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

VOLUME DETERMINATION OF LEG ULCER USING REVERSE ENGINEERING METHOD

Reverse Engineering is defined as the process of obtaining a geometric CAD model by digitizing the existing objects. In medical application, it is applied to obtain the CAD model of human skin surface. Chronic leg ulcer refers to the wound which does not heal in the predictable period. Approximately 1% of the world population will develop leg ulcers in their lifespa

Imparting 3D representations to artificial intelligence for a full assessment of pressure injuries.

During recent decades, researches have shown great interest to machine learning techniques in order to extract meaningful information from the large amount of data being collected each day. Especially in the medical field, images play a significant role in the detection of several health issues. Hence, medical image analysis remarkably participates in the diagnosis process and it is considered a suitable environment to interact with the technology of intelligent systems. Deep Learning (DL) has recently captured the interest of researchers as it has proven to be efficient in detecting underlying features in the data and outperformed the classical machine learning methods. The main objective of this dissertation is to prove the efficiency of Deep Learning techniques in tackling one of the important health issues we are facing in our society, through medical imaging. Pressure injuries are a dermatology related health issue associated with increased morbidity and health care costs. Managing pressure injuries appropriately is increasingly important for all the professionals in wound care. Using 2D photographs and 3D meshes of these wounds, collected from collaborating hospitals, our mission is to create intelligent systems for a full non-intrusive assessment of these wounds. Five main tasks have been achieved in this study: a literature review of wound imaging methods using machine learning techniques, the classification and segmentation of the tissue types inside the pressure injury, the segmentation of these wounds and the design of an end-to-end system which measures all the necessary quantitative information from 3D meshes for an efficient assessment of PIs, and the integration of the assessment imaging techniques in a web-based application

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

VOLUME DETERMINATION OF LEG ULCER USING REVERSE ENGINEERING METHOD

Reverse Engineering is defined as the process of obtaining a geometric CAD model by digitizing the existing objects. In medical application, it is applied to obtain the CAD model of human skin surface. Chronic leg ulcer refers to the wound which does not heal in the predictable period. Approximately 1% of the world population will develop leg ulcers in their lifespa

Mobile Wound Assessment and 3D Modeling from a Single Image

The prevalence of camera-enabled mobile phones have made mobile wound assessment a viable treatment option for millions of previously difficult to reach patients. We have designed a complete mobile wound assessment platform to ameliorate the many challenges related to chronic wound care. Chronic wounds and infections are the most severe, costly and fatal types of wounds, placing them at the center of mobile wound assessment. Wound physicians assess thousands of single-view wound images from all over the world, and it may be difficult to determine the location of the wound on the body, for example, if the wound is taken at close range. In our solution, end-users capture an image of the wound by taking a picture with their mobile camera. The wound image is segmented and classified using modern convolution neural networks, and is stored securely in the cloud for remote tracking. We use an interactive semi-automated approach to allow users to specify the location of the wound on the body. To accomplish this we have created, to the best our knowledge, the first 3D human surface anatomy labeling system, based off the current NYU and Anatomy Mapper labeling systems. To interactively view wounds in 3D, we have presented an efficient projective texture mapping algorithm for texturing wounds onto a 3D human anatomy model. In so doing, we have demonstrated an approach to 3D wound reconstruction that works even for a single wound image

Goal directed fluid therapy in colorectal surgery : strategies for the low risk patient

Morbidity and mortality following major surgery has considerable variation both nationally and globally, and hence considerable research has been focused on how post operative outcomes can be improved. In order to achieve improvement it is essential to be able to stratify a patient’s risk, and hence direct appropriate therapy and interventions to those who will benefit.Fluid therapy is used peri‐operatively to expand the circulating volume to optimise cardiac output, and hence increasing oxygen delivery to tissues, allowing the patient to meet the metabolic demands of surgery. There has been considerable debate on the optimal fluid regime for major surgery. Goal directed fluid therapy utilises cardiac output monitoring to optimise haemodynamic status on an individualised basis. Various protocols have shown improved post‐operative outcomes, and new non-invasive technologies are emerging which will allow uptake of targeted fluid therapy to be extended within the surgical population. The oesophageal Doppler is an established technology used to target fluid therapy, and various studies have shown reduced morbidity when it is used in patients undergoing major abdominal surgery. Plethysmograph variability index (PVI) is a non‐invasive technology, which evaluates variations in the plethysmographic waveform with the respiratory cycle indicating fluid responsiveness. However, currently there are no published outcome studies of its use for intra‐operative goal directed fluid therapy. The aim of this thesis is to examine the use of PVI in low-risk colorectal surgery patients, primarily investigating if similar volumes of fluids are administered when goal directed therapy is targeted using PVI or oesophageal Doppler. Fluid balance, post-operative morbidity and length of hospital stay are also compared to evaluate if PVI can be used as an alternative target for intra-operative goal-directed fluid therapy in this patient group

Perioperative cardiovascular monitoring of high-risk patients: a consensus of 12.

A significant number of surgical patients are at risk of intra- or post-operative complications or both, which are associated with increased lengths of stay, costs, and mortality. Reducing these risks is important for the individual patient but also for health-care planners and managers. Insufficient tissue perfusion and cellular oxygenation due to hypovolemia, heart dysfunction or both is one of the leading causes of perioperative complications. Adequate perioperative management guided by effective and timely hemodynamic monitoring can help reduce the risk of complications and thus potentially improve outcomes. In this review, we describe the various available hemodynamic monitoring systems and how they can best be used to guide cardiovascular and fluid management in the perioperative period in high-risk surgical patients