Photographic assessment of burn wounds: A simple strategy in a resource-poor setting
Open accessAbstract
Objective To validate the use of photographic burn wound assessment in evaluation of burn size and wound characteristics.Methods Feasibility study of agreement between methods of measurement of burn size and characteristics, in patients admitted to the burn unit at Kamuzu Central Hospital (KCH), Malawi, over two months in 2011. Burn wounds were photographed and assessed clinically, concurrently, by an experienced clinician. Photographs reviewed by two blinded burn clinicians after 4-6 weeks. Correlation between clinical assessment and photographic evaluation was calculated using kappa score and Pearson's correlation coefficient.Results Thirty-nine patients were included in evaluation of TBSA, and fifty wounds assessed for their characteristics. Pearson's correlation coefficient for agreement of TBSA between clinical exam and photograph review by expert#1, and #2, was 0.96, 0.93 (p<0.001), respectively. Pearson's correlation coefficients comparing expert#1 and #2 to the gold standard were: proportion of full-thickness burn (0.88 and 0.81, p<0.001), and epithelialized superficial burn (0.89 and 0.55, p<0.001). Kappa scores were significant for wound evolution (expert#1 0.57, expert#2 0.64, p<0.001), and prognosis (expert#1 0.80, expert#2 0.80, p<0.001).Conclusions Burn assessment with digital photography is a valid and affordable alternative to direct clinical exam, alleviating access issues to burn care in developing countries.
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An important feature of most mHealth interventions was that interactions between participants usually took place on the basis of standardized information exchange protocols.
“An important feature of most mHealth interventions was that interactions between participants usually took place on the basis of standardized information exchange protocols [36, 39, 40, 42, 43, 45–47, 49, 52, 54].”
From A realist review of mobile phone-based health interventions for non-communicable disease management in sub-Saharan Africa (2017) · cites this paper as [43]
Almost all included studies highlighted that mHealth interventions facilitate access to previously unavailable services.
“In fact, almost all included studies highlighted this characteristic feature of mHealth interventions [20, 36–51].”
From A realist review of mobile phone-based health interventions for non-communicable disease management in sub-Saharan Africa (2017) · cites this paper as [43]
Participating patients or providers usually required only a few days of training on how to use the mobile technology and the consultation procedures.
“Participating patients or providers usually required only a few days of training on how to use the mobile technology (such as the mobile phone and its application software) and the consultation procedures [41, 43, 46–48, 50, 55].”
From A realist review of mobile phone-based health interventions for non-communicable disease management in sub-Saharan Africa (2017) · cites this paper as [43]
In 12 included studies, mHealth interventions essentially consisted of mobile phone-based consultations between two healthcare providers, where a specialized provider could be reached by another provider, indirectly improving patient access to specialized care.
“In 12 studies, mHealth interventions essentially consisted of mobile phone-based consultations between two healthcare providers, where a specialized provider could be reached by another provider, thus indirectly improving patient access to specialized care [36, 38–43, 45, 47–49, 52].”
From A realist review of mobile phone-based health interventions for non-communicable disease management in sub-Saharan Africa (2017) · cites this paper as [43]
Specialized providers found mHealth easier to use in the context of certain disease conditions (acne, herpes simplex, Kaposi's sarcoma, and flame burns in dermatology) than in others (scald burns, thickness wounds, and atopic dermatitis).
“However, specialized providers found mHealth easier to use in the context of certain disease conditions, such as acne, herpes simplex, Kaposi’s sarcoma, and flame burns in dermatology, than in others (scald burns, thickness wounds, and atopic dermatitis) [36, 43] and easier for certain diagnostic and treatment tasks (sharing feedback with patients, continuous clinical follow-ups) than for others (”
From A realist review of mobile phone-based health interventions for non-communicable disease management in sub-Saharan Africa (2017) · cites this paper as [43]
Specialized providers found mHealth easier for certain diagnostic and treatment tasks (sharing feedback with patients, continuous clinical follow-ups) than for others (conducting physical examinations, special tests, and probing for additional information).
“However, specialized providers found mHealth easier to use in the context of certain disease conditions, such as acne, herpes simplex, Kaposi’s sarcoma, and flame burns in dermatology, than in others (scald burns, thickness wounds, and atopic dermatitis) [36, 43] and easier for certain diagnostic and treatment tasks (sharing feedback with patients, continuous clinical follow-ups) than for others (”
From A realist review of mobile phone-based health interventions for non-communicable disease management in sub-Saharan Africa (2017) · cites this paper as [43]
Over-burdening workload contributed to specialized providers' perceived usefulness of mHealth.
“Also for (specialized) providers, several need factors contributed to the perceived usefulness of the intervention, including, for example, an over-burdening workload [20, 36, 38–41, 43, 45, 47, 50] and a lack of adequate referral and transport systems [38, 46, 47].”
From A realist review of mobile phone-based health interventions for non-communicable disease management in sub-Saharan Africa (2017) · cites this paper as [43]
Assurance of privacy was an enabling resource for patients.
“Other enabling resources were assurance of privacy [43, 48], support from partners/relatives [51, 55], reduced costs of travel, and reduced time away from home or work [24, 50–53].”
From A realist review of mobile phone-based health interventions for non-communicable disease management in sub-Saharan Africa (2017) · cites this paper as [43]
Using technologies from basic SMS to smartphones, built-in camera, and battery-saving apps was associated with healthcare providers' perception that mHealth was easy to use.
“The same enabling resources — easy portability and operability [36, 39], using technologies from basic SMS to smartphones, built-in camera, and battery-saving apps [41, 43, 45, 52] — were also found to be associated with the perception among healthcare providers that mHealth was easy to use.”
From A realist review of mobile phone-based health interventions for non-communicable disease management in sub-Saharan Africa (2017) · cites this paper as [43]
Availability of policy guidelines regarding data protection, phone usage, etc. was one of the most important enabling resources for specialized healthcare providers.
“For (specialized) healthcare providers, the most important enabling resources were a tolerable additional workload [40, 46, 47], the use of financial incentives [47, 55], and the availability of policy guidelines regarding data protection, phone usage, etc. [40, 43, 45, 52].”
From A realist review of mobile phone-based health interventions for non-communicable disease management in sub-Saharan Africa (2017) · cites this paper as [43]
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- Authors
- Kiser, M., Beijer, G., Mjuweni, S., Muyco, A., Cairns, B., & Charles, A.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- Karolinska Institutet (SE)
- Kamuzu Central Hospital (MW)
- Corresponding author
- Charles, Anthony
- Venue
- Burns
- Publisher
- Elsevier BV
- Published
- 2013-02
- Volume
- 39
- Issue
- 1
- Pages
- 155-161
- ISSN
- 0305-4179 (ISSN-L)
- OpenAlex
- W2128014575
- Cited by
- 36
- References
- 37
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 5 · 2022: 1 · 2021: 3 · 2020: 4 · 2019: 2 · 2018: 1 · 2017: 6 · 2016: 4 · 2015: 3 · 2014: 3 · 2013: 2
- FWCI
- 1.92
- Type
- journal article
- Language
- en
- Open access
- green
- doi.org
- Locations
- Burns (publishedVersion)
- PubMed (publishedVersion)
- Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion)
- UNC Libraries
- Topics
- Health Sciences › Medicine › Epidemiology › Burn Injury Management and Outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Digital Imaging in Medicine
- Health Sciences › Medicine › Dermatology › Dermatologic Treatments and Research
- Keywords
- burn wound assessment, digital photography, burn size estimation, total body surface area, third-degree burns, wound characteristics, burn prognosis, interobserver agreement, resource-limited settings
- MeSH terms
- Adolescent, Burns, Child, Child, Preschool, Developing Countries, Feasibility Studies, Female, Humans, Malawi, Male, Photography
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