Journal Article

Developing an AI-powered wound assessment tool: a methodological approach to data collection and model optimization

Niri, Rania, Probst, Sebastian, Pichon, Swann, Zahia, Sofia, Stefanelli, Alessio, Chanel, Guillaume

2025

Overview

Background Chronic wounds (CWs) represent a significant and growing challenge in healthcare due to their prolonged healing times, complex management, and associated costs. Inadequate wound assessment by healthcare professionals (HCPs), often due to limited training and high clinical workload, contributes to suboptimal treatment and increased risk of complications. This study aimed to develop an artificial intelligence (AI)-powered wound assessment tool, integrated into a mobile application, to support HCPs in diagnosis, monitoring, and clinical decision-making. Methods A multicenter observational study was conducted across three healthcare institutions in Western Switzerland. Researchers compiled a hybrid dataset of approximately 4,000 wound images through both retrospective extraction from clinical records and prospective collection using a standardized mobile application. The prospective data included high-resolution images, short videos, and 3D scans, along with structured clinical metadata. Retrospective data were anonymized and manually annotated by wound care experts. All images were labeled for wound segmentation and tissue classification to train and validate deep learning models. Results The resulting dataset represented a broad spectrum of wound types (acute and chronic), anatomical locations, skin tones, and healing stages. The AI-based wound segmentation model, developed using the Deeplabv3 + architecture with a ResNet50 backbone, achieved a DICE score of 92% and an Intersection-over-Union (IOU) score of 85%. Tissue classification yielded a preliminary mean DICE score of 78%, although accuracy varied across tissue types, especially fibrin and necrosis. The models were optimized for mobile implementation through quantization, achieving real-time inference with an average processing time of 0.3 seconds and only a 0.3% performance reduction. The dual approach to data collection, prospective and retrospective—ensured both image standardization and real-world variability, enhancing the model’s generalizability. Conclusions This study laid the foundation for an AI-driven digital tool to assist clinical wound assessment and education. The integration of robust datasets and AI models demonstrated the potential to improve diagnostic precision, support personalized care, and reduce wound-related healthcare costs. Although challenges remained, particularly in tissue classification, this work highlighted the promise of AI in transforming wound care and advancing clinical training. Trial registration Not applicable. Key Points This study aims to develop an AI-powered wound assessment tool that supports clinical decision-making and enhances wound care quality through accurate tissue segmentation, wound monitoring, and healing prediction. A large and diverse wound image database, including over 4000 wound assessments—will be created to train and validate AI models, ensuring clinical relevance across various wound types and patient profiles. This innovation addresses a critical gap in wound care expertise, aiming to reduce diagnostic variability, support guideline adherence, and ultimately improve patient outcomes while lowering healthcare costs.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Accuracy / Algorithms / Applications programs / Artificial Intelligence / Automation / Calibration / Care and treatment / Chronic Disease / Chronic illnesses / Classification / Clinical decision making / Clinical outcomes / Cost assessments / Data collection / Data Collection - methods / Data entry / Datasets / Decision making / Deep Learning / Design and construction / Diabetes / Diagnosis / Fibrin / Foot diseases / Health care / Health Informatics / Humans / Image processing / Image resolution / Image segmentation / Inclusion / Information Systems and Communication Service / Leg ulcers / Machine learning / Management of Computing and Information Systems / Measurement techniques / Medical imaging / Medicine / Medicine & Public Health / Methods / Mobile Applications / Mobile computing / Necrosis / Observational studies / Patients / Pressure ulcers / Privacy / Real time / Retrospective Studies / Segmentation / Standardization / Tissue segmentation / Training / Wound assessment / Wound healing / Wound monitoring / Wound segmentation / Wounds and injuries / Wounds and Injuries - diagnosis / Wounds and Injuries - diagnostic imaging