and 0.94 per observer); however, depth correlation was poor ( R = 0.49 and 0.65). Conclusions: 3D wound cameras offer practical advantages over ruler-based measurement. In diabetes-related foot ulceration, the reliability and comparability of area measurement was excellent across both methods, although depth was more reliably obtained by the probe. These limitations, together with cost, are important considerations if implementing this technology in diabetes foot care.

Assessment, management and prevention of chronic wounds in the Australian context: a scoping review

“…Studies assessing healing reported that: surface area change per day was superior to wound edge linear advancement 17 ; changes in ulcer area measured by thermal imaging correlated with healing by 12 weeks 18 ; and ulcer surface area, planimetry area and planar volume and curved volume were useful prognostic markers 19 20 . There was also good agreement between: a digital program and clinicians 21 ; 3-D cameras 22,23 ; and reproducibility of gait and plantar pressures 24 . However, inconsistent agreement between visual and objective periwound assessment was determined 25 .…”

The clinical value of intelligent wound measurement devices in patients with chronic wounds: A scoping review

“…A total of 2610 literatures were retrieved from the preliminary search. After step‐by‐step screening, 14 literatures 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 met the inclusion criteria. The literature screening process is shown in Figure 1 .…”

Reliability of a Three-Dimensional Wound Camera for Measurement of Diabetes-Related Foot Ulcers in a Clinical Setting

“…Using the ruler and probe, measurements of length (maximum diameter), width (perpendicular diameter), and maximum depth were obtained. Based on these measurements, surface area was calculated using the elliptical wound measurement method 1 and compared against the ARANZ SilhouetteStar values.…”

“…In clinical settings, diabetes-related foot ulcers (DFUs) have traditionally been measured using the ruler and probe 1 ; however, this method has poor inter- and intra-rater reliability between clinicians. 2 We aimed to evaluate the reliability of the ARANZ SilhouetteStar device (ARANZMedical Ltd, Merivale, Christchurch, New Zealand) in comparison to the traditional ruler and probe method in patients with DFU in a real-world clinical setting.…”