The digital age has finally reached two of the oldest medical problems: pressure sore and skin ulcer, which can be very painful and need to be cured forever.
Doctors often track the progress of these wounds in months, sometimes years, and change the treatment if they don't see the improvement.
The tools for this kind of tracking are undoubtedly old --
Fashioned: a plastic ruler or tape measure to see if the wound is getting smaller, insert the cotton swab into the sensitive lesion site, check the depth of the wound, and simply observe any new tissue growth.
This inaccurate method will reduce accuracy and bring more pain to patients.
Efforts are now being made to advance wound care by replacing a ruler and cotton swab with a smartphone and ipad.
Two local starts
Ups has created a system that allows caregivers to take photos using apps downloaded to mobile devices.
The photos were then analyzed to determine the size of the wound and the degree of death and healing of the affected tissue.
Daniel Ceradini, plastic surgeon at the Langone Medical Center at New York University, said: "In the field of wounds, things are still in the dark . " He was not involved in any company.
"Some medical centers do use digital-based systems, but the vast majority of practices still use physical rulers.
"A big problem with the ruler and cotton swab is the inaccuracy and human error involved.
For example, nurses are often asked to record the maximum length and width of the wound
This is not an easy thing when the wound appears in various shapes and sizes.
Then, by multiplying the length and width of the wound by this length and width, the size of the wound was estimated, and one study found that the method overestimated on average about 40%.
In addition, the numbers may vary greatly depending on the person measured.
All of these factors can lead to wrong information about wound healing
This may result in a doctor giving up the treatment that is going on or insisting on the treatment that is not going on.
"In short, we are removing speculation from wound care," said co-physician Kevin Kinahan.
The founder of the beginningups, Baltimore-
Based on organizational analysis.
With its app, clinicians use their smartphones to take photos of wounds.
Correct each picture for attributes such as brightness and shooting angle;
The algorithm of the application then calculates the wound size, circumference and how much the wound has shrunk since the last measurement.
It also tracks the percentage of tissue that is healing and the percentage of death.
The app also links to a website that allows doctors to access photos and wound data from any computer.
This feature allows information collected by the home-
The nursing nurse will be teletransmitted to the doctor, which may reduce the number of outpatient visits that patients have to perform, which can be cumbersome for people with painful chronic wounds. E-
Kare, a derivative of the Children's National Health System in the region, also uses a depth sensor to clip the depth sensor onto the iPad, offering 3-
Image of the wound. (
So far, the app can only be used with the iPad. )
The nursing staff took two sets of photos at the same time: the image of the depth sensor and the ordinary 2-D photos.
The algorithm then analyzes the two sets of photos to determine the depth, area and volume of the wound.
As with the application for Organization analysis, e-
Kare's photos and data are automatically uploaded to the network so that they can be accessed by any computer.
"We will all go fundamentally into this digital space to provide standardized wound care," said E . "Kare co-
Peter C, founder and pediatrician. W. Kim.
The system also classifies the tissue according to the healing state, such as granulation (healing tissue), slough (
Dead yellow paper)and eschar (
Dark, hard-skinned dead paper towels).
And his colleagues have not yet determined the payment option, but they tend to subscribe --
Based on this model, hospitals and clinics have access to applications, cloud servers that store images and data, and hardware.
The initial estimate is about $100 a month.
Both applications are tested in a clinical setting. E-
Kare's products are being evaluated by plastic surgeons, foot doctors and nurses at MedStar Georgetown University Hospital and Children's National Medical Center.
So far it has been tested in 40 patients and the company is expected to start selling this month.
Tissue analysis was conducted through the John Hopkins family care team for the feasibility study.
Nursing nurses began using the system for patients with chronic wounds.
How wounds and burns heal is unpredictable and involves a complex set of repair responses.
Said you cut your finger.
First, white blood cells rush to the injured place and eat any bacteria or foreign bodies.
Then, special cells, known as fiber cells, secrete collagen scaffold to allow the growth of new tissues, fill any skin gap left by the wound, and promote the growth of new blood vessels.
Finally, the collagen is rearranged by the fiber cells to further strengthen the tissue that is closed on the wound.
This is a normal course of treatment, each step thanks to a strong immune system, good nutrition and proper circulation.
For a person who lacks these things, part of the healing process cannot move forward as it should.
This is when an acute wound, such as a simple wound, can become a chronic wound that cannot be healed and may be susceptible to infection.
"If there is a wound that is being treated, it will traditionally heal by constructing from the depth up and the perimeter up," Ceradini said . ".
"If the wound doesn't really change in a month's time, you may want to change the way you treat it.
Most chronic wounds affect about 6.
5 million Americans were divided into three groups: pressure sore from tissue with long-term external stress damage;
Venous ulcer, developing on the skin between the ankle and the calf when blood returns and prevents normal circulation of the leg;
Diabetic foot ulcers, caused by stimulation and trauma, cannot be cured due to damage to the immune system and poor blood circulation.
Ceradini uses blood work, genetic testing, and tissue culture to obtain a complete profile of chronic wounds.
He prefers to examine the wound himself.
With your own eyes and fingers
Instead of relying on photos or computer algorithms.
Still, he is excited about the possibility of a digital surveillance system
Especially their 3-D ability-
Believe they will be an effective tool for wound care.
"There's no doubt that I think it's great that someone does it in the end," he said . ".
"Most measurements are 2-
Therefore, there are objective, quantifiable depth data and 3-
Of course, volume D will help guide the treatment.
Kim is a freelance science journalist in Philadelphia.