Reliability and Accuracy of Wound Surface Measurement Using Mobile Technology

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Aim: To evaluate the accuracy and reliability of the mobile application + WoundDesk, used for the measurement of wound surface, compared with a reference method, the digital planimetry. 

Context: The evolution of the wound surface over the time is good predictive factor for wound healing. Wound surface measurement is a part of the wound treatment and should be regularly performed. Most of the time wound surface is not measured because the available methods are time consuming, or correlated with a high infectious risk. The camera integrated in mobile phone can be used as a non-contact and quick method to measure wound surface.  

Design: A comparative non-randomized study. 

Method: 30 wounds have been measured using the mobile application +WoundDesk by three different raters, and the results have been compared with the measures made by digital planimetry. The repeatability has been measured using the inter-rater and intra-rater reliability, the accuracy using the Pearson correlation coefficient. The standard error of measurement (SEM) was used to assess the accuracy of measurements. To fully appreciate the correlation between the 2 techniques, the graphical method of Bland and Altman was used. 

Results: The intra-rater correlation was excellent with an ICC at 0.99. Inter-examiner correlation is also excellent with ICC values 0.98 (CI 0.96 0.98). The correlation was also excellent with a Pearson coefficient (r) 0.99 (p < 0.001). Compared to the reference measurement, +WoundDesk measures realize an overestimation of 13% (IC 1-35) of the surface. 

Conclusion: The mobile technology used in the application +WoundDesk is easy to use and quick. The wound surface measurements performed with the mobile application +WoundDesk are reliable, repeatable and reproducible. The accuracy is good for small irregular wounds. The limit of the method is related to the form of the wound. By large rectangular wound the accuracy decreases. Further big scales studies are needed to confirm the first conclusions.