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Measuring healing in leg ulcers: practice considerations

M Johnson1, R Miller

  • 1South Western Sydney Centre for Applied Nursing Research, Australia.

Applied Nursing Research : ANR
|November 1, 1996
PubMed
Summary
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This study evaluated methods for measuring leg ulcer healing. Digital planimetry and the Kundin Wound Gauge are reliable and valid for clinical practice, unlike the Healing and Johnson Scales.

Area of Science:

  • Wound healing research
  • Clinical nursing practice
  • Medical device evaluation

Background:

  • Accurate measurement of leg ulcer healing is crucial for effective clinical nursing practice.
  • Existing methods for assessing wound healing vary in reliability and validity.
  • Standardized and validated tools are needed for clinical trials and patient monitoring.

Purpose of the Study:

  • To compare the reliability and validity of four leg ulcer measurement methods: digital planimetry, Kundin Wound Gauge, Healing Scale, and Johnson Scale.
  • To evaluate these methods against stereophotogrammetry, the established standard for topographical mapping.
  • To identify suitable methods for clinical nursing practice and research in leg ulcer management.

Main Methods:

  • Comparative study design involving 82 hospital and community patients with leg ulcers.

Related Experiment Videos

  • Weekly clinical assessments using digital planimetry, Kundin Wound Gauge, Healing Scale, and Johnson Scale.
  • Validation against stereophotogrammetry, a topographical mapping technique for volume and area measurement.
  • Main Results:

    • Stereophotogrammetry demonstrated reliability and suitability for clinical trials and monitoring.
    • Digital planimetry (r = .99) and Kundin Wound Gauge (r = .98) showed high reliability and concurrent validity with stereophotogrammetry.
    • The Healing Scale and Johnson Scale lacked concurrent validity and had limited reliability compared to stereophotogrammetry.

    Conclusions:

    • Digital planimetry and the Kundin Wound Gauge are reliable and valid tools for monitoring leg ulcer healing in clinical practice.
    • Stereophotogrammetry is suitable for clinical trial evaluations and hospital/clinic monitoring.
    • Consideration of instrument error rates and delayed healing in older populations is necessary for clinical trials and practice evaluation.