Technique to Measure Wound Size with Image J

Background: Urinary bladder matrix MatriStem® from Acell©, Inc. Columbia, MD has shown promising results in healing diabetic foot ulcers in retrospective studies. 

Purpose: We seek to develop a more accurate measurement protocol to measure wound size after treatment with Urinary Bladder Matrix. 

Methods: Image J is a freely available software from the National Institute of Health (NIH) that allows measurement of sizes and area in photographs of wounds with different set up of values.
After taking several pictures of the wound we obtained 4 values for every measurement: length and width (longest area of exposed tissue, respectively), and area of the wound measured in centimeters squared (cm2), using different pictures, thus achieving the average and the standard deviation of the 4 different measurements. 

We present a case report of two patients that underwent urinary bladder extracellular matrix application (MatriStem® from ACell©, Inc. Columbia, MD) on chronic diabetic foot ulcers following debridement. Patients were followed up at one weeks’ time in the office post-procedure.

Results: The measurements from the images were obtained pre-procedure and post-procedure. Noticeable changes were noted during clinical evaluation post-procedure at week 1. Both patients had a decrease in wound length, width, and area following procedure with urinary bladder extracellular matrix. Patient 1 had a relative difference of 14% in length and difference of 13% in width. Patient 2 had a difference of 33% in length and 1% in width. Whereas area (cm2) of the wound decreased with a difference of 37% for patient 1 and 36% for patient 2.

Conclusion: Image J may be a simple and useful tool in future studies where more accurate measurements need to be taken to assess wound size.