Predictive validity of granulation tissue color measured by digital image analysis for deep pressure ulcer healing: A multicenter prospective cohort study

Shinji Iizaka, Toshiko Kaitani, Junko Sugama, Gojiro Nakagami, Ayumi Naito, Hiroe Koyanagi, Chizuko Konya, Hiromi Sanada

Research output: Contribution to journalArticlepeer-review

16 Citations (Scopus)

Abstract

This multicenter prospective cohort study examined the predictive validity of granulation tissue color evaluated by digital image analysis for deep pressure ulcer healing. Ninety-one patients with deep pressure ulcers were followed for 3 weeks. From a wound photograph taken at baseline, an image representing the granulation red index (GRI) was processed in which a redder color represented higher values. We calculated the average GRI over granulation tissue and the proportion of pixels exceeding the threshold intensity of 80 for the granulation tissue surface (%GRI80) and wound surface (%wound red index 80). In the receiver operating characteristics curve analysis, most GRI parameters had adequate discriminative values for both improvement of the DESIGN-R total score and wound closure. Ulcers were categorized by the obtained cutoff points of the average GRI (≤80, >80), %GRI80 (≤55, >55-80, >80%), and %wound red index 80 (≤25, >25-50, >50%). In the linear mixed model, higher classes for all GRI parameters showed significantly greater relative improvement in overall wound severity during the 3 weeks after adjustment for patient characteristics and wound locations. Assessment of granulation tissue color by digital image analysis will be useful as an objective monitoring tool for granulation tissue quality or surrogate outcomes of pressure ulcer healing.

Original languageEnglish
Pages (from-to)25-34
Number of pages10
JournalWound Repair and Regeneration
Volume21
Issue number1
DOIs
Publication statusPublished - 01-2013
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Surgery
  • Dermatology

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