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Brinda.S1, Gayathri.B2, Sandhiya.T3, Swedha.G4 , D.Hemapriya5
1
Brinda.S Student, Dr. N.G.P Institute Of Technology,Coimbatore.
2Gayathri.B Student, Dr. N.G.P Institute Of Technology,Coimbatore.
3Sandhiya.T Student, Dr. N.G.P Institute Of Technology,Coimbatore.
4Swedha.G Student, Dr. N.G.P Institute Of Technology,Coimbatore.
5D.Hemapriya Asst. Professor, Dept. of Biomedical Engineering, Dr.N.G.P Institute Of Technology Coimbatore, Tamil Nadu,
India
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Abstract - Diabetic foot ulcer is one of most significant
health issue, where the wound assessment is done by
clinicians and nurses based on the visual examination of
wound and healing status .In this smartphone based wound
assessment method, the patients and the caretakers performs
active role in daily wound care potentially can accelerate
wound healing,it reduce healthcare expenses and save the cost
of travel. The wound image is captured by using high
resolution digital camera on smartphone with assistance of an
image capture box and then wound segmentation is performed
by applying mean shift algorithm. Specifically wound
boundary is determined based on erosion and dilation method
within this healing status is assessed based on red-yellow-
black color evaluation model.
Key Words: Diabetic patient ,wound analysis, Mean shift
algorithm.
1.INTRODUCTION
In US 5-6 million individuals are affected with type 2
diabetes, foot ulcers are painful, susceptible to infection and
very slow to heal. Patients are facing several problems for
treating diabetic foot ulcer ,they must go to wound clinic for
regular basic wound checking by their clinicians. This make
patient inconvenient and time consuming for both patient and
clinicians ,it also require special transportation cost e.g.
ambulance ,etc. The clinician wound assessment process is
based on visual examination in which the wound is described
by physical dimension of wound and color of its tissues, but it
does not produce objective measurement and quantifiable
parameters of healing status. Most of the researchers have
applied SVM(Support Vector Mechanism) and image
segmentation for wound analysis.SVM provides good result
for wound images but it is not feasible to implement the
feature extraction and training process on smartphone because
of its computational demands and it requires a large number
of image samples and experimental clinical input. This
method is difficult and costly. This paper we provide low cost
image analysis algorithm that run on smartphone. It converts
ordinary smartphone into self-management device for diabetic
patient with foot ulcer. For performing this method we need to
address the following tasks : i) capture the images of foot
ulcer by using simple methods. ii) Develop the highly
accurate algorithm for real time wound analysis that is able to
operate within the computational smartphone.
2.METHODOLOGY
In this method, First the foot ulcer image is taken from
diabetic patient and that image processed by following various
preprocessing technique then the output of the preprocessing
image is segmented by image segmentation process then it is
followed by foot outline detection and wound boundary
detection then healing state of wound is performed by color
segmentation then the wound healing trend analysis is
performed based on time sequence of wound images given by
the patient.
2.1 Wound image analysis system overview:
Wound assessment system consist of modules including
wound image capture ,image storage, image preprocessing,
boundary determination, wound analysis by color
segmentation and wound trend analysis based on time
sequence of wound images for a given patient. In the Image
preprocessing the original image is converted into gray scale
image. Then the gray scale image is perform filtering and
image enhancement technique to enhance the contrast of the
gray scale image. Then the image is smoothening is
performed by using Gaussian blur method. Image
segmentation where the original image is divide into various
pixel groups with homogeneous color values. Then Foot
outline detection is performed based on the color of largest
connected components present in the segmented image.
Afterwards Wound boundary determination is performed from
the output of foot outline detection ,where the foot area is
marked as โ€žwhiteโ€Ÿ and the wound area is marked as โ€žblackโ€Ÿ, it
is easy to determine the wound boundary within the foot
area .Then the Color segmentation is used for finding the
healing state of wound. Then the Wound healing trend
analysis is performed to monitor the wound healing status
based on the time sequence of images given by patient.
2.2 Mean shift segmentation algorithm.
The segmentation algorithm can be applicable for various skin
color smoothness by adjusting the resolution parameters. But
the mean shift algorithm is suitable for parallel
implementation where the basic processing unit is pixel. In
International Research Journal of Engineering and Technology (IRJET) e-ISSN: 2395-0056
Volume: 06 Issue: 03 | Mar 2019 www.irjet.net p-ISSN: 2395-0072
Wound Assessment System for Patients with Diabetic Ulcers using
ยฉ 2019, IRJET | Impact Factor value: 7.211 | ISO 9001:2008 Certified Journal | Page 7431
maturation phase. yellow tissues imply shown in figure (b-f).
tissue contains slough. Black tissue imply
e.
Input and downsapled image
Fig-2,(b) CIE L*A*B COLOUR SPACE
the optimization:
p or PCs,
in most
d based
PUs and
thms. A
etect the
without
ormation,
ght-map
all datas
ean shift
aks the
nd their Fig-3,(c) Segmentad Result
this algorithm used for finding density estimation based on
non-parametric clustering methods, which used to analyze the
feature space like color space, spatial space or the
combination of two spaces. In this mean shift algorithm the
feature vector is associated with each pixel like color and
position of image grid as sample from the unknown
probability density function and find the clusters in this
distribution.
2.3 Wound boundary determination and analysis
algorithm.
The mean shift algorithm only segment the original image
into various homogeneous regions based on similar features,
but the object recognition is needed for accurate wound
boundary detection that can be easily understood by the users.
The wound boundary detection method has three assumptions.
i) The foot image contains little irrelevant background
information. ii) The skin on the sole of the foot is nearly
uniform color feature. iii) The foot ulcer is cannot be located
on the edge of foot outline. The RYB model is one of simple
assessment model to evaluate wounds. The red yellow and
black or mixed tissues represent the different phases of wound
healing process. The red tissue represent inflammatory phase,
proliferation or
infection phase and
necrotic tissue phas
Fig-1(a)
3. GPU based on
The CPUs are not nearly as powerful as those lapto
so that the GPUs are parallelly implemented
computational demanding modules like androi
smartphones. The hybrid implementation on both G
CPUs can improve the time efficiency for algori
program may access the following features like d
foot region, detect the wound area and color analysis
having to write code. In which the color space transf
color histogram generation and discretization and wei
generation steps are implemented on CPU and then
are moved to GPU. The parallel implementation of m
algorithm copies the image to device and bre
computation of mode seeking into single pixels a
intermediate surrounding neighboring region.
4. Image Capture Box
There are various devices are used for capture the images of
diabetic foot ulcer, however these devices have drawbacks
like large dimensions ,high cost and most of the devices
require Wi-Fi connectivity and laptop or PC for image
processing. We design compact ,rugged and inexpensive
device called image capture box that allows the patient to
view the sole of their foot on the smartphone screen and
capture the image of wound. It allows the patient to rest their
feet on device comfortably, without requiring any angles of
the camera or foot and capture the image of left foot sole as
well as right foot sole. We make this device by use of two
front surface mirrors placed at the angle of 90 with respect to
each other and the common line of contact tilted 45 with
respect to horizontal. To provide consistent light for wound
image capturing and viewing, the warm white LED lighting is
used.
5. Experimental Results
The experimental result for the wound images taken from the
patient is given as the input of the system fig(a) .The wound
boundary determination results with mean shift algorithm
International Research Journal of Engineering and Technology (IRJET) e-ISSN: 2395-0056
Volume: 06 Issue: 03 | Mar 2019 www.irjet.net p-ISSN: 2395-0072
ยฉ 2019, IRJET | Impact Factor value: 7.211 | ISO 9001:2008 Certified Journal | Page 7432
Fig-4,(d) Mean shift Cluster Result
Fig-5,(e) Foot Outline Detection
system installed with MATLAB starter application and CPU,
GPU application.
REFERENCES
Fig-6,(f) K means result
We design the wound image analysis algorithm for the patient
who suffering type2 diabetes foot ulcer. By using the
smartphone camera placed on the image capture box the
wound images are captured and then wound analysis
algorithm and is implemented by utilizing CPU and GPU.
Where the clinicians can remotely analysis the wound results.
Hence the wound database of the patient will be constructed
on a cloud based server. This is the simplest technique used to
determine the wound healing process of type2 diabetes foot
ulcer, it comprises of smartphone camera and a computer
[1] A. Mary Juliet, โ€œFoot Reflexology positions to
control Diabetic foot ulcersโ€, Journal of chemical
and pharmaceutical research, Vol. 7, No. 2, 2015, pp.
866-871.
[2] C. Toledo , F.J. Ramos , J. Gutierrez, A. Vera2 and L.
Leija, โ€œNon-Invasive Imaging Techniques to Assess
Diabetic Foot Ulcers: A State of the Art
Reviewโ€,Health care exchanges, 2014, pp. 1-4.
[3] B.Varga, K. Karacs, โ€œHigh-Resolution Image
Segmentation Using Fully Parallel Mean Shift,โ€
EURASIP J. Advances in Signal Processing, vol. 1,
no. 111, 2011.
[4] K.M. Buckley, L.K. Adelson and J.G. Agazio,
โ€œReducing the risks of wound consultation: Adding
digital images to verbal reports,โ€ Wound Ostomy
Continence Nurs., vol. 36, no. 2, pp. 163-170, Mar.
2009
[5] Julia Shaw and Patrick M. Bell, โ€œWound
Measurement in Diabetic Foot Ulcerationโ€, United
Kingdom, 2011.
[6] H. Wannous, Y. Lucas, S. Treuillet, โ€œCombined
machine learning with multi-view modeling for
robust wound tissue assessment,โ€ Proc. of 5th
International Conf. on Computer Vision Theory and
Application , pp. 98-104, May. 2010.
[7] L. Wang, P.C. Pedersen, D. Strong, B. Tulu, E. Agu,
โ€œSmartphone-based wound assessment system for
diabetic patients,โ€ presented in 13th Diabetes
Technology Meeting, Oct. 2013.
[8] Kunjam Nageswara Rao, P srinivasa Rao, Allam
Appa Rao, Dr. G R Sridhar, โ€œSobel Edge Detection
Method To Identify And Quantify The Risk Factors
For Diabetic Foot Ulcersโ€, International journal of
computer science and information technology, Vol.
5,No.1, 2013, pp.39-46.
International Research Journal of Engineering and Technology (IRJET) e-ISSN: 2395-0056
Volume: 06 Issue: 03 | Mar 2019 www.irjet.net p-ISSN: 2395-0072
ยฉ 2019, IRJET | Impact Factor value: 7.211 | ISO 9001:2008 Certified Journal | Page 7433
3. CONCLUSION

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  • 1. Smartphone Brinda.S1, Gayathri.B2, Sandhiya.T3, Swedha.G4 , D.Hemapriya5 1 Brinda.S Student, Dr. N.G.P Institute Of Technology,Coimbatore. 2Gayathri.B Student, Dr. N.G.P Institute Of Technology,Coimbatore. 3Sandhiya.T Student, Dr. N.G.P Institute Of Technology,Coimbatore. 4Swedha.G Student, Dr. N.G.P Institute Of Technology,Coimbatore. 5D.Hemapriya Asst. Professor, Dept. of Biomedical Engineering, Dr.N.G.P Institute Of Technology Coimbatore, Tamil Nadu, India ---------------------------------------------------------------------***--------------------------------------------------------------------- Abstract - Diabetic foot ulcer is one of most significant health issue, where the wound assessment is done by clinicians and nurses based on the visual examination of wound and healing status .In this smartphone based wound assessment method, the patients and the caretakers performs active role in daily wound care potentially can accelerate wound healing,it reduce healthcare expenses and save the cost of travel. The wound image is captured by using high resolution digital camera on smartphone with assistance of an image capture box and then wound segmentation is performed by applying mean shift algorithm. Specifically wound boundary is determined based on erosion and dilation method within this healing status is assessed based on red-yellow- black color evaluation model. Key Words: Diabetic patient ,wound analysis, Mean shift algorithm. 1.INTRODUCTION In US 5-6 million individuals are affected with type 2 diabetes, foot ulcers are painful, susceptible to infection and very slow to heal. Patients are facing several problems for treating diabetic foot ulcer ,they must go to wound clinic for regular basic wound checking by their clinicians. This make patient inconvenient and time consuming for both patient and clinicians ,it also require special transportation cost e.g. ambulance ,etc. The clinician wound assessment process is based on visual examination in which the wound is described by physical dimension of wound and color of its tissues, but it does not produce objective measurement and quantifiable parameters of healing status. Most of the researchers have applied SVM(Support Vector Mechanism) and image segmentation for wound analysis.SVM provides good result for wound images but it is not feasible to implement the feature extraction and training process on smartphone because of its computational demands and it requires a large number of image samples and experimental clinical input. This method is difficult and costly. This paper we provide low cost image analysis algorithm that run on smartphone. It converts ordinary smartphone into self-management device for diabetic patient with foot ulcer. For performing this method we need to address the following tasks : i) capture the images of foot ulcer by using simple methods. ii) Develop the highly accurate algorithm for real time wound analysis that is able to operate within the computational smartphone. 2.METHODOLOGY In this method, First the foot ulcer image is taken from diabetic patient and that image processed by following various preprocessing technique then the output of the preprocessing image is segmented by image segmentation process then it is followed by foot outline detection and wound boundary detection then healing state of wound is performed by color segmentation then the wound healing trend analysis is performed based on time sequence of wound images given by the patient. 2.1 Wound image analysis system overview: Wound assessment system consist of modules including wound image capture ,image storage, image preprocessing, boundary determination, wound analysis by color segmentation and wound trend analysis based on time sequence of wound images for a given patient. In the Image preprocessing the original image is converted into gray scale image. Then the gray scale image is perform filtering and image enhancement technique to enhance the contrast of the gray scale image. Then the image is smoothening is performed by using Gaussian blur method. Image segmentation where the original image is divide into various pixel groups with homogeneous color values. Then Foot outline detection is performed based on the color of largest connected components present in the segmented image. Afterwards Wound boundary determination is performed from the output of foot outline detection ,where the foot area is marked as โ€žwhiteโ€Ÿ and the wound area is marked as โ€žblackโ€Ÿ, it is easy to determine the wound boundary within the foot area .Then the Color segmentation is used for finding the healing state of wound. Then the Wound healing trend analysis is performed to monitor the wound healing status based on the time sequence of images given by patient. 2.2 Mean shift segmentation algorithm. The segmentation algorithm can be applicable for various skin color smoothness by adjusting the resolution parameters. But the mean shift algorithm is suitable for parallel implementation where the basic processing unit is pixel. In International Research Journal of Engineering and Technology (IRJET) e-ISSN: 2395-0056 Volume: 06 Issue: 03 | Mar 2019 www.irjet.net p-ISSN: 2395-0072 Wound Assessment System for Patients with Diabetic Ulcers using ยฉ 2019, IRJET | Impact Factor value: 7.211 | ISO 9001:2008 Certified Journal | Page 7431
  • 2. maturation phase. yellow tissues imply shown in figure (b-f). tissue contains slough. Black tissue imply e. Input and downsapled image Fig-2,(b) CIE L*A*B COLOUR SPACE the optimization: p or PCs, in most d based PUs and thms. A etect the without ormation, ght-map all datas ean shift aks the nd their Fig-3,(c) Segmentad Result this algorithm used for finding density estimation based on non-parametric clustering methods, which used to analyze the feature space like color space, spatial space or the combination of two spaces. In this mean shift algorithm the feature vector is associated with each pixel like color and position of image grid as sample from the unknown probability density function and find the clusters in this distribution. 2.3 Wound boundary determination and analysis algorithm. The mean shift algorithm only segment the original image into various homogeneous regions based on similar features, but the object recognition is needed for accurate wound boundary detection that can be easily understood by the users. The wound boundary detection method has three assumptions. i) The foot image contains little irrelevant background information. ii) The skin on the sole of the foot is nearly uniform color feature. iii) The foot ulcer is cannot be located on the edge of foot outline. The RYB model is one of simple assessment model to evaluate wounds. The red yellow and black or mixed tissues represent the different phases of wound healing process. The red tissue represent inflammatory phase, proliferation or infection phase and necrotic tissue phas Fig-1(a) 3. GPU based on The CPUs are not nearly as powerful as those lapto so that the GPUs are parallelly implemented computational demanding modules like androi smartphones. The hybrid implementation on both G CPUs can improve the time efficiency for algori program may access the following features like d foot region, detect the wound area and color analysis having to write code. In which the color space transf color histogram generation and discretization and wei generation steps are implemented on CPU and then are moved to GPU. The parallel implementation of m algorithm copies the image to device and bre computation of mode seeking into single pixels a intermediate surrounding neighboring region. 4. Image Capture Box There are various devices are used for capture the images of diabetic foot ulcer, however these devices have drawbacks like large dimensions ,high cost and most of the devices require Wi-Fi connectivity and laptop or PC for image processing. We design compact ,rugged and inexpensive device called image capture box that allows the patient to view the sole of their foot on the smartphone screen and capture the image of wound. It allows the patient to rest their feet on device comfortably, without requiring any angles of the camera or foot and capture the image of left foot sole as well as right foot sole. We make this device by use of two front surface mirrors placed at the angle of 90 with respect to each other and the common line of contact tilted 45 with respect to horizontal. To provide consistent light for wound image capturing and viewing, the warm white LED lighting is used. 5. Experimental Results The experimental result for the wound images taken from the patient is given as the input of the system fig(a) .The wound boundary determination results with mean shift algorithm International Research Journal of Engineering and Technology (IRJET) e-ISSN: 2395-0056 Volume: 06 Issue: 03 | Mar 2019 www.irjet.net p-ISSN: 2395-0072 ยฉ 2019, IRJET | Impact Factor value: 7.211 | ISO 9001:2008 Certified Journal | Page 7432
  • 3. Fig-4,(d) Mean shift Cluster Result Fig-5,(e) Foot Outline Detection system installed with MATLAB starter application and CPU, GPU application. REFERENCES Fig-6,(f) K means result We design the wound image analysis algorithm for the patient who suffering type2 diabetes foot ulcer. By using the smartphone camera placed on the image capture box the wound images are captured and then wound analysis algorithm and is implemented by utilizing CPU and GPU. Where the clinicians can remotely analysis the wound results. Hence the wound database of the patient will be constructed on a cloud based server. This is the simplest technique used to determine the wound healing process of type2 diabetes foot ulcer, it comprises of smartphone camera and a computer [1] A. Mary Juliet, โ€œFoot Reflexology positions to control Diabetic foot ulcersโ€, Journal of chemical and pharmaceutical research, Vol. 7, No. 2, 2015, pp. 866-871. [2] C. Toledo , F.J. Ramos , J. Gutierrez, A. Vera2 and L. Leija, โ€œNon-Invasive Imaging Techniques to Assess Diabetic Foot Ulcers: A State of the Art Reviewโ€,Health care exchanges, 2014, pp. 1-4. [3] B.Varga, K. Karacs, โ€œHigh-Resolution Image Segmentation Using Fully Parallel Mean Shift,โ€ EURASIP J. Advances in Signal Processing, vol. 1, no. 111, 2011. [4] K.M. Buckley, L.K. Adelson and J.G. Agazio, โ€œReducing the risks of wound consultation: Adding digital images to verbal reports,โ€ Wound Ostomy Continence Nurs., vol. 36, no. 2, pp. 163-170, Mar. 2009 [5] Julia Shaw and Patrick M. Bell, โ€œWound Measurement in Diabetic Foot Ulcerationโ€, United Kingdom, 2011. [6] H. Wannous, Y. Lucas, S. Treuillet, โ€œCombined machine learning with multi-view modeling for robust wound tissue assessment,โ€ Proc. of 5th International Conf. on Computer Vision Theory and Application , pp. 98-104, May. 2010. [7] L. Wang, P.C. Pedersen, D. Strong, B. Tulu, E. Agu, โ€œSmartphone-based wound assessment system for diabetic patients,โ€ presented in 13th Diabetes Technology Meeting, Oct. 2013. [8] Kunjam Nageswara Rao, P srinivasa Rao, Allam Appa Rao, Dr. G R Sridhar, โ€œSobel Edge Detection Method To Identify And Quantify The Risk Factors For Diabetic Foot Ulcersโ€, International journal of computer science and information technology, Vol. 5,No.1, 2013, pp.39-46. International Research Journal of Engineering and Technology (IRJET) e-ISSN: 2395-0056 Volume: 06 Issue: 03 | Mar 2019 www.irjet.net p-ISSN: 2395-0072 ยฉ 2019, IRJET | Impact Factor value: 7.211 | ISO 9001:2008 Certified Journal | Page 7433 3. CONCLUSION