Photographic image tissue characterization of the ulcerated diabetic foot during treatment: technical note

Abstract

Treatment of an ulcerated diabetic foot was documented photographically. We adapted the ultrasonographic tissue characterization (USTC or CATUS) technique to develop a photographic image tissue characterization (p-IMTC or CATIM) method. Five photographs, taken during medical treatment of an ulcerated diabetic foot following digital amputation, were quantified using imaging software designed to determine brightness intensity in grey scale images. The grey scale median (GSM) changed from 127 to 98; 86; 76; and 83 (out of 255) during follow-up. The area of lesion was estimated by number of pixels and reduced from 17.85 cm² to 12.44; 3.68; 2.11; and 0.15 cm². The percentage of total number of pixels showing granulation tissue increased from 11% to 34%; 56%; 62%; and 75%. p-IMTC quantified treatment progress. GSM quantified generalized changes in tissues, while the area of lesion and granulation tissue were documented quantitatively. Lesions, ulcers, wounds or other tissues can be analyzed using p-IMTC, allowing quantification, characterization and control of the progression of a condition or treatment.