Fully Automatic Diabetic Wound Segmentation Using Lightweight Deep Convolutional Neural Networks

Diabetic foot ulcers, resulting from neuropathic and/or vascular complications in patients with diabetes mellitus, pose a major global health challenge. Early detection and consistent monitoring of wound progression are essential for timely intervention, effective treatment, and the prevention of severe complications such as amputation. In modern diabetic foot care, images captured using digital cameras and mobile phones are increasingly employed for remote wound assessment. In this context, automated segmentation of these wounds from such images plays a vital role by enabling objective and quantitative evaluation of wound areas-crucial for tracking the progression of healing over time. Recent years have witnessed growing interest in deep learning-based wound segmentation techniques, with a particular focus on models that are both computationally efficient and suitable for deployment on resource-constrained devices, including smartphones and point-of-care platforms. In this study, we propose a lightweight convolutional neural network (CNN) for diabetic foot wound segmentation that augments the U-Net architecture with ghost feature generation and Convolutional Block Attention Modules (CBAM) to improve computational efficiency and feature representation. The model was evaluated on a privately annotated dataset of 3450 diabetic foot wound images and compared against state-of-the-art architectures, including SegNet, U-Net, MobileNetV2, Mask R-CNN, and the domain-specific approach of Wang et al. We further investigated a fully automated two-step pipeline for wound segmentation incorporating a prior foot segmentation-based ROI detection. Using ROI detection, the proposed CNN achieved a precision of 85.13%, recall of 91.84%, Dice coefficient of 86.95%, and IoU of 77.23%. These results demonstrate competitive performance relative to high-capacity models while maintaining substantially reduced computational complexity, highlighting its suitability for real-time clinical deployment in low-resource environments.