Yan Wang1, Guanjian Liu, Nanbing Yuan, Xingwu Ran. 1. Diabetic Foot Care Center, Department of Endocrinology, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P. R. China.
Abstract
OBJECTIVE: To assess the reliability of diabetic cutaneous ulcer surface area (DCUSA) measurement using digital planimetry method (A) and transparency tracing method (B). METHODS: Images of diabetic cutaneous ulcers from 35 inpatients with diabetic skin ulcers from September 2005 to April 2007 were taken by a digital camera once a week or twice a week over a period of 12 weeks, resulting in 305 photographs; the ulcers were traced on a grid with acetate wound tracings, simultaneously. A total of 305 pairs of DCUSA which were calculated respectively throughout digital camera combined with Image J medical imaging software and transparency tracing with grid sheet by two independent observers sequentially were obtained. The intraclass correlation coefficients (ICCs, one-way random effect model) was used as an indicator of chance-corrected agreement to estimate the relative reliability for the interobserver data. Multiple linear regression analysis was also used to measure the relationship of these two methods. RESULTS: DCUSA obtained from method A and obtained from method B was (4.84 +/- 7.73) cm2 and (5.03 +/- 7.89) cm2, respectively; no significant difference was found (P > 0.05). ICCs was high (ICCs = 0.949 for method B and 0.965 for method A), indicating that the relative reliability for the interobserver was excellent. The method A were highly correlated with measurements obtained from method B (r = 0.957, P < 0.05). CONCLUSION: The digital planimetry method described in this study represents a simple, practical, without any wound damage and contamination, and inexpensive technique to accurately evaluate the areas of diabetic cutaneous ulcers. The photographic technique combined with Image J medical imaging software should be considered for wound measurement.
OBJECTIVE: To assess the reliability of diabetic cutaneous ulcer surface area (DCUSA) measurement using digital planimetry method (A) and transparency tracing method (B). METHODS: Images of diabetic cutaneous ulcers from 35 inpatients with diabetic skin ulcers from September 2005 to April 2007 were taken by a digital camera once a week or twice a week over a period of 12 weeks, resulting in 305 photographs; the ulcers were traced on a grid with acetate wound tracings, simultaneously. A total of 305 pairs of DCUSA which were calculated respectively throughout digital camera combined with Image J medical imaging software and transparency tracing with grid sheet by two independent observers sequentially were obtained. The intraclass correlation coefficients (ICCs, one-way random effect model) was used as an indicator of chance-corrected agreement to estimate the relative reliability for the interobserver data. Multiple linear regression analysis was also used to measure the relationship of these two methods. RESULTS: DCUSA obtained from method A and obtained from method B was (4.84 +/- 7.73) cm2 and (5.03 +/- 7.89) cm2, respectively; no significant difference was found (P > 0.05). ICCs was high (ICCs = 0.949 for method B and 0.965 for method A), indicating that the relative reliability for the interobserver was excellent. The method A were highly correlated with measurements obtained from method B (r = 0.957, P < 0.05). CONCLUSION: The digital planimetry method described in this study represents a simple, practical, without any wound damage and contamination, and inexpensive technique to accurately evaluate the areas of diabetic cutaneous ulcers. The photographic technique combined with Image J medical imaging software should be considered for wound measurement.