Clinical implementation of a novel wound assessment tool (Silhouette Star) for the accurate measurement and assessment of wound healing rates of DFUs with specific focus on the use of human fibroblast-derived dermal substitute (Dermagraft)

Abstract

Purpose: To test the cost effectiveness and efficacy of Dermaraft in the treatment of non-healing DFUswithin a clinical setting. o assess the potential advantages of using a more advanced sysem of photographic record keeping and computer assisted wound easurement in a clinical setting, using the Silhouette Star Sysem, focusing on accuracy, reproducibility, reliability vs. standard ound measurement techniques. Method: Use of the Silhouette System, which includes the camra (Silhouette Star), the local software system (Silhouette connect) nd the external database (Silhouette central). The system calcuates wound area and depth and stores all wound photographs. It rackswoundhealing at each patient visit and creates a graphic and umerical representation of changes in the wound area and depth. he data is then automatically archived. Dermagraft was applied to ach wound at each patient visit. Preliminary results: The average healing ratewas 1.54 cm2/week ver the first 6 weeks of the study compared with 0.45 cm2/week ited for conventional care. Conclusion/discussion: The use of Dermagraft has thus far shown o be highly beneficial with wound healing rates noted at 6 weeks f 1.52 cm2/week. The photographic record and calculations of the ound healing rates using reduction in area can be viewed and valuated by any practitioner given access to the record. The clear ictures, graphs and numerical calculations are an advantage to the linician in evaluating wound healing. There isnoquestion thata ruleror tapemeasure ishighly inaccuate and unreliable as the standard practice of measuring wounds hen those wounds are not a perfect or near perfect geometric hape. Measurements of length and width in these cases cannot ccurately determine thewound area and changes in area to assess ound progress on a week to week basis. There are many advantages to the Silhouette System. It allows or access of the information obtained at any remote site. Multiple ameras and multiple sites can share information. Patient treatent can be greatly enhanced with this information being shared f a patient moves or is seen at another institution. The stored data analsobeused formulti-site researchprojects, CMSorother insurnce audits or payment requests, and for home care agencies. Other otential uses could be in areas such as child abuse, domestic abuse nd crime victim documentation in hospitals, for law enforcement nd for other local, state and federal agencies.