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Comino F, Pollock PJ, Fulton I, Hewitt-Dedman C, Handel I, Gorvy DA. A novel tension relief technique to aid the primary closure of traumatic equine wounds under excessive tension. Equine Vet J 2024; 56:514-521. [PMID: 37559442 DOI: 10.1111/evj.13987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 07/20/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND To achieve an excellent functional and cosmetic result, primary closure is preferred over leaving wounds to heal by secondary intention. However, traumatic wounds are often under excessive tension during wound closure and incorrect suture technique can compromise microcirculation, leading to skin necrosis and impaired wound healing. OBJECTIVE To describe an inexpensive and effective tension relief technique that helps the successful primary closure of a variety of equine wounds at high risk of dehiscence. STUDY DESIGN Retrospective case series. METHODS All wounds that were managed with the Tension Tile System (TTS) at four Equine Hospitals between March 2017 and May 2021 were evaluated. The wounds were classified according to various criteria including anatomical location, time elapsed prior to surgery, depth of wound and post-surgical use of immobilisation. Outcome criteria were based on the success of primary intention healing. The duration of convalescence (weeks) after surgery was also recorded. RESULTS During the study period, the TTS was used in 191/860 (22%) wounds repaired under general anaesthesia or standing sedation. Overall, primary intention healing (Group A) was achieved in 132 of 191 cases (69%, CI 62%-75%), with partial dehiscence (Group B) in a further 30/191 cases (16%, CI 11%-22%). Severe dehiscence (Group C) was recorded in 29/191 cases (15%, CI 11%-21%). The median convalescence time was 4 weeks (Range 3-15, interquartile range 4-6) in Group A. MAIN LIMITATIONS Retrospective nature of the study and subjective outcome assessment. The technique was applied to wounds under significant tension; however, this was based on a subjective assessment by the surgeons involved. CONCLUSIONS The Tension Tile System is an economical and effective technique for challenging equine wounds under tension, in a variety of anatomical locations.
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Affiliation(s)
- Francesco Comino
- SLU University Animal Hospital (UDS), Equine Hospital, Uppsala, Sweden
| | - Patrick J Pollock
- The University of Edinburgh Royal (Dick) School of Veterinary Studies, Edinburgh, UK
| | - Ian Fulton
- Ballarat Veterinary Practice, Victoria, Australia
| | | | - Ian Handel
- The University of Edinburgh Royal (Dick) School of Veterinary Studies, Edinburgh, UK
| | - Dylan A Gorvy
- SLU University Animal Hospital (UDS), Equine Hospital, Uppsala, Sweden
- Mälaren Hästklinik, Sigtuna, Sweden
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Chang CW, Hsieh MC, Lin IW, Chen RF, Kuo YR, Lee SS. Accreditation of the handheld 3-dimensional scanner and conventional photo images for area measurement. Medicine (Baltimore) 2024; 103:e35376. [PMID: 38335411 PMCID: PMC10860941 DOI: 10.1097/md.0000000000035376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 07/05/2023] [Accepted: 09/04/2023] [Indexed: 02/12/2024] Open
Abstract
Accurate assessment of wound areas is crucial in making therapeutic decisions, as the prognosis and changes in the size of the wound over time play a significant role. An ideal assessment method should possess qualities such as speed, affordability, accuracy, user-friendliness for both patients and healthcare professionals, and suitability for daily clinical practice. This study aims to introduce a handheld 3-dimensional (3D) scanner and evaluate its accuracy in measuring wound areas. Engineers from the Industrial Technology Research Institute in Taiwan developed a handheld 3D scanner with the intention of extending its application to the medical field. A project was conducted to validate the accuracy of this 3D scanner. We utilized a smartphone (Asus ZenFone 2 with a 13-million-pixel rear camera), a digital single-lens reflex digital camera (Nikon, D5000, Tokyo, Japan), and the 3D scanner to repeatedly measure square papers of known size that were affixed to the curved surface of life-size facial mask or medical teaching breast models. The "Image J" software was employed for 2-dimensional image measurements, while the "3D Edit" software was used to assess the "area of interest" on 3D objects. By using square papers with predetermined dimensions, the measurement-associated error rate (ER) could be calculated for each image. Three repeated measurements were performed using the "Image J" software for each square paper. The ERs of the 3D scan images were all below 3%, with an average ER of 1.64% in this study. The close-up mode of the smartphone exhibited the highest ER. It was observed that as the area increased, the ER also increased in the digital single-lens reflex camera group. The extension distortion effect caused by the wide-angle lens on the smartphone may increase the ER. However, the definition of a healthy skin edge may vary, and different algorithms for calculating the measurement area are employed in various 3D measurement software. Therefore, further validation of their accuracy for medical purposes is necessary. Effective communication with software engineers and discussions on meeting clinical requirements are crucial steps in enhancing the functionality of the 3D scanner.
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Affiliation(s)
- Chao-Wei Chang
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Meng-Chien Hsieh
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - I-Wen Lin
- Department of Nursing, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Rong-Fu Chen
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Yur-Ren Kuo
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Su-Shin Lee
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Capturing Essentials in Wound Photography Past, Present, and Future: A Proposed Algorithm for Standardization. Adv Skin Wound Care 2022; 35:483-492. [PMID: 35993857 DOI: 10.1097/01.asw.0000852564.21370.a4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
GENERAL PURPOSE To discuss a standardized methodology for wound photography with a focus on aiding clinicians in capturing high-fidelity images. TARGET AUDIENCE This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES After participating in this educational activity, the participant will be able to:1. Discriminate the components of high-quality wound photography.2. Identify the technological innovations that can augment clinical decision-making capacity.3. Choose strategies that can help clinicians avoid adverse medicolegal outcomes.
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Onuh OC, Brydges HT, Nasr H, Savage E, Gorenstein S, Chiu E. Capturing essentials in wound photography past, present, and future: A proposed algorithm for standardization. Nurs Manag (Harrow) 2022; 53:12-23. [PMID: 36040729 DOI: 10.1097/01.numa.0000855948.88672.7a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Ogechukwu C Onuh
- Ogechukwu C. Onuh and Hilliard T. Brydges are clinical research fellows in the Hansjörg Wyss Department of Plastic Surgery at NYU Langone Health in New York, N.Y. Hani Nasr is a general surgery resident at Brookdale Hospital and Medical Center in Brooklyn, N.Y., and a postdoctoral clinical research fellow in the Hansjörg Wyss Department of Plastic Surgery at NYU Langone Health, New York, N.Y. Elizabeth Savage is an adult health clinical nurse specialist, a certified wound care nurse, a certified ostomy nurse, and manager of the Wound and Ostomy Program at NYU Langone Health in New York, N.Y. Scott Gorenstein is an associate professor in the Department of Surgery at NYU Langone Hospital in Long Island, Mineola, N.Y. Ernest Chiu is a professor at Hansjörg Wyss Department of Plastic Surgery, the director of the Kimmel Hyperbaric and Advanced Wound Healing Center, and the inpatient director, Consultative Wound Service at Tisch Hospital, NYU Langone Health in New York, N.Y
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Şahin E, Rizalar S, Özker E. Effectiveness of negative-pressure wound therapy compared to wet-dry dressing in pressure injuries. J Tissue Viability 2022; 31:164-172. [PMID: 35022147 DOI: 10.1016/j.jtv.2021.12.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 12/20/2021] [Accepted: 12/23/2021] [Indexed: 02/03/2023]
Abstract
This study aims to compare the effects of Negative-Pressure Wound Therapy (NPWT) and wet-to-dry dressing on Stages 3 and 4 pressure injuries (PI), This study is a randomized controlled trial. A total of 30 patients with Stages 3 and 4 pressure injuries were included in the study. The patients were divided into two groups: NPWT group and the wet-to-dry dressing group. All patients received 3 rounds of treatment. Data were collected with a Patient Identification Form, Pressure Ulcer Scale for Healing (PUSH) Tool and the findings of the Three-Dimensional Wound Measurement (3DWM) device. We found that granulation tissue formation was more significant in the experimental group (p < .05), and that there was more significant wound shrinkage (p < .05) with a more significant decrease in the PUSH Tool scores (p < .05). The wounds were assessed with the tool and the 3DWM system. Device measurements were found to be correlated with PUSH Tool findings (p < .05). There was a significant correlation between device-measured granulation findings and PUSH Tool score results of the experimental group's third measurements (p < .05). We conclude that NPWT is an effective treatment method for pressure injuries, and 3DWM device is a useable wound assessment tool.
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Affiliation(s)
- Ezgi Şahin
- Başkent University Istanbul, Health Research Application Hospital, Istanbul, Turkey
| | - Selda Rizalar
- Health Science University, Hamidiye Nursing Faculty, Department of Surgical Nursing , Istanbul, Turkey.
| | - Emre Özker
- Acibadem Mehmet Ali Aydinlar University, Health Science School, Istanbul, Turkey
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Foltynski P, Ladyzynski P. Digital Planimetry With a New Adaptive Calibration Procedure Results in Accurate and Precise Wound Area Measurement at Curved Surfaces. J Diabetes Sci Technol 2022; 16:128-136. [PMID: 33000645 PMCID: PMC8875057 DOI: 10.1177/1932296820959346] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The purpose of this study was to determine the accuracy of wound area measurement at a curved surface using a digital planimetry (DP) with the newly proposed adaptive calibration. METHODS Forty wound shapes were printed and placed at the side surfaces of cylinders with diameters of 9.4 and 6.2 cm. Area measurements were carried out using a commercial device SilhouetteMobile (Aranz, New Zealand) and the planimetric app Planimator. Planimetric area measurements were carried out using 2 one-dimensional calibration markers placed above and below the wound shape. The method of adaptive calibration for DP was described. Reference area values of wound shapes were obtained by pixel counting on digital scans made with an optical scanner. Relative errors (REs) and relative differences (RDs) for area measurements were analyzed. RESULTS The median of REs for the DP with adaptive calibration (DPwAC) was equal to 0.60% and was significantly smaller than the median for the SilhouetteMobile device (SMD) (2.65%), and significantly smaller than the median for the DP (2.23%). The SD of RDs for the DPwAC of 0.87% was considerably lower than for the SMD (6.45%), and for the DP without adaptive calibration (2.51%). The mean of RDs for the DPwAC (0.082%) was not significantly different from zero, which means that the systematic error was not present for the DPwAC. CONCLUSIONS The use of the adaptive calibration in DP to measure the areas at curved surface resulted in a significant increase of accuracy and precision, and removal of systematic error. The DPwAC revealed 4.4 times lower error and 7.4 times higher precision of area measurement at curved surfaces than the SMD.
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Affiliation(s)
- Piotr Foltynski
- Nalecz Institute of Biocybernetics and Biomedical Engineering Polish Academy of Sciences, Warsaw, Poland
- Piotr Foltynski, PhD, DSc, Nalecz Institute of Biocybernetics and Biomedical Engineering Polish Academy of Sciences, 4, Trojdena Str, Warsaw, 02-109, Poland.
| | - Piotr Ladyzynski
- Nalecz Institute of Biocybernetics and Biomedical Engineering Polish Academy of Sciences, Warsaw, Poland
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Foltynski P, Ciechanowska A, Ladyzynski P. Wound surface area measurement methods. Biocybern Biomed Eng 2021. [DOI: 10.1016/j.bbe.2021.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Bergant Suhodolčan A, Luzar B, Kecelj Leskovec N. Matrix metalloproteinase (MMP)-1 and MMP-2, but not COX-2 serve as additional predictors for chronic venous ulcer healing. Wound Repair Regen 2021; 29:725-731. [PMID: 33768649 DOI: 10.1111/wrr.12915] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 02/03/2021] [Accepted: 03/18/2021] [Indexed: 02/01/2023]
Abstract
Chronic venous ulcers affect 1% of the adult population and are associated with a marked reduction in quality of life, especially if healing is prolonged. Several matrix metalloproteinases (MMPs) appear to be involved in the pathophysiology of chronic venous ulcer healing, but their exact role is still unclear. Cyclooxygenase-2 (COX-2) is an important enzyme in prostanoid synthesis, induced during inflammation in chronic venous ulcer. The first aim of our study was to compare the expression of MMP-1, MMP-2, and COX-2 in wound tissue to that in normal skin. The second aim was to observe the expression of the above factors in 29 chronic venous ulcers in 22 patients at the beginning and 4 weeks later in relation to healing rates and final healing outcome after 24 weeks. The enrolled population was divided into two groups, healed and non-healed wounds after 24 weeks. The intensity of expression of MMP-1, MMP-2 and COX-2 was assessed for each ulcer in paired wound biopsy samples and wound size measurements using laser triangulation at the beginning and after 4 weeks of observation. Initial healing rates in the first 4 weeks were calculated and proved to be an important predictive factor of healing in 24 weeks. Decreases in MMP-1 and MMP-2 after 4 weeks of observation were distinct, positive predictors for ulcer healing. Healing odds were 3.7 times higher for a decrease in MMP-1 and 2.1 times higher for a decrease in MMP-2 compared to the healing odds for a non-decrease in MMP-1 and MMP-2. In conclusion, a decrease in MMP-1 and MMP-2, but not COX-2, in wound biopsy samples after 4 weeks of observation can predict better healing of chronic venous ulcer.
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Affiliation(s)
- Aleksandra Bergant Suhodolčan
- Department of Dermatovenereology, University Medical Centre Ljubljana, Ljubljana, Slovenia.,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Boštjan Luzar
- Institute of Pathology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
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Abstract
Telemedicine use in the field of wound care had been increasing in popularity when the novel coronavirus 2019 paralyzed the globe in early 2020. To combat the constraints of healthcare delivery during this time, the use of telemedicine has been further expanded. Though many limitations of telemedicine are still being untangled, the benefits of virtual care are being realized in both inpatient and outpatient settings. In this article, the advantages and disadvantages of telemedicine are discussed through two case examples that highlight the promise of implementation during and beyond the pandemic.
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Rogelj L, Pavlovčič U, Stergar J, Jezeršek M, Simončič U, Milanič M. Curvature and height corrections of hyperspectral images using built-in 3D laser profilometry. APPLIED OPTICS 2019; 58:9002-9012. [PMID: 31873681 DOI: 10.1364/ao.58.009002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Optical imaging systems use a light source that illuminates a sample and a photodetector that detects light reflected from or transmitted through the sample. The sample surface curvature, surface-to-camera distance, and illumination-source-to-surface distance significantly affect the measured signal, resulting in image artifacts. To correct the images, a three-dimensional (3D) profilometry system was used to obtain 3D surface information. The 3D information enables image correction using Lambert cosine law and height correction. In this study, the feasibility of the correction method for push-broom hyperspectral imaging of three different objects is presented. Results show a significant reduction of image artifacts, making further image analysis more accurate and robust. The presented 3D profilometry method is applicable to all push-broom imaging systems and the described correction procedure can be applied to all spectral or monochromatic imaging systems.
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den Blanken MD, van der Bent S, Liberton N, Grimbergen M, Hofman MBM, Verdaasdonk R, Rustemeyer T. Quantification of cutaneous allergic reactions using 3D optical imaging: A feasibility study. Skin Res Technol 2019; 26:67-75. [PMID: 31423660 PMCID: PMC7003777 DOI: 10.1111/srt.12765] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 06/28/2019] [Indexed: 11/29/2022]
Abstract
Background User‐independent quantitative measures of cutaneous allergic reactions can help the physicians manage and evaluate the treatment of cutaneous allergic reactions. In this paper, we present and validate a method to quantify the elevation, volume and area of cutaneous allergic reactions to red tattoos. Methods The skin surface of allergic tattoo reactions was imaged using an optical 3D scanner. The in‐house developed analysis tool measured the elevation, volume and area of the lesions, compared to a reference surface. This reference surface was created by 3D interpolation of the skin after manual removal of the lesions. The error of the interpolation tool was validated using a digital arm model. The error of our optical scanner was determined using a 3D printed lesion phantom. The clinical feasibility of the method was tested in 83 lesions in 17 patients. Results The method showed clear potential to assess skin elevation, volume change and area of an allergic reaction. The validation measurements revealed that the error due to interpolation increases for larger interpolation areas and largely determined the error in the clinical measurements. Lesions with a width ≥4 mm and an elevation ≥0.4 mm could be measured with an error below 26%. Patient measurements showed that lesions up to 600 mm2 could be measured accurately, and elevation and volume changes could be assessed at follow‐up. Conclusion Quantification of cutaneous allergic reactions to red tattoos using 3D optical scanning is feasible and may objectify skin elevation and improve management of the allergic reaction.
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Affiliation(s)
- Mark D den Blanken
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
| | - Sebastiaan van der Bent
- Department of Dermatology, Academic Tattoo Clinic Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Niels Liberton
- Medical Technology, 3D innovationlab, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
| | - Matthijs Grimbergen
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
| | - Mark B M Hofman
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
| | - Ruud Verdaasdonk
- Biomedical Photonics and Imaging group, TechMed Center, University of Twente, Amsterdam, The Netherlands
| | - Thomas Rustemeyer
- Department of Dermatology, Academic Tattoo Clinic Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
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