High-frequency ultrasound imaging in wound assessment: current perspectives

Non-invasive imaging modalities for wound assessment have become increasingly popular over the past two decades. The wounds can be developed superficially or from within deep tissues, depending on the nature of the dominant risk factors. Developing a reproducible quantitative method to assess wound-healing status has demonstrated to be a convoluted task. Advances in High-Frequency Ultrasound (HFU) skin scanners have expanded their application as they are cost-effective and reproducible diagnostic tools in dermatology, including for the measurement of skin thickness, the assessment of skin tumours, the estimation of the volume of melanoma and non-melanoma skin cancers, the visualisation of skin structure and the monitoring of the healing of acute and chronic wounds. Previous studies have revealed that HFU images carry dominant parameters and depict the phenomena occurring within deep tissue layers during the wound-healing process. However, the investigations have mostly focussed on the validation of HFU images, and few studies have utilised HFU imaging in quantitative assessment of wound generation and healing. This paper is an introductory review of the important studies proposed by the researchers in the context of wound assessment. The principles of dermasonography are briefly explained, followed by a review of the relevant literature that investigated the wound-healing process and tissue structures within the wound using HFU imaging

The accuracy of ultrasound, thermography, photography and sub-epidermal moisture as a predictor of pressure ulcer presence – a systematic review

Aim: To determine the accuracy of SEM, ultrasound, thermography and photography in predicting pressure ulcer presence. Method: Systematic review. Background: Pressure ulcers are areas of skin damage that develop, normally over bony prominences, as a result of pressure and shear. Pressure ulcers are a healthcare problem that impacts in the individual, healthcare system and society. Risk factors such as mobility and nutritional status also influence the onset and aggravation of pressure ulcers. Thus risk assessment tools can help identify those individuals that might present with risk factors for the onset of pressure ulcers. Nonetheless, these tools do not allow for the identification of tissue changes and for this reason it is necessary to identify other methods, like SEM, thermography, ultrasound and photography that might identify cellular and underlying tissue changes and predicting the presence of pressure ulcers, in order to prevent its further development. Findings: Following a systematic search of the literature, four SEM, one thermography and five ultrasound studies were included in this review. Photography was not a method, considering the data in the studies retrieved, which allows for the early prediction of pressure ulcer presence. SEM and ultrasound were the best methods for allowing a more accurate prediction of early pressure ulcer presence. Conclusion: It can be concluded that SEM and ultrasound are accurate on the early detection of pressure ulcers, based on the studies analysed and these methods should be further studied and used in practice for the prevention of pressure ulcer development

Neonatal skin injuries from mechanical forces: a multicentre, mixed methods study

Deanne August studied neonatal skin injuries through a multicentre, mixed methods research comprised of eight methods, to explore and determine epidemiologic factors of injury. Findings included methods for neonatal injury assessment, multiple forces contributed towards injury; neonates have increased risk compared to older populations; many injuries are currently unpreventable, and identification of new extrinsic and intrinsic risk factors

Aerospace medicine and biology: A cumulative index to the continuing bibliography of the 1973 issues

A cumulative index to the abstracts contained in Supplements 112 through 123 of Aerospace Medicine and Biology A Continuing Bibliography is presented. It includes three indexes: subject, personal author, and corporate source

ASSESSMENT OF ULCER WOUNDS USING 3D SKIN SURFACE IMAGING

In medical care, ulcer wound refers to open wound or sore in which certain conditions exist that impede healing. Nonhealing wounds can cause economical and psychological distress for patients. Wound size measurement (top area, true surface area, depth, and volume) is an objective indicator for wound healing. Top area measurement is useful for the follow up of shallow wounds, while true surface area if done accurately can work for all types of wounds. Calculating ulcer volume is crucial since studies showed that wounds start healing from the bottom. Overestimation in top area and true surface area measurement can be solved by digitizing the traced part. The objective of this research is to develop computer algorithms to measure ulcer wound size using 3D surface imaging. The wounds of interest are the wounds located at the leg. The algorithms should construct wound models and compute volume without getting affected by irregularities on wound surface and they should model leg curvature. Two algorithms for constructing wound models and volume computation are developed and evaluated; namely midpoint projection and convex hull approximation (Delaunay tetrahedralization). Parameters that describe the wounds are developed based on real ulcer wound surface images for wound modelling. Wound models representing possible ulcer wounds developed using AutoCAD software are used to investigate the performance of solid reconstruction methods. Results and analysis show that, for volume computation midpoint and convex hull methods can compute volume of leg ulcer without getting affected by irregularities in the healthy skin around the wound. The results show that, for convex hull low errors are produced in cases of regular boundary models excluding the elevated base models. Overestimation in volume for convex hull method can either be due to irregular boundary and/or elevation at the base (both global and local). Surface division is performed prior to convex hull approximation so that the high curvature of the leg and irregularity at the boundary can be represented using a number of linear segments. With the increase in surface division, error due to irregular boundary is reduced. In the case of global curvature, the reconstructed model using convex hull preceded by surface division simulates the leg curvature. Midpoint outperforms convex hull for models excluding elevated base models. Midpoint can construct solids for wound surfaces with local curvature while for surfaces with high global curvature the error is high. Midpoint method is not suitable for shallow and very large wounds