Iterative design and testing of a hand-held, non-contact wound measurement device

A variety of wound measurement techniques are available to clinicians. Options range from relatively simple and inexpensive to complex, expensive devices. An iterative design approach was used to evaluate and improve performance and clinical utility of a new wound measurement device (WMD). The design was based upon a commercially available Smartphone. Accuracy was assessed using bench testing and reliability of area measurements was determined using multiple evaluators. Clinical utility was investigated by deploying the WMD during wound rounds in a rehabilitation hospital. Accuracy testing revealed an average error <2% at 0° or skew and an average error of 4.28% at 10° of skew. The intra-rater reliability exceeded 0.975 for all raters and inter-rater reliability was 0.966. Clinical utility testing provided the opportunity to address several usability concerns including the software interface and computation times. The accuracy and reliability of a new, non-contact wound measurement device exceeded that of other manual techniques and were, at least, equivocal to other computer-based technologies. Some limitations of using a Smartphone were identified by the clinicians that can be addressed by the more advanced processing power of newer technology. Overall, the WMD was shown to have the potential as a useful clinical tool.