for clinical practice

Effective Quality Management requires attention to be given to the processes and pathways used in caring for your patients. It is common to find interdisciplinary teams who are charged not only with delivering quality care but also with striving to improve care and improve outcomes. While there are generally accepted standards for characterizing and assessing wounds and consequently for measuring and reporting progress towards healing, the most fundamental and often quoted metric is that of area reduction over time. While processes and pathways must take into account other indicators of the patient’s status, this metric of wound area is used fundamentally in the evaluation of a wound’s progress (1) and hence ‘downstream’ in the evaluation of the effectiveness of processes and practices. In addition to this, demonstration of wound progress, including size reduction, is becoming increasingly important to payers as a determinant of reimbursement.

In general clinical practice today, the measurement of wounds employs very basic and fundamentally inaccurate techniques to determine wound dimensions. Such primitive techniques have been reported as introducing errors of as much as 40% (2). As the focus on managing health care costs continues to intensify, such imprecision will lead to increased exposure and risk of adverse financial consequences, whether for example through challenges to the clinical necessity of frequent debridements or the use of advanced therapies, or through challenges to the adequacy of documentation and evidence of the status of a wound during a transfer between care settings.
The challenge of significantly increasing the accuracy of determining wound dimensions without adversely impacting caregiver productivity has been met by the Silhouette Product Suite.

Silhouette is the first system of its kind to incorporate an imaging device which can precisely and consistently measure the size of a wound. It integrates quantified wound images with other patient and wound observational data to provide an accurate and complete record of the assessment and treatment of a wound. As such, the record set produced using the Silhouette Product Suite can meet the requirements for demonstrating wound progress over time in a compelling way, by summarizing observational data and photographic data, anchored by very precise wound measurements including area, depth and volume calculation.

References

1. Measuring wound length, width, and area: which technigue? Langemo D, Anderson J, Hanson D, Hunter S Thompson P. Advances in Skin & Wound Care, January 2008, 21(1): 42-45.
2. Percent change in wound area of diabetic foot ulcers over a 4-week period is a robust predictor of complete healing in a 12-week prospective trial, Sheehan P, Jones P, Caselli A, Giurini J, Veves A. Diabetes Care, June 2003, 26(6): 1879-1882.