Convolutional neural networks for wound detection: the role of artificial intelligence in wound care

2019 ◽  
Vol 28 (Sup10) ◽  
pp. S13-S24
Author(s):  
Norihiko Ohura ◽  
Ryota Mitsuno ◽  
Masanobu Sakisaka ◽  
Yuta Terabe ◽  
Yuki Morishige ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Wound Care ◽  
Area Under The Curve ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
High Specificity ◽  
Assessment System ◽  
Data Sets ◽  
Venous Leg Ulcer ◽  
Wound Assessment

Objective: Telemedicine is an essential support system for clinical settings outside the hospital. Recently, the importance of the model for assessment of telemedicine (MAST) has been emphasised. The development of an eHealth-supported wound assessment system using artificial intelligence is awaited. This study explored whether or not wound segmentation of a diabetic foot ulcer (DFU) and a venous leg ulcer (VLU) by a convolutional neural network (CNN) was possible after being educated using sacral pressure ulcer (PU) data sets, and which CNN architecture was superior at segmentation. Methods: CNNs with different algorithms and architectures were prepared. The four architectures were SegNet, LinkNet, U-Net and U-Net with the VGG16 Encoder Pre-Trained on ImageNet (Unet_VGG16). Each CNN learned the supervised data of sacral pressure ulcers (PUs). Results: Among the four architectures, the best results were obtained with U-Net. U-Net demonstrated the second-highest accuracy in terms of the area under the curve (0.997) and a high specificity (0.943) and sensitivity (0.993), with the highest values obtained with Unet_VGG16. U-Net was also considered to be the most practical architecture and superior to the others in that the segmentation speed was faster than that of Unet_VGG16. Conclusion: The U-Net CNN constructed using appropriately supervised data was capable of segmentation with high accuracy. These findings suggest that eHealth wound assessment using CNNs will be of practical use in the future.

Health professionals' perspectives on delivering patient-focused wound management: a qualitative study

2019 ◽  
Vol 28 (Sup7) ◽  
pp. S4-S13 ◽  
Author(s):  
Janet L. Kuhnke ◽  
David Keast ◽  
Sue Rosenthal ◽  
Robyn Jones Evans
Keyword(s):  
Health Care ◽  
Health Professionals ◽  
Best Practice ◽  
Care Delivery ◽  
Wound Care ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Wound Management ◽  
Evidence Based ◽  
Venous Leg Ulcer

Objective: This study examined the perspectives of health professionals on the barriers and solutions to delivery of patient-focused wound management and outcomes. Methods: A qualitative, descriptive study design was used. Participants were health-care managers, clinical leaders, nurses and allied health members who are part of wound care services. Open-ended surveys were distributed to participants in a series of learning workshops, and data analysed to identify leading themes. Results: A total of 261 participants took part and 194 surveys were returned (response rate: 74%). From the analysis five themes emerged: patient/family wound-related education; health professional wound-related education; implementation of evidence-based wound care and dissemination of evidence-based wound information across professions and contexts; teamwork and respectful communication within teams; and a higher value and priority placed on wound care through collaborative teams by managers, leaders and policymakers. Conclusion: Findings suggest that ongoing, system-wide education is needed to improve prevention, assessment, treatment and management of four wound types: venous leg ulcer (VLU), diabetic foot ulcer (DFU), pressure ulcer (PU) and surgical wounds. Health professionals are committed to delivering best practice in wound care. Participants identified that effective patient-focused, evidence-based wound care involves having a health-care system with a clear mandate to ensure wound care is a priority. A high value placed on wound care by managers and clinical leadership could transform the present systems. Additionally, effective and widespread dissemination of evidenced-informed practice information is crucial to positive patient outcomes. Education and team commitment for consistent and respectful communication would improve care delivery.

scholarly journals Extracellular matrix and cellular senescence in venous leg ulcers

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Debbie X. E. Lim ◽  
Toby Richards ◽  
Muholan Kanapathy ◽  
Thankiah Sudhaharan ◽  
Graham D. Wright ◽  
...  
Keyword(s):  
Cellular Senescence ◽  
Chronic Wounds ◽  
Second Harmonic ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Venous Leg Ulcer ◽  
Non Invasive ◽  
Wound Assessment ◽  
High Prevalence ◽  
Invasive Method

AbstractHigh prevalence of non-healing chronic wounds contributes to a huge healthcare burden across the world. Early treatment interventions for non-healing wounds are vital. It was previously shown that accumulation of 15% or more of senescent cells in a chronic wound edge is an indicator that the wound is unlikely to heal. However, determining the presence of senescent cells would require invasive procedures such as tissue biopsies to be taken. In this study, we found a strong correlation between decreased collagen area and presence of senescent cells in human chronic wounds i.e. venous leg ulcer (VLU), diabetic foot ulcer (DFU) and pressure ulcer (PRU). We also report that the lowest collagen levels were found in VLU patients less than 60 years of age, with a persistent wound of > 24 months. Elevated levels of senescent cells were also found in VLU of males. Second harmonic imaging of collagen at the edge of chronic wounds with a handheld multiphoton device could be used to predict the number of senescent cells, indicating if the wound is on a healing trajectory or not. Our data support the use of collagen imaging in cutaneous wound assessment for a faster and non-invasive method to predict cellular senescence and determining wound trajectory of healing.

scholarly journals Extracellular matrix and cellular senescence in venous leg ulcers

2021 ◽  
Author(s):  
Debbie Xiu En Lim ◽  
Toby Richards ◽  
Muholan Kanapathy ◽  
Thankiah Sudhaharan ◽  
Graham Daniel Wright ◽  
...  
Keyword(s):  
Cellular Senescence ◽  
Chronic Wounds ◽  
Second Harmonic ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Venous Leg Ulcer ◽  
Non Invasive ◽  
Wound Assessment ◽  
High Prevalence ◽  
Invasive Method

Abstract High prevalence of non-healing chronic wounds contributes to a huge health burden across the world. Early treatment interventions for non-healing wounds are vital. It was previously shown that accumulation of 15% or more senescent cells in a chronic wound edge is an indicator that the wound is unlikely to heal. However, determining the presence of senescent cells would require invasive procedures such as tissue biopsies to be taken. In this study, we found a strong correlation between decreased collagen area and presence of senescent cells in human chronic wounds i.e venous leg ulcer (VLU), diabetic foot ulcer (DFU) and pressure ulcer (PRU). We also reported that the lowest collagen levels were found in VLU patients less than 60 years of age, with a persistent wound of > 24 months. Elevated levels of senescent cells were also found in VLU of males. Second harmonic imaging of collagen at the edge of chronic wounds with a handheld multiphoton device could be used to predict the number of senescent cells, indicating if the wound is on a healing trajectory or not. Our data support the use of collagen imaging in cutaneous wound assessment for a faster and non-invasive method to predict cellular senescence and determining wound trajectory.

Short Report: The Moisture Balance with Aloe Vera Gel in Diabetic Wound Healing

2018 ◽  
Vol 1 (1) ◽  
pp. 21-23
Author(s):  
Fahrianto Selamet ◽  
Andi Mayasari Usman ◽  
Rian Adi Pamungkas
Keyword(s):  
Diabetes Mellitus ◽  
Wound Healing ◽  
Wound Care ◽  
Aloe Vera ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Short Report ◽  
Bacterial Reduction ◽  
Moisture Balance ◽  
Patients With Diabetes

Diabetic foot ulcer (DF) is a chronic complication of diabetes mellitus (DM), which impact on the morbidity, mortality and quality of patients’ lives.Of those patients with diabetes mellitus, approximately 15% to 25% developed to the foot ulcer. Beside has the infection and debridement of devitalized tissue downloading; the moisture imbalance becomes the factors of recalcitrant to healing. Moist wound healing is often contraindicated to the non-healable wounds. While wound care involves the debridement, bacterial reduction, and moisture balance in order to achieve the good granulation of the tissue development and adequate blood supply.

Machine learning prediction of diabetic foot ulcers in the inpatient population

Vascular ◽  
2021 ◽  
pp. 170853812110409
Author(s):  
Stavros Stefanopoulos ◽  
Samar Ayoub ◽  
Qiong Qiu ◽  
Gang Ren ◽  
Mohamed Osman ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Model Performance ◽  
Area Under The Curve ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
International Classification Of Diseases ◽  
Healthcare Research ◽  
Tree Model ◽  
Chi Square ◽  
Variable Model

Background The objective of this study was to create an algorithm that could predict diabetic foot ulcer (DFU) incidence in the in-patient population. Materials and Methods The Nationwide Inpatient Sample datasets were examined from 2008 to 2014. The International Classification of Diseases 9th Edition Clinical Modification (ICD-9-CM) and the Agency for Healthcare Research and Quality comorbidity codes were used to assist in the data collection. Chi-square testing was conducted, using variables that positively correlated with DFUs. For descriptive statistics, the Student T-test, Wilcoxon rank sum test, and chi-square test were used. There were six predictive variables that were identified. A decision tree model CTREE was utilized to help develop an algorithm. Results 326,853 patients were noted to have DFU. The major variables that contributed to this diagnosis (both with p < 0.001) were cellulitis (OR 63.87, 95% CI [63.87–64.49]) and Charcot joint (OR 25.64, 95% CI [25.09–26.20]). The model performance of the six-variable testing data was 79.5% (80.6% sensitivity and 78.3% specificity). The area under the curve (AUC) for the 6-variable model was 0.88. Conclusion We developed an algorithm with a 79.8% accuracy that could predict the likelihood of developing a DFU.

scholarly journals THE RELATIONSHIP OF THE INITIAL WOUND WITH THE WOUNDS LONG TREATMENT IN DIABETICUM PATIENTS AT CIBINONG HOSPITAL BOGOR

2020 ◽  
Vol 11 (2) ◽  
pp. 35-40
Author(s):  
Ranti Ranti
Keyword(s):  
General Hospital ◽  
Diabetic Foot ◽  
Wound Care ◽  
Day Treatment ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Stage I ◽  
Stage Iii ◽  
P Value ◽  
Early Wound

According to the survey data of American Diabetes Association (ADA) in 2014, the global prevalence rate of DM patients in 2014 was 8,3% out of total population of the world, and it has increased to 387 cases in 2014. Sulistyowati, D. A. stated that in 2015 for the prevalence of the patients suffering from diabetic foot ulcer was 15% with the risk of amputation of 30%, mortality rate of 32%, and in Indonesia, diabetic foot ulcer is the disease whose probability to be hospitalized is 80%. This research aims at finding out the relation between the early wound stage and the length of wound care towards the patients of ulcus diabeticum at Cibinong General hospital in 2018. This study is a quantitative analytic research with the approach of cross sectional. The population of this research is 40 respondents, and the research sample is 40 respondents by taking the technique of Total Sampling. The data collection is derived from the observation sheet. Based on the research findings, it is known that 14 respondents (77.8%) who suffered from the stage I-II wound needed 3-5 day treatment. Moreover, 19 respondents (86,4%) who suffered from stage III-IV wound needed 6-8 day treatment. The result of statistical test by taking cremer von mises test derived the value p=0,000 meaning that p value <0,05 signifies Ha received. This indicates that there is a significant relation between the early wound stage and the length of wound care towards the patients of ulcus diabeticum. Result analysis also obtains the value OR of 22.167 meaning that the wound stage III-IV will have the possibility of influencing the length of wound care of 22.167 times compared to the stage I-II. There is a relation between the early wound stage and the length of wound care towards the patients of ulcus diabeticum at Cibinong General Hospital. This research finding is expected to be a recommendation for the patients suffering from ulcus diabeticum, particularly those who suffer from stage III-IV with a long wound care.

scholarly journals A randomized controlled trial of the safety and efficacy of a topical gentamicin–collagen sponge in diabetic patients with a mild foot ulcer infection

2018 ◽  
Vol 6 ◽  
pp. 205031211877395 ◽  
Author(s):  
Ilker Uçkay ◽  
Benjamin Kressmann ◽  
Sébastien Di Tommaso ◽  
Marina Portela ◽  
Heba Alwan ◽  
...  
Keyword(s):  
Antimicrobial Therapy ◽  
Diabetic Foot ◽  
Wound Care ◽  
Controlled Trial ◽  
Pilot Trial ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Collagen Sponge ◽  
Diabetic Patients ◽  
Topical Antibiotic

Objectives: The initial phase of infection of a foot ulcer in a person with diabetes is often categorized as mild. Clinicians usually treat these infections with antimicrobial therapy, often applied topically. Some experts, however, believe that mild diabetic foot ulcer infections will usually heal with local wound care alone, without antimicrobial therapy or dressings. Methods: To evaluate the potential benefit of treatment with a topical antibiotic, we performed a single-center, investigator-blinded pilot study, randomizing (1:1) adult patients with a mild diabetic foot ulcer infection to treatment with a gentamicin–collagen sponge with local care versus local care alone. Systemic antibiotic agents were prohibited. Results: We enrolled a total of 22 patients, 11 in the gentamicin–collagen sponge arm and 11 in the control arm. Overall, at end of therapy, 20 (91%) patients were categorized as achieving clinical cure of infection, and 2 (9%) as significant improvement. At the final study visit, only 12 (56%) of all patients achieved microbiological eradication of all pathogens. There was no difference in either clinical or microbiological outcomes in those who did or did not receive the gentamicin–collagen sponge, which was very well tolerated. Conclusion: The results of this pilot trial suggest that topical antibiotic therapy with gentamicin–collagen sponge, although very well tolerated, does not appear to improve outcomes in mild diabetic foot ulcer infection.

scholarly journals Case Study: Diabetic Foot Ulcer Nursing Management Using Ozone Regional Non-Invasive (ORNI)Therapy as A Combination Of Care

2021 ◽  
Vol 16 (2) ◽  
Author(s):  
Irma Puspita Arisanty ◽  
Debie - Dahlia
Keyword(s):  
Assessment Tool ◽  
Wound Care ◽  
Healing Process ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Wound Healing Process ◽  
Nursing Management ◽  
Ozone Therapy ◽  
Average Growth ◽  
Non Invasive

<p><strong><em>Background: </em></strong><em>DFU patients must be treated properly less than 30 days to prevent infection spread to the bone, causes smaller opportunity to recovery and higher risk for amputation. Ozone therpay has a clearer clinical effect, affects the wound healing process, it can be seen by decreasing the length of stay.</em><strong><em> Method:</em></strong><em> Case studies of 3 DFU patients who were given ORNi therapy. Wound evaluation using </em><em>Bettes-Jenssen Assessment tool skoring system. </em><strong><em>Results: </em></strong><em>There were significant improvement in these cases after given a noninvasive regional ozone therapy (ORNi) as a combination in standard treatment for 5 – 7 times. There are no sign of infection, granulation and epithelization processes were running optimal and exudate production was controlled. </em><strong><em>Conclusions and recommendation: </em></strong><em>Using ORNi therapy as an adjunct to standard care has shown a significant improvement. The rate of granulation and epithelization during 15 days of treatment has an average growth rate of granulation and epithelization up to 22%. Researchers recommend to do more research with suficcient sample size related to the use of ozone therapy as an adjunct in wound care. </em></p>

Management of Diabetic Foot Ulcer by Nishadi Yoga Avachoornana - A Case Study

2017 ◽  
Vol 2 (06) ◽  
Author(s):  
Chiranth Kumar R. ◽  
Syeda Ather Fathima
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Foot ◽  
Life Style ◽  
Genetic Factor ◽  
Wound Care ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Foot Complications ◽  
Scientific Approach

Diabetes is considered as ‘ice burg’ of diseases as only 1/3rd of its manifestations can be made out clinically, though the exact cause is not known following are the theories put forth to explain diabetes mellitus - Genetic factor, Life style disorder, Autoimmune cause. Slight injury to glucose laden tissue will cause infection which is precipitated by an ulcer and it tends to a state of non - healing. Main stay of treatment includes antibiotics, debridement, local wound care. Inspite of these treatments there is less reduction in the statistics of diabetic foot complications and amputations. In Sushrutha Samhitha we get the most scientific approach for the management of Vrana, where Sushrutha has mentioned 60 Upakrama’s (modalities of treatment) of which Avachoornana (dusting) is one modality, seen to be effective in the management of diabetic non healing ulcers (Madhu Mehaja Dusta Vrana).

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