Clinical Update TEN TOP TIPS Taking high-quality digital images of wounds
" Wound images provide a visual reference, not matched by
memory or the written word."
4 5 A REFERENCES
1. The Phrase Finder. Available at:
http://bit.ly/1gIMtYV (accessed 04.02.14)
2. Buckley KM, Adelson LK, Agazio JG (2009) Reducing the risks of wound consultation: adding digital images to verbal reports. J Wound Ostomy Continence Nurs 36(2): 163–70
3. Sperring B (2013) Using telehealth and photography for wound assessment in Western Australia. Wounds International 4(4): 8–11
4. Sikka N, Pirri M, Carlin KN et al (2012) The use of mobile phone cameras in guiding treatment decisions for laceration care. Telemed J E Health 18(7): 554–7
5. Creighton S, Alderson J, Brown S, Minto CL (2012) Medical photography: ethics, consent and the intersex patient. BJU Int 89(1): 67–72
6. Burns K, Belton S (2012) Click first, care second" photography. Med J Aust 197(5): 265
7. Routsalainen P (2010) Privacy and security in teleradiology. Eur J Radiol 73(1): 31–5
8. Fernando J (2013) mHEALTH - snoops out! Pulse+IT Magazine [20 May]: 36–7
9. Garg V, Brewer J (2011) Telemedicine security: a systematic review. J Diabetes Sci Technol 5(3): 768–77
10. Prentice J, Baker R (2013) Digital Photography in Wound Management. Department of Health, Perth
11. Rennert R, Golinko M, Kaplan D et al (2009) Standardization of wound photography using the Wound Electronic Medical Record. Adv Skin Wound Care 22(1): 32–8
12. Swann G (2010) Photography in wound care. Nurs Times 96(45): 9
TAKE THE FIRST PHOTOGRAPH OF PATIENT DATA
The first photograph should display the patient's demographics, including patient name/ identification number, date of birth, location, and a brief clinical history. Store this photograph with the patient’s other images to help identify images for quality improvement audits.
MAKE THE WOUND THE ONLY FOCUS
Remove clutter from the background and use a white drape behind subject or limb [Figure 3].
B
Take a close up photograph using the macro setting (as described in top tip 1; Figure 1). Place a ruler near the wound to give an accurate indication of wound size [Figure 5]. An L-shaped ruler is preferred, however, a
Figure 3. [A] Do not photograph the wounds with clutter in the background. [B] A white drape should be placed behind the wound to allow clear visualisation.
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STANDARDISE THE VIEWS TAKEN OF THE WOUND
Check any previous photographs taken of that wound to ensure you take similar views, magnification and angles. This will assist when reviewing images over a period of time.
GET THE ANGLE RIGHT TO TAKE A PROPORTIONAL IMAGE
When taking a photograph, ensure the camera body is parallel to the subject [Figure 4A]. This results in a photograph that presents accurate proportions of the subject [Figure 4C]. If the camera body is not parallel to the subject [Figure 4B], the proportions of the subject will be distorted [Figure 4D], making assessment of the size and extent of the wound in the image difficult.
ESTABLISH THE WOUND LOCATION FOR THE VIEWER
The first photograph should show the location of the wound in relation to the body.
CLOSE-UP IMAGES ESTABLISH DETAIL FOR THE VIEWER
Figure 5. A close-up image including scale. 10
SECURELY SAVE AND STORE THE IMAGES
Upload the images to a secure location or database at the end of the consultation and delete the images from the camera. The most secure method of removing images is to reformat the DS memory card via the camera menu.
CONCLUSION Wound images provide a visual reference, not matched by memory or the written word.[12] These simple guidelines will assist the unskilled photographer to achieve clear, crisp wound images. The use of a digital camera facilitates the taking and storing of images for an improved diagnosis and treatment, when care at a distance is necessary. n
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standard ruler also works well. Check that the photograph is in focus on the screen before leaving the patient; blurred photographs should be discarded as they can be misleading.
Figure 4. [A] Correct position for the camera body to be held in order to take [C] a proportional view of the subject. [B] Holding the camera body at an angle to the subject results in [D] a distorted image.
Ten Top Tips
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