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Reliability and Validity of the Revised Photographic Wound Assessment Tool on Digital Images Taken of Various Types of Chronic Wounds

Thompson, Nicole MCLSc (WH), BScOT; Gordey, Lisa MCLSc (WH), BScN, RN; Bowles, Heather MCLSc (WH), BScN, RN; Parslow, Nancy MCLSc (WH), RN, CETN(C); Houghton, Pamela PhD, PT

Advances in Skin & Wound Care:
doi: 10.1097/01.ASW.0000431329.50869.6f
Features: Original Investigations

OBJECTIVE: The objective of this study was to examine the validity and reliability of the revised Photographic Wound Assessment Tool (revPWAT) on digital images taken of various types of chronic, healing wounds.

SETTING: This multicenter trial was performed in a variety of settings where chronic wounds are assessed.

PARTICIPANTS: A total of 206 different photographs taken of 68 individuals with 95 chronic wounds of various etiologies were reviewed in this study. Wound etiologies included people with venous/arterial leg wounds (n = 13), diabetic foot wounds (n = 18), pressure ulcers (n = 32), and wounds of other etiologies (n = 5).

MAIN OUTCOME MEASURES: An initial wound assessment using the revPWAT was performed at the bedside, and 3 digital photographs were taken—2 within 72 hours when no change had occurred, and a third was taken 3.5 to 6 weeks later.

MAIN RESULTS: The revPWAT scores derived from photographs assessed by the same rater on different occasions and by different raters showed moderate to excellent intrarater intraclass correlation coefficients (ICCs) (ICC = 0.52–0.93), as well as test-retest (ICC = 0.86-0.90) and interrater (ICC = 0.71) reliability. There was excellent agreement between bedside assessments and assessments using photographs (ICC = 0.89).

CONCLUSION: The revPWAT is a valid and reliable tool to assess chronic wounds of various etiologies where digital images are viewed.

In Brief

The authors examine the validity and reliability of the revised Photographic Wound Assessment Tool on digital images taken of various types of chronic, healing wounds.

Author Information

Nicole Thompson, MCLSc (WH), BScOT, is an Occupational Therapist, Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada. Lisa Gordey, MCLSc (WH), BScN, RN, is a Clinical Nurse Educator, Northern Alberta Renal Program, Edmonton, Alberta, Canada. Heather Bowles, MCLSc (WH), BScN, RN, is a Nurse Clinician, London Health Sciences Centre, London, Ontario, Canada. Nancy Parslow, MCLSc (WH), RN, CETN(C), is an Enterostomal Therapy Nurse, University Health Network, Toronto, Ontario, Canada. Pamela Houghton, PhD, PT, is a Professor, School of Physical Therapy, Western University, London, Ontario, Canada. Ms Thompson, Ms Gordey, Ms Bowles, and Ms Parlow have disclosed that they have no financial relationships related to this article. Dr Houghton has disclosed that Western University has received previous grant funding from Derma Sciences; Prizm Medical, Inc; Roho Group; and Argentum Medical. Submitted August 31, 2012; accepted in revised form January 28, 2013.

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