Measuring wound outcomes

Chronic cutaneous wounds include leg ulcers, pressure ulcers, and diabetic foot ulcers. Each of these conditions is difficult to heal within an acceptably short time, and to maintain as healed. Patients suffer tremendous discomfort and pain, and are often socially deprived as a result. The financial consequences of this medical problem are enormous. Chronic or nonhealing ulcers are characterized by defective remodeling of the extracellular matrix, a failure to reepithelialize, and prolonged inflammation. In order to obtain biochemical and physical information about the wound bed and the surrounding skin, different options of noninvasive and invasive measurements have been developed and tested. Monitoring of acute and chronic wounds can be performed by measuring in an objective, precise, and reproducible way and by simply adapting existing validated technologies. When speaking of cutaneous wounds, one refers to defects in the skin surface. It is generally believed that a full and correct characterization of the level of tissue damage must be carried out by analyzing 2 distinct groups of parameters: dimensional parameters and chromatic parameters. Recently, the concept of wound bed preparation has been introduced and classified according to the clinical parameters of chronic wounds. In order to monitor the different aspects of wound bed preparation, various instrumental techniques are now under investigation, allowing improved, more objective characterization of the tissue repair process. The advantage of this new scientific discipline is the ability to study living skin in real time. The main physical wound parameters that have received the most attention over the past few years in terms of outcome in wound measurement are: area and volume, color, surface pH, temperature, wound fluid analysis, odor, pain, and tissue perfusion.