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Topic: Current Concepts in Wound Healing




          Computer assessment of the composition


          of a generic wound by image processing




          Rohit Nayak , Pramod Kumar , Ramesh R. Galigekere             4
                                           2,3
                        1
          1 Department of Electrical and Computer Engineering, University of Rochester, Rochester, NY 14623, USA.
          2 Department of Plastic Surgery, King Abdulaziz Specialist Hospital, Sakaka 42421, Al‑Jouf, Saudi Arabia.
          3 Department of Plastic Surgery and Burns, Kasturba Medical College, Manipal 576104, Karnataka, India.
          4 Department of Biomedical Engineering, Manipal Institute of Technology, Manipal University, Manipal 576104, Karnataka, India.
          Address for correspondence: Dr. Ramesh R. Galigekere, Department of Biomedical Engineering, Manipal Institute of Technology, Manipal
          University, Manipal 576104, Karnataka, India. E‑mail: ramesh.galigekere@manipal.edu


                ABSTRACT
                Aim: This paper addresses the assessment of the composition of a general wound, in terms of all
                identifiable categories of tissue and pigmentation in an attempt to improve accuracy in assessing and
                monitoring wound health. Materials and Methods: A knowledgebase of clusters was built into the hue,
                saturation and intensity (HSI) color space and then used for assessing wound composition. Based on the
                observation that the clusters are fairly distinct, two different algorithms, that is, Mahalanobis distance (MD)
                based and the rotated coordinate system (RCS) method, were used for classification. These methods
                exploit the shape, spread, and orientation of each cluster. Results: The clusters in the HSI color space,
                built  from  about  9,000  (calibrated)  pixels  from  48  images  of  various  wound  beds,  showed  8  fairly
                distinct regions. The inter‑cluster distances were consistent with the visual appearance. The efficacy
                of the MD and RCS based methods in 120 experiments taken from a set of 15 test images (in terms of
                average percent‑match) was found to be 91.55 and 93.71, respectively. Conclusion: Our investigations
                established eight categories of tissue and pigmentation in wound beds. These findings help to determine
                the stage of wound healing more accurately and comprehensively than typically permitted through use
                of the 4‑color model reported in the literature for addressing specific wound types.

                Key words:
                Wound  composition,  color‑image  processing,  hue,  saturation  and  intensity  model,  classification,
                Mahalanobis distance, rotated coordinate system method


          INTRODUCTION                                        and limited in precision and consistency. A  computerized
                                                              system for assessment and documentation of the evolution
          Accurate assessment of wound health is essential in the   of a wound is useful in providing a better understanding of
          reduction of morbidity and mortality, which in turn reduces   wounds, the healing process, and validation of treatment
          the cost of health care. Factors characterizing the health of   protocols, and wound care products.
          a  wound  include  its  composition  in  terms  of  tissue  type,   Color composition  is  the  most  important  factor in
          pigmentation (with a one‑to‑one correspondence to distinct   determining the status of a wound, and its computerized
          colors), size (area, depth, and volume), shape, regularity
          and texture. Traditionally, wound composition has been
          assessed by visual inspection, which is subjective, tedious   This is an open access article distributed under the terms of the Creative Commons
                                                              Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix,
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                                                               How to cite this article: Nayak R, Kumar P, Galigekere RR.
                                                               Computer assessment of the composition of a generic wound by image
                                   DOI:                        processing. Plast Aesthet Res 2015;2:261-5.
                                   10.4103/2347-9264.165444
                                                               Received: 15-12-2014; Accepted: 08-07-2015

          © 2015 Plastic and Aesthetic Research | Published by Wolters Kluwer - Medknow                     261
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