Automatic evaluation of pressure sore status by combining information obtained from high-frequency ultrasound and digital photography

In this study, the different phases of pressure sore generation and healing are investigated through a combined analysis of high-frequency ultrasound (20 MHz) images and digital color photographs. Pressure sores were artificially induced in guinea pigs, and the injured regions were monitored for 21 days (data were obtained on days 3, 7, 14, and 21). Several statistical features of the images were extracted, relating to both the altering pattern of tissue and its superficial appearance. The features were grouped into five independent categories, and each category was used to train a neural network whose outputs were the four days. The outputs of the five classifiers were then fused using a fuzzy integral to provide the final decision. We demonstrate that the suggested method provides a better decision regarding tissue status than using either imaging technique separately. This new approach may be a viable tool for detecting the phases of pressure sore generation and healing in clinical settings.