Main Article Content
This comparative study aimed at comparing wound surface area measurement
methods between wound tracing and wound photography and using Visitrak™ as a
reference measurement device. Their sizes were measured using Photoshop CS3 Extended
and ImageJ by two different assessors for the comparison. The subjects were 45 open
wounds with no skin coverage, of patients who were treated at a tertiary hospital in
Bangkok from June 2013-September 2014. Data were analyzed using intraclass
correlation, Friedman’s test, and Wilcoxson matched-pair signed-ranks test. The findings
showed that agreements of wound assessment by two assessors were high (ICC = .99-
1.00). The wound sizes from wound tracing and measuring with Photoshop CS3
Extended were not significantly different from those measured with Visitrak™, but were
smaller than those measured with ImageJ. Both Photoshop CS3 Extended and ImageJ
measured wound sizes from photography smaller than those measured from wound
tracing. However, in small-sized wounds assessed from photographs, the wound sizes
measured with Photoshop CS3 Extended were not different from those measured with
ImageJ, and those from wound tracing measured with Visitrak.™ The results of this
study suggest that, for accurate area measurement, wounds should be assessed with
photography and measured with Photoshop CS3 Extended.
Keywords: Wound size, Wound tracing, Wound photograph, Photoshop CS3 Extended,
บทความ ข้อมูล เนื้อหา รูปภาพ ฯลฯ ที่ได้รับการตีพิมพ์ในรามาธิบดีพยาบาลสาร ถือเป็นลิขสิทธิ์ของวารสาร หากบุคคลหรือหน่วยงานใดต้องการนำทั้งหมดหรือส่วนหนึ่งส่วนใดไปเผยแพร่หรือเพื่อกระทำการใด ใด จะต้องได้รับอนุญาตเป็นลายลักษณ์อักษรจากรามาธิบดีพยาบาลสารก่อนเท่านั้น
technique. Arch Phys Med Rehabil. 2006;87:1396-1402.
2. Sheehan P, Jones P, Caselli A, Giurini J, Veves A. Percent change in wound area of diabetic foot ulcers over a 4-week period is a robust predictor of complete healing in a 12 week prospective trial. Diabetes Care. 2003;26(6):1879-
3. Hammond CE. The ARANZ Medical SilhouetteTM: an innovative wound measurement and documentation
system. Acute Care Perspectives. 2008; Summer:12-5.
4. Little C, McDonald J, Jenkins MG, McCorron P. An overview of techniques used to measure wound area and
volume. J Wound Care. 2009;18(16):250-3.
5. Shaw J, Hughes CM, Lagan KM. An evaluation of three wound measurement techniques in diabetic foot wounds.
Diabetes Care. 2007;30(10):2641-2.
6. Chang AC, Dearman B, Greenwood JE. A comparison of wound area measurement techniques: Visitrak versus
photography. EPlasty. 2011;11:158-66.
7. Li PN, Li H, Wu ML, Wang SY, Kong QY, Zhen Z. et al. A cost-effective transparency-based digital imaging
for efficient and accurate wound area measurement. PLoS One. 2012;7(5):e38069. doi:10.1371/journal.pone.
8. Junorn T, Kanogsunthorntrat N, Orathai P. Validity of wound surface area measurement methods. Rama Nurs J.
2014;20(3):314-23. (in Thai)
9. Sugama J, Matsui Y, Sanada H, Konya C, Okuwa M,Kitagawa A. A study of the efficiency and convenience of
an advanced portable wound measurement system (VisitrakTM). J Clin Nurs. 2007;16:1265-9.
10. Faul F, Erdfelder E, Lang AG, Buchner A. Power 3: a flexible statistical power analysis program for the social,
behavioral, and biomedical science. Behav Res Methods. 2007;39(2):175-91.
11. van Zuijlen, PPM, Angeles AP, Suijker MHK Reis RW,Middelkoop E. Reliability and accuracy of practical
techniques for surface area measurements of wounds and scars. Int J Low Extrem Wounds.2004;3(1):7–11.
12. Portney LG, Watkins MP. Foundations of clinical research:applications to practice. 3rd ed. Upper Saddle River:
Pearson/Prentice Hall; 2015.
13. Harris-Love MO, Seamon BA, Teixeira C, Ismail C.Ultrasound estimates of muscle quality in older adults:
reliability and comparison of Photoshop and Image J for the grayscale analysis of muscle echogenicity. Peer J.
2016;4:e1721. doi:10.7717/ peerj.1721.
14. Stockton KA, McMillian CM, Storey KJ, David MC,Kimble RM. 3D photography is as accurate as digital
plainmetry tracing in determining burn wound area. Burns.2015;41:80-4.
15. Bhedi A , Saxena AK Gadani R, Patel R. Digital photography and transparency-based methods for
measuring wound surface area. Indian J Surg.2013;75(2):111–14. doi:10.1007/s12262-012-0422-y
16. Tang XN, Berman AE, Swanson RA, Yenari MA. Digitally quantifying cerebral hemorrhage using Photoshop and
Image J. J. Neurosci. Methods. 2010;190(2):240–3.