Scaled healing assessment index: A novel method for measuring the degree of wound bed preparation

Avi Shai, Vadim Avrin, Alex Zvulunov, Its'hak Dinstein

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Background/purpose: The color of a wound bed reflects its degree of 'cleanness'and serves as an indicator in evaluating the progression of wounds toward healing. We were aiming to develop a standard tool, for use in clinical research studies, which would analyze and provide objective data as to the color distribution of wound surfaces. To this end, we designed the 'Scaled Healing Assessment Index'algorithmic tool to provide a scoring system to determine the average color of wound surfaces. Methods: The scale is graded from 1 to 10, with 1 representing the most unclean yellow wound, and 10 representing the optimal red wound. In order to test the accuracy of the software, 102 chronic wounds in 88 patients were examined. Each wound was assessed using a grading from 1 to 10, according to its color, using three separate methods: (1) by three dermatologists [average clinical score (ACS)] in the outpatient clinic; (2) by three other dermatologists with the same wounds presented on a computer screen [average photo score (APS)]; and (3) by the Scaled Healing Assessment Index [software score (SS)]. The results of the three methods were examined statistically using Pearson's correlation. Results: We found a high correlation between the ACSs and the SSs (0.86), between the APSs and the SSs (0.863), as well as the ACSs with the APSs (0.95). Conclusion: The Scaled Healing Assessment Index algorithm provides objective and reliable data, and can be used in research studies aimed at examining the beneficial effect of products intended for wound healing.

Original languageEnglish
Pages (from-to)227-235
Number of pages9
JournalSkin Research and Technology
Issue number3
StatePublished - 1 Aug 2007


  • Color measurement
  • Digital camera
  • Image analysis
  • Visual grading
  • Wound healing

ASJC Scopus subject areas

  • Dermatology


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