Time-Saving Comparison of Wound Measurement Between the Ruler Method and the Swift Skin and Wound App

Abstract

Chronic wounds are a major problem: an estimated 6.5 million people in the United States have chronic wounds that are highly susceptible to infection and difficult to manage. 1 Early identification of problematic wounds allows effective treatment, capable of changing disease course. 2 Accurate documentation and measurement of wounds are critical. The gold standard for measuring wounds is a ruler: measuring the longest axis (length) and the greatest perpendicular width. This can overestimate wound area by up to 73.9%. Measuring wounds with digital photography has been shown to be more reliable. 3 Swift Medical (Toronto, Ontario, Canada) has created a mobile application (Swift app) for wound management. The application calculates wound dimensions, including surface area, allowing highly accurate and reliable measurements, enabling wound progress to be tracked over time. 4 There are also administrative advantages in digitizing the wound documentation and measurement workflow (eg, time saving and accessing images). The study objective was to investigate the impact of the Swift app on clinicians' time efficiency, specifically wound assessment and documentation time, compared to the ruler method. Twenty medical students and dermatology residents (Faculty of Medicine, McGill University) participated voluntarily. The Swift app was used to photograph, measure, and document model wound images, using an iPhone (Apple, Cupertino, California), following training on the app. The time taken for each participant to measure the wound images (20 in total) using the Swift app and ruler method was recorded. For the ruler method, participants were instructed to draw an image representing the wound and indicate where they measured length and width. Mixed analysis of variance was used to compare measurement type (time taken to measure wound length and width, ruler vs app) across the 20 wounds repeated by each subject. Reliability was determined using intraclass correlation coefficients (ICCs) calculated in R. 5 We compared time efficiencies when measuring and documenting wounds using the ruler method compared to the Swift app (Figure 1A [dashboard] and Figure 1B,C [drawing vs photo documentation comparison]). Measurement time by the ruler method was significantly slower than using the Swift app (Table 1; mean [SD], 48.17 [7.81] vs 30.77 [5.21] seconds; P < .001, ruler vs Swift app). For the ruler method, measurements took 16.85 seconds, while charting time took an additional 31.32 seconds. Hence, for combined measurement and documentation, the Swift app was 57% faster than the ruler method and paper charting.

Wound assessment, imaging and monitoring systems in diabetic foot ulcers: A systematic review

“…SilhouetteMobile was the only product which was described in our systematic review, including articles by Foltynski et al and Rogers et al 19,22 The use of the remaining five products described in peer‐reviewed literature was on general wound measurement without the inclusion of diabetic foot ulcers and were hence excluded from this systematic review. The relevant articles on measurement accuracy of the products, are however, referenced and listed in Table 3 28‐34 …”

“…The relevant articles on measurement accuracy of the products, are however, referenced and listed in Table 3. [28][29][30][31][32][33][34]…”

Clinical validation of an artificial intelligence‐enabled wound imaging mobile application in diabetic foot ulcers

“…9 Of which, six of the identified 18 wound assessment products have been described and/or validated in the literature: EPISCAN I-200 (Longport, Inc., Pennsylvania), Scout (WoundVision, Indiana), Silhouette (ARANZ Medical Ltd., Christchurch, New Zealand), Swift Skin and Wound (Swift Medical, Ontario, Canada), WoundMatrix (WoundMatrix, Inc., Pennsylvania) and WoundZoom (WoundZoom, Inc., Wisconsin). [15][16][17][18][19][20][21][22][23] Khong et al evaluated the use of WoundAide (Konica Minolta Business Solutions Asia Pte Ltd, Tokyo), an application that uses image segmentation and enhancement techniques. 23 The use of C4W imaging system in our study was non-inferior compared to their study (which assessed the use of WoundAide, WoundZoom (WoundZoom, Inc., Wisconsin) and Visitrak (Smith & Nephew, London, UK); we similarly demonstrated ICC of >0.900 for both intra-rater and inter-rater reliability.…”

Experimental Study on Wound Area Measurement with Mobile Devices

“…Yee et al [34] enable communication between healthcare professionals and patients, but they acquire video that may have some network constraints in rural areas. Sequentially, the authors of [39][40][41] require more complex conditions for the image's acquisition with the mobile application and a specific device is required. Finally, Huang et al [37] implement a method in a mobile device that does not allow for contact between healthcare professionals and patients and they use an outdated platform, i.e., a Windows phone.…”

“…Other studies have been conducted on wound area measurement [38][39][40][41], but the methods implemented were the same as in the previously described studies. Taken together, the studies reveal that wound area measurement is an active and vital subject and that correct measurement is crucial in order to avoid future problems.…”