IEEE TRANSACTIONS ON BIOMEDICAL ENGINEERING. VOL. 42. NO. 5.
MAY 1995
An Instrument to Measure the
Dimensions of Skin Wounds
Bryan F. Jones and Peter Plassmann
Abstract-A new instrument based on the principle of color-
coded structured light has been developed to measure the area,
volume, and color of skin ulcers and pressure sores. A set
of parallel stripes of alternating colors is projected onto the
ulcerated skin and recorded by a CCD camera. The color,
width, distance, and coding of the stripes have been adjusted to
maximize the precision of the instrument. Algorithms have been
developed to extract the stripes and determine their centers to
better than 0.1 mm, even under circumstances where the skin
reflectivity varies widely over short distances. A depth map for
the ulcerated skin is calculated by triangulation. The volume of
the ulcer is that sandwiched between the base of the lesion and
the original healthy skin, which is simulated by a cubic spline
interpolation between the surrounding areas of healthy skin. The
instrument measures the ulcer’s volume with a precision of about
5% provided the ratio of the ulcer’s volume to area is greater
than 0.4 Em. The technique has been used in hospital clinics for
a wide variety of wounds.
I. INTRODUCTION
M ANY chronically ill people suffer from skin ulcers
which may develop from minor injuries when the
elasticity of the skin is decreased by a variety of causes such
as old age, a side effect of medication, or a weakened immune
system. Another common cause is poor blood perfusion in
certain regions of the skin induced by disease, for example
varicose veins, and by behavioral influences such as smoking.
Anaemia, diabetes, and vitamin deficiencies are examples of
other contributory factors.
Pressure sores are closely related to skin ulcers and origi-
nate when immobile patients are exposed constantly to high
pressures on bony prominences. Between 6% and 8% of
the hospital population suffer from pressure sores [4], which
respond only slowly to treatment.
There is general agreement that there are two main phases
of treating wounds. The first cleansing phase is characterized
by the presence of necroses, pus, or fibrin in the wound [3].
This phase lasts for a few weeks during which the wound
may be cleaned by the application of enzymes and treated
surgically and with 0.9% sodium chloride solution [12]. The
second granulatiodepithelialization phase may last for several
months. Surveys have shown that there are literally hundreds
of treatments used during this phase [ 131.
Manuscript received July 1 1 . 1993; revised January 25, 1995. The work
of P. Plassmann was partly supported by the German Academic Exchange
Service (DAAD).
B. F. Jones is with the Department of Computer Studies, University of
Glamorgan, Pontypridd, Mid Glamorgan CF37 lDL, U.K.
P. Plassmann is with the Department of Electronics and Information
Technology, University of Glamorgan, Pontypridd, Mid Glamorgan CF37
IDL, U.K.
IEEE Log Number 9410034.
0018-9294/95$04.00 0 1995 IEEE
The pattem of healing is poorly understood and clinicians
need an instrument which will give an objective measure of
the dimensions and color of a wound so that changes in the
short term can be detected. The risk of introducing infection
should be minimized by ensuring that the instrument does not
touch the patient.
Owing to the lack of precise measurement methods, physi-
cians have tried to establish an empirical scale for the classi-
fication of ulcers and sores. Shea [lo] describes a four-point
schedule, for example. Additionally, the measurement of diam-
eter has been suggested, but wounds are rarely sufficiently reg-
ular to allow a diameter to be clearly defined. Bulstrode et al.
[6] trace ulcer edges through plastic sheets and are able to mea-
sure areas to within 25%, but at a risk of infecting the wound,
Volume measurements are of greater interest since ulcers
tend to heal from the base rather than from the borders.
Raw assessments have been made by filling the ulcer with
saline from a calibrated syringe. Some of the saline will be
absorbed by the wound and the estimated precision of 20%
is probably optimistic [ 5 ] . Stereo photogrammetry produces
accurate results for the volume, but it is slow because the
photographs must be processed and traced manually [6], [7].
Ulcers are also assessed by their optical properties. Ring [9]
has measured an infrared line scan through an ulcer. Within the
ulcer boundary, the thermogram shows reduced temperatures
caused by the absence of skin, which has a high absorption
(and hence emission) coefficient for infrared, and the presence
of fluids which cool the lesion by evaporation. The temperature
of the perimeter of the ulcer does indicate the effectiveness
of blood perfusion, though the raised temperatures rarely
corresponded with the ulcer boundary, thus ruling out an area
measurement. Reflectivities in the visible and near infrared
regions are able to provide data for predicting the healing
time. Afromowitz et al. [ l ] are able to forecast healing times
for bums which have similar optical properties to skin ulcers.
They claim that healing times may be predicted with better
accuracy than experienced physicians from a scatter plot of
the ratio of green (550 nm) to infrared (880 nm) against the
ratio of red (640 nm) to infrared.
Amqvist et al. [3] classify healing ulcers by image pro-
cessing of color photographs. They identified black areas with
necrotic eschar, yellow with necrosis and fibrin, and red with
granulation tissue. The percentages of the colors vary as the
wound heals.
The aim of this work is to produce an instrument which
assesses the status of the healing of skin ulcers and pressure
sores subject to the constraints that:
JONES AND PLASSMANN: INSTRUMENT TO MEASURE DIMENSIONS OF SKIN WOUNDS
Fig. 1. (a) A schematic representation of the camera and projector housing. (b) A photograph of the instrument in use.
1) no contact is made with the patient,
2) the instrument is easy to operate, fast, and has a precision
of 5%,
3 ) the instrument should be portable and operate in normal
hospital conditions.
Our instrument is based on the technique known as struc-
tured light [14], [15], adapted for conditions where the re-
flectivity of the surface is low and variable. Algorithms to
detect and identify stripes and to reconstruct the damaged skin
surface are described.
11. DESCRIPTION
OF THE INSTRUMENT
HARDWARE
The instrument comprises a PAL color CCD PULNIX
camera and a projector with a 24-V 250-W tungsten halogen
bulb. Both are housed in a portable box which is 500 mm
high, 300 mm wide, and 100 mm deep; the dimensions of
this box are reduced by using two mirrors (Fig. l(a)). The
housing is completely closed and has a smooth surface for
465
easy disinfection. Electrical safety is ensured by the use of
insulating materials for the housing and a double-insulated
transformer; the maximum voltage used is 48 V.
The base of the housing is a rectangular frame which defines
the optimum distance and field of view when it is held close
to the skin (see Fig. l(b)).
The camera is able to operate at f = 1.4 with a minimum
illumination of 25 lux and a color temperature of 3300 K. Its
horizontal resolution is 43 pixels per mm; its vertical resolution
is 88 pixels per mm for the green channel and 44 pixel per
mm for the blue and red channels. Two images of the wound
are captured: the first illuminated by unfiltered light from the
halogen bulb, the second illuminated by a slide of alternating
red and blue stripes, with a single reference green stripe in the
center. The stripes are projected in the direction corresponding
to the camera’s higher resolution. The camera electronics
generate a standard PAL TV signal with 575 columns and
330 rows. The dynamic range of the camera is about 50 dB
(compared to 200 dB for a human eye); small dynamic ranges
466 IEEE TRANSACTIONS O N BIOMEDICAL t N G I N E t K I N G . VOL 42, N O 5. MAY 1995

loo[ Transmittance / X
L I Projector (Py. Pz)

6 Wavelength / nm

"1
Y

Wound Surface

1
6o Tranamlttance / X
Fig. 4. The geometry of triangulation.
40 brlpht blue

optical components is shown in Fig. 2(a); plots 1 and 2 are

20
dark blue
for transparent and black EktachromeTM slides, respectively.
10
Both materials transmit a high proportion of infrared radiation
Y at wavelengths greater than 800 nm, which is where the output
400 600 600 __
'on
7nn
Wevslenpth / nm from the halogen bulb operating at 3300 K is greatest. Since
(b) this radiation is transmitted by the black areas of the striped
Fig. 2. (a) Transmittance spectra of the system's optical components: (1) slide, this part of the spectrum must be removed by an infrared-
transparent slide, (2) black slide, (3) IR-cut filter. (4) camera lens, and (5) cut filter (see plot 3 in Fig. 2(a)), otherwise the camera detects
projector lens and mirrors. (bJ Transmittance spectra of different shades of this radiation in its R channel, and even to some extent in the
blue on EktachromerM film.
G and B channels.
The system is calibrated for color at the color temperature
l o o \ Reflectance / X of the halogen bulb (about 3300 K), rather than daylight (about
5200 K). A thin chip of magnesium oxide is used as a white
standard; this is placed at the center of the rectangular frame
at the base of the instrument housing, and the camera color
balancing controls are adjusted until all three color channels
give the same output. This process is repeated occasionally to
track the change in the color temperature of the bulb as it ages.
The output from the camera is fed into a color frame grabber
I
600 600 700 800 card housed in a portable IBM compatible personal computer.
Wavelength / nm
Two images of the wound are captured within 0.45 s. This
Fig. 3. Reflectance of untanned Caucasian (CJ and Negro (N) skin. A&P: ensures that the patient does not move between pictures and
after Anderson and Parish [2], K&H: after Kuppenheim and Heer [SI.
problems of registration do not occur. Most of the delay
between images is taken up by changing the slide (about 0.1 s),
cause dark areas to be displayed as black, while brighter areas and a 0.2-s delay to allow vibrations to subside. The remaining
appear white. time is needed to synchronize the camera and frame grabber
The colors of the stripes are optimized so that the camera and to acquire the pictures in the frame grabber memory.
output is maximized in each channel and the channel cross- The system is calibrated geometrically to determine the
talk is minimized. Color film normally has only three types of relative positions of the camera and projector. The distance
granules corresponding to the primary colors; the photographer of the camera's focal point from the frame at the base of the
can control the brightness of the color, but has no influence housing and the location of the focal points of the camera and
over the bandwidth (see Fig. 2(b)). The transmission spectra projector enable all the necessary quantities, such as angles
of slides made with a range of exposures were measured of incidence, to be derived. The system housing is robust and
for several brands of film. The slides were matched to the prevents changes in the geometrical settings owing to vibration
transmission spectrum of the equipment and to the reflectivity and rough handling during transportation. The positions of the
focal points of the camera and projector lenses are two fixed
of the skin. The reflectance of human skin has been measured
corners of a triangle which are used to calculate the depth map
by Anderson and Parish [2] and Kuppenheim and Heer [8] and
of the surface by triangulation (see Fig. 4). The algorithms are
is shown in Fig. 3 for untanned white (Caucasian) and black
described in the next section.
(Negro) skin. The best match was obtained with EktachromeTM
film.
The use of primary colors minimizes the cross-talk between 111. DESCRIPTION OF THE ALGORITHMS AND SOFTWARE
the RGB output channels. The slides are produced from com- Algorithms are adapted and developed both to enhance and
mon EktachromeTM film. The transmittance of the system's restore the captured images. The pixels near the center of the
JONES AND PLASSMANN: INSTRUMENT TO MEASURE DIMENSIONS OF SKIN WOUNDS 467

cyan white

I blue
Gd71 yellow

i I
bottom top
Fig 5 Vertical luminance scans for the RGB channels perpendicular to the
projected stripes Fig. 6 . The RGB color cube with a volume enclosing red granulation tissue
colors.
picture are checked to ensure that they are not capped at the
maximum gray level. If this is the case, the operator is warned smoothed by a simple 1-D moving average filter. This filter
to repeat the procedure, but with a reduced camera aperture. generates a new gray level, g(y), at position y from the gray
Typical luminance scans for the RGB channels perpendicular level of the original image, f ( y ) , using
to the stripes are shown in Fig. 5. Scans are shown for pictures
Y+2
with and without stripes. Cross-talk between the channels is
evident, especially in the green channel. However, the only g(Y) = 0.2 * f(+ (1)
i=y-2
point in the green channel where the luminance for the picture
with stripes exceeds that without stripes corresponds to the Reducing noise in the spatial domain rather than using a
location of the single projected green stripe. low-pass filter in the frequency domain has two advantages: it
The color of the image captured with white light is mea- is fast to compute and it preserves the positions of the peaks
sured; the ratio of the numbers of black to yellow pixels within and troughs of the stripes.
the wound's area is an indicator of necroses, and a large The luminance of the stripes is calculated using a dynamic
number of red pixels indicates the presence of granulation threshold. The threshold line, which defines the width of the
tissue. The ulcerated area is outlined using a mouse to trace green stripe, is derived from the image without stripes. In the
the perimeter, and the color of each pixel within the ulcer is G channel in Fig. 5 , the green stripe is the only region for
measured after convolving with a 3 x 3 averaging filter. The which the image with stripes has a larger luminance than the
color is represented as a point in an RGB color cube. Fig. 6 image captured with white light. This is used to locate the
shows a volume in a typical RGB color cube enclosing all green stripe. The high-frequency oscillations in the G channel
the coordinates which represent red granulation tissue. The arise from cross-talk from the R and B channels. The low-
volume is defined as a reference after manually analyzing a frequency oscillation follows the changing reflectivity of the
large number of ulcer photographs. The impression of red is skin; in the white light image, this oscillation is just large
caused by the balance between the three primary colors, rather enough to enclose the stripes.
than the absolute intensity of the red channel at a specific #en the green stripe is identified, the centroid for pixels
point. This may be seen in Fig. 5 where the central area within the stripe is calculated. In Fig. 5 , the plot, which is
appears red, but the R channel has a lower luminance than labeled (blue-red), shows the difference between the blue and
in the surrounding skin where the red is balanced by strong red planes, and the median of the local peaks and troughs. The
luminances in the G and B channels. Following the proposal edges of the stripes are defined to be the points of intersection
of Amqvist et al. [3], the pixels are divided into four classes: of the median and the (blue-red) scan; these pixel positions
red, yellow, black, and unclassified. The counts are displayed are labeled a and b.
on the computer screen as a histogram. The centroid, C, is given by
The area and volume measurements start with a procedure to
h I b
locate the center of the stripes, after which the remainder of the
image can be discarded. In other structured light applications
y=a
[14], [15], standard algorithms for finding the center of stripes
operate in conditions where the surface is opaque and has a The center of the stripe algorithm is based on that of Takagi
uniform reflectivity and color. In this application, the lack of and Hata [ 111, and calculates the center typically to within one-
uniformity of the surface demands a more robust algorithm. tenth of a pixel width. The role of the dynamic threshold is
Noise is introduced to the original image from a variety of crucial in maintaining the true width of the stripe when the
sources, such as the camera electronics. The raw image must skin reflectivity changes. The dynamic threshold is unsuited
therefore be smoothed. The center of stripe calculation uses for the R and B channels where the stripes are enclosed in the
a single column of pixels at a time and the raw image is white light luminance. In this case, the stripes are enhanced
468 IEEE TRANSACTIONS ON BIOMEDICAL tNGINtERING, V O L 42. NO S. MAY I Y Y S
by subtracting the R channel from the B channel. This method
has the added advantages that cross-talk between the R and B
channels is substantially reduced, including that arising from
the strong green stripe. The stripes are extracted easily from
the resulting graph, in which peaks correspond to blue stripes
and troughs to red stripes. The peaks and troughs are identified
by checking that peaks and troughs occur alternately with a
minimum distance of 15 pixels; the maximum width of a stripe
is 30 pixels. These rules apply for our image which contains
60 stripes.
The low reflectivity in certain areas of the wound causes the
stripe to disappear; the machine must then label each stripe and
fill in the gaps. The gap-closing algorithm only operates if the
gap parallel to the stripes is smaller than that perpendicular,
otherwise a new image must be captured. Gaps are filled by
a polynomial interpolation. The depth map of the surface is
calculated by triangulation using the positions of the center of
the stripes.
The reference plane at the base of the instrument is super-
imposed with a notional rectangular grid. The depth map is the
numerical representation of the relative depths of the surface
measured at this array of grid points. Three spatial coordinates
(G, . G,. G,) relative to an arbitrary origin are associated with
each grid point; G,rand G, are the positions in the plane of the
skin surface and G , is the depth of the surface. The rectangular
plate at the base of the instrument acts as a reference plane.
The system is represented schematically in two dimensions
in Fig. 4. Suppose that a grid point G lies at the center of a
stripe on the surface of the skin. The projector and camera are
located at (P, . P,) and (Cy.C z ) ,respectively. The equation
for the line AG (Fig. 4) is
(3)
where (A,..ily) and (BZ, L?,) are the coordinates of the points
-4 and B , and for the line BG
(4)
The coordinates at the point of intersection, G, are given by
and
The analysis can be extended to three dimensions when the
value for G, is given by
G,. . ( A , - C X )- A , . C,
G,. = - (7)
C2
Thus, changes in height cause a lateral shift in the stripes'
position from point B to A (Fig. 4); the magnitude of the shift
is used to calculate the depth of the surface below the reference
plane using the above equations.
The volume of the ulcer is that enclosed by the former
healthy surface, which is defined by a cubic spline interpolated
negarive
cubic
spline
volume.
Fig. 7. A cross-section of a typical ulcer showing the measured and re-
constructed surfaces.
between the surrounding areas of healthy skin, and the existing
ulcer surface, whose position is defined by the depth map. The
perimeter of the ulcer is defined by the operator who traces
around the edge using a mouse. The operator may superimpose
the extracted stripes onto the white light image as a help in
defining the edge. The edges of the ulcer may be swollen and
slightly raised. Fig. 7 shows the cross-section of a typical ulcer
where the swollen edges lead to a negative volume.
The area and volume are calculated together. The rectan-
gular surface grid is subdivided into a mesh of triangles. The
area of the ulcer is determined by summing the areas of all the
resulting triangles which lie within the ulcer's boundary. The
ulcer's volume is calculated by multiplying the area of each
triangle by the average depth at the three comers and summing
the volumes of those elements which fall within the ulcer.
Iv. THE PRECISION OF THE INSTRUMENT
Inaccuracy is defined to be any bias in the system and
is manifest in the difference between the mean of repeated
measurements and the known real value. The accuracy of the
area measurement is 2% or better.
The precision is a measure of the scatter of single mea-
surements about their mean. The precision of the instrument
is of much more importance to the clinician since the trend
in volume and area measurements with time is of greater
significance than their absolute values.
The precision of the area measurement depends mainly on
three factors: the exactness with which the operator follows
the perimeter, the quantization of this area by the grid which
describes the surface, and the distance between the surface
and the instrument.
The first factor is subjective and may vary from person to
person and from day to day for the same person.
As far as the second factor is concerned, the grid is defined
to be 60 rows (which is the number of stripes projected) by 52
columns whose separation is six pixels. This is a compromise
between the demands of a fast processing time, the need for a
satisfactory precision in the area and volume calculation, and
the resolution of the camera. The area is thus quantized into
squares with sides of six pixels which, in the present case, is
equivalent to about 2.2 mm; each square is divided into two
triangles each of which have an average area of 0.024 cm2.
These are the basic units for the calculation. Triangles which
are contained entirely within the area are counted, and half the
areas of the border cells which are contained partly within the
wound are added. To a first approximation, the errors cancel.
JONES AND PLASSMANN: INSTRUMENT TO MEASURE DIMENSIONS OF SKIN WOUNDS
standard dev /f \ \
1 9 16 25 36 49
area/cm
(a)
standard dev
of the v o l u m
error a s B
of t h e
volume 20
I A-
0 iu LU )U 4u
volumeicm’
(b)
Fig. 8. (a) The precision of the area measurement as a function of area and
distance. (h) The precision of the volume measurement as a function of the
area and volume. The shaded plane is at 5% precision.
The third factor is determined by the camera lens and the
area which needs to be measured. The camera has a lens of
focal length 8.5 mm with a field of view of 54.7’; this may
be focused at any point between 20 cm and infinity. At a
distance of 25 cm, an area of 25 by 30 cm just fills the screen.
The spherical aberration of the lens introduces a much greater
inaccuracy than other mechanisms such as noise in the camera
electronics. The observed “barrel” distortion is compensated
by adjusting the observed position (s’,y’) relative to an origin
at the point where the camera lens’ optical axis cuts the
reference plane. The corrected coordinates are
with a corresponding equation for y; C, is the height of the
camera above the reference plane. When this compensation is
applied to stripes projected onto a flat surface, the resulting
stripes are straight to within f 0.25 pixel.
Fig. S(a) shows how the precision varies with distance
between the instrument and ulcer and area. The best results
are obtained for ulcers with large areas when the instrument
is close to the patient.
The precision of the volume measurement depends on four
factors: the boundary defined by the operator, the quantization
of the measurement grid, the position calculations for the
469
area v o l u m e
cm’ c p 3
I
04
cl 1 2 3 4 5
time / months
62
Fig. 9. Change in area and volume of a pressure sore over a five-month
period.
surface points in the measurement grid, and the ability of the
interpolation algorithm to predict the original healthy surface.
Experiments on 15 models of skin ulcers with different known
areas and volumes are measured 10 times each at a fixed
distance of 30 mm; the results show that the last two sources
of error are the most important. The mean of the measured
volumes is always about 3% higher than the real volume of
the models, and the areas about 2% higher than the true values.
Several interpolation algorithms for reconstructing the
healthy skin were tested, including cubic splines and Bezier
curves. The cubic splines give consistently good results
3u because they produce curves with a minimum curvature;
in that respect, they model the behavior of skin. However, the
precision falls for shallow ulcers of large area where small
inaccuracies in the interpolation lead to substantial differences
in the volume integral. Wounds bigger than 70 cm2 occupy
so much area that too little healthy skin appears in the field
of view to enable the healthy surface to be reconstructed
successfully. Fig. 8(b) shows the precision as a function of
ulcer volume and area; the shaded plane is at a precision
of 5%. The precision deteriorates significantly when shallow
wounds with a volume-to-area ratio of less than 0.4 cm are
measured. In addition, wounds which are small in area with
steep sides cannot be measured with sufficient precision at
present.
The optical properties and shape of the skin affect the ability
of the machine to detect the stripes. A wet wound may give
rise to specular reflections of high intensity; these may be
eliminated either as part of the algorithm or by incorporating
polarizing filters. If the gradient of the sides of the wound are
steep, the stripes are shifted so that they become very close.
Furthermore, the optical properties of the skin tend to cause
blurring of the stripes which become difficult to delineate.
When the angle of incidence becomes too small, the stripes’
width increases and their intensity falls. Thus, the precision
falls for deep wounds. Fig. 8(b) shows an increase for wounds
of low areas.
V. MEASUREMENTS
ON A PATIENT
The instrument has been used in two hospital clinics on a
wide variety of patients suffering with skin ulcers, pressure
sores, postoperative wounds, and other skin wounds.
470 IEEE TRANSACTIONS ON BIOMEDICAL ENGINEERING. VOL 42, NO. 5. MAY 1995
Fig. 9 shows the area and volume measurements for one
patient with a pressure sore located on the buttocks over
a period of six months. The uncertainty of the first two
measurements is high because they were made with an early
version of the instrument; the later version has an improved
precision.
This experiment helps to confirm the view of some physi-
cians that pressure sores heal from the base first, which is
confirmed by the rapid decrease in volume between one and
three months. Then, the wound heals from the boundary, which
shows as a slow decrease in area.
VI. CONCLUSIONS
The area and volume of skin ulcers and pressure sores can be
measured rapidly using the principle of color-coded structured
light.
The area can be measured with a precision of about 5%
provided that the area is greater than 9 cm2 and is at a distance
of less than 3 cm.
The volume can be measured with a precision of about 5%
provided the volume-to-area ratio is greater than 0.4 cm, i.e.,
the wounds are not shallow and large in area.
ACKNOWLEDGMENT
The authors would particularly like to thank Prof. E. F. J.
Ring of the Royal National Hospital in Bath and of the Univer-
sity of Glamorgan, who first introduced them to the problem
of wound measurement and helped with many stimulating
discussions. They would also like to thank Dr. K. Harding
of the Wound Healing Research Unit, University of Wales
College of Medicine, Cardiff, and Prof. Ring for assessing the
instrument in their clinics and for many helpful suggestions on
improving the instrument. Thanks also go to the referees for
their constructive comments which have enabled us to improve
the paper.
REFERENCES
[ I ] M. A. Afromowitz, G. S. Van Liew, and D. M. Heimbach, “Clinical
evaluation of burn injuries using an optical reflectance technique,” IEEE
Trc“ Biomed. Eng., vol. BME-34, pp. 114-127, 1987.
[2] R. R. Anderson and J. A. Parish, “The optics of human skin, J.
Investigcitive Dermatology, vol. 77, pp. 13-19, 1981.
[3] J. Arnqvist, L. Hellgren, and J. Vincent, “Semiautomatic classification
of secondary healing ulcers,” in Proc. 9th Int. Con5 Pattern Recognition,
New York, IEEE, pp. 459461, 1988.
[4] J. C. Barbenel, M. M. Jordan, and S. M. Nicol, “Incidence of pressure
sores in the greater Glasgow Health Board area,” Lancet, p. 548, 1977.
[5] W. Berg, C. Traneroth, A. Gunnarson, and C. Losing, “A method for
measuring pressure sores,” Lancet, vol. 335, pp. 1445-1446, 1990.
[6] C. J. K . Bulstrode, A. W. Goode, and P. J. Scott, “Stereophotogrammetry
for measuring rates of cutaneous healing,” Clin. Sci., vol. 71, pp.
4 3 7 4 4 3 , 1986.
[7] R. A. Frantz and D. A. Johnson, “Stereophotography and computer-
ized image analysis: A three-dimensional method of measuring wound
healing,” Wounds: Compendium Clin. Res. Practice. vol. 4, pp. 58-64,
1992.
[8] H. F. Kuppenheim and R. R. Heer, “Spectral reflectance of white and
negro skin between 440 and 1000 nm,” J. Applied Physiology, vol. 4,
pp. 800-806, 1952.
[9] E. F. J. Ring, Video Thermal Imciging in Thermological Method.\.
Heidelberg: Verlag Chemie, 1985, pp. 101-1 1 I .
[IO] J. D. Shea, “Pressure sores: Classification and management,” Clin.
Orthop.. vol. 112, pp. 89-100, 1975.
[ I I] Y. Takagi and S. Hata, “High speed precise 3-D vision sensor using the
slit light method,” in Pmc. Int. Wkshp. Ind. Applical. Machine Vision.
Tokyo, Japan, pp. 235-239, 1987.
[I21 G. Eriksson, A. E. Eklund, and S. Zetterquist, “Comparison of different
treatments of venous leg ulcers,” Current Therapeutic Res., vol. 35, pp.
678-684, 1984.
[I31 A. L. Knight, “Medical management of pressure sores,” J . Family
Practice, vol. 27, pp. 95-100, 1988.
[I41 K. L. Boyer and A. C. Kak, “Color encoded structured light for rapid
active ranging,” IEEE Trcms. Pattern Anal. Muchine Intell., vol. PAMI-9,
pp. 14-28, 1987.
[I51 M. Goharl’ee and M. Raaberg, “Applications of structured light for
volume measurement,” in P roc. SPIE: Optics. Illumination cmd Imcige
Sensing,for Machine Vision, vol. 728, pp. 279-291, 1988.
Bryan F. Jones received the B Sc (Honors) in
physics from Manchester University in 1965 and
the Ph D from Nottingham University i n 1968
After developing computer models of high-
pressure gas discharges in the Thorn EM1 research
laboratories Leicester, he joined the University
of Glamorgan and is now Redder and Research
Coordinator in the Department of Computer Studies
9 His mdin research interests are in medical image
processing and the application of genetic algorithms
to the automatic testing ot software
Peter Plassmann received the Dipl.-lng. degree
in electrical engineering from the Fachhochschule
Hannover, Germany in 1989 and the Ph.D. degree
in electrical engineering from the University of
Glamorgan. United Kingdom, in 1992.
He is currently a Research Fellow at the Depart-
ment of Electronics and Information Technology at
the University of Glamorgan. His current research
interests are in the areas of image processing and
the design of medical instrumentation.