Extended Reality Glasses in Chronic Wound Monitoring

Written by Md Hridoy Bhuyan, M.Sc on 25.04.2023

Digital technology is already immensely integrated within health care, but new innovations in this space could result in unconventional opportunities to improve patient outcomes. Augmented reality (AR), which is the enhancement of reality by virtual content, is one such innovation [1]. Augmented reality has many uses in health care such as wound monitoring, remote viewing, hands free measurement etc. The use of AR to virtually assess wounds has been found to have promising reliability. The Project med4PAN aims to use extended reality (XR) application in chronic wound monitoring. Remote Assist and the HoloLens 2 can be an important solution in documenting the progression of wound healing. Augmented-reality (AR)-based devices like HoloLens2 will be helpful in accurately measuring the wound. Med4PAN aims to improve such use-case by collaborating with other institutions such as Red Cross and finding out the needs of the healthcare professionals in managing chronic wounds.

Chronic wounds are any disruption in the integrity of the skin which can be either caused by external forces such as trauma, by weakening of the physiologic and anatomic integrity of the skin, or it can be from both. Wound healing is an important process to prevent further damage to the affected and surrounding area [2]. There are several types of chronic wounds, namely: venous ulcers, pressure ulcers, and diabetic foot ulcers. These wounds, when left unchecked, can pose significant morbidity to a patient, or may even cause death [3]. They also posed an increased risk of amputation especially in non-healing wound ulcers [4]. Somewhere in the world, one leg is amputated every 30 seconds [5].

From a clinical perspective, wound documentation is an important process to be able to accurately monitor the wound healing. To be able to facilitate wound healing, the wound needs to be cleaned, disinfected, and be protected from contamination of the external environment. Typically, healthcare workers measure the size of the wound with a ruler or measuring tape, and then write them down on the patient’s health record [6]. They also write the description of the wound such as the presence or absence of pus, the warmth of the surrounding skin, the ointment or cream applied, and others.

Another form of wound documentation is through taking photographs of the wound and including them to the patient’s health record. This can simultaneously happen when one healthcare worker cleans and treats the wound, while another healthcare worker documents the wound. While this method is efficient, there is a possibility of process deviations, which can affect consistency of the wound documentation. Since healthcare professionals typically work in shifts, there is a possibility that wound documentation done later or shift will differ from prior documentation [6].

Figure 1: Demonstration on how the HoloLens can measure a wound size. An artificial, silicone-based wound is embedded on a curved anatomy (e.g. skull) and then subsequently measured using an app inside the HoloLens

References:

[1] Hill R. Using augmented reality to improve patient outcomes with negative pressure wound therapy. Wounds. 2022 Feb;33(2):47-50. doi: 10.25270/wnds/2022.4750. PMID: 35108668.

[2]   P.-H. Wang, B.-S. Huang, H.-C. Horng, C.-C. Yeh, and Y.-J. Chen, “Wound healing,” J Chin Med Assoc, vol. 81, no. 2, pp. 94–101, Feb. 2018, doi: 10.1016/j.jcma.2017.11.002.

[3]   C. K. Sen et al., “Human skin wounds: A major and snowballing threat to public health and the economy,” Wound Repair and Regeneration, vol. 17, no. 6, pp. 763–771, Nov. 2009, doi: 10.1111/j.1524-475X.2009.00543.x.

[4]   A. Shah, C. Wollak, and J. B. Shah, “Wound Measurement Techniques: Comparing the Use of Ruler Method, 2D Imaging and 3D Scanner,” J Am Coll Clin Wound Spec, vol. 5, no. 3, pp. 52–57, Dec. 2013, doi: 10.1016/j.jccw.2015.02.001.

[5]   F. Zvietcovich, B. Castañeda, B. Valencia, and A. Llanos-Cuentas, “A 3D assessment tool for accurate volume measurement for monitoring the evolution of cutaneous leishmaniasis wounds,” Annu Int Conf IEEE Eng Med Biol Soc, vol. 2012, pp. 2025–2028, 2012, doi: 10.1109/EMBC.2012.6346355. 

[6]   K. Klinker, M. Wiesche, and H. Krcmar, “Digital Transformation in Health Care: Augmented Reality for Hands-Free Service Innovation,” Inf Syst Front, vol. 22, no. 6, pp. 1419–1431, Dec. 2020, doi: 10.1007/s10796-019-09937-7.