... turn your smartphone into a medical device
MOWA (Mobile Wound Analyzer) is an app, for iPhone 4.3.5 and upper. The software makes possible to differentiate types of tissues found in pressure ulcer. The analysis can be made on photos taken with the on board camera or uploaded pictures from other sources. It identifies three types of tissues in the bed of the lesion: Necrotic, fibrinous and granulation. Calculates the area of the lesion and indicates the treatment LG EPUAP-
Mowa's functions are 8:
1. Taking a picture (manual);
2. Design of the mask (manual);
3. Tissue analysis (Auto);
4. Parameter settings (manual);
5. Calculation of the area (manual / automatic);
6. Directions / suggestions on treatment (automatic);
7. Analysis Report in pdf (automatic);
8. Jpg and pdf file sending via mail (manual)
Why use MOWA?
It is not invasive: it doesn't make contact with the patient;
It is objective: it follows international guidelines;
It is a medical device: registered in the list of the Italian ministry of health as a class I A CE directives;
It is fast, analysis process takes less than 3 minutes;
It is easy to use: just take a picture of the ulcer;
It is unique in the world: it is the only app for mobiles with this utility;
Advantages and Benefits
Improve ulcer therapy;
Improve the quality of assistant;
Help to identify and measure the ulcer tissues;
Define the priorities in treatment;
Suggest the therapeutic treatment;
Improve the follow up of the cure;
Automate the clinical documentation;
Improve the communication and collaboration;
Help medical/nurse training and education;
Facilitate sector study investigations;
Ease effectiveness monitoring of new products
Reducing use of ineffective products;
Reducing care times;
Reducing hospitalization time;
Supporting home care assistance;
Automatic calculation of the surface area of the ulcer using a blue label mark;
Added Portuguese language
Healing process assessment comparing photos in time
Graph charts of tissues percentages against time
Quick Reference Guide for iPhone
When the application is started you have to acquire a picture (figure 1). On the Start Menu you can choose to take the picture with the on-
Mask Area Creation
The mask area page is visualized right after a new image acquisition (figure 3). The Mask Area is essential: is the only way in which MOWA can recognize which specific parts of the image you want to be analyzed. To draw the Mask, MOWA does not use vectors or geometrical shapes, you simply draw it freehand (figure 5). The total amount of pixels set in the Mask is used in the calculus of the wound area. The Mask Page can be accessed from the Start Menu pushing the Mask.
After drawing the mask, the special algorithm created specifically for this application, calculates and identifies the tissues present in the wound image by three colors:
the quantities, expressed in percent of recognized tissues in the whole analyzed area, are classified as:
necrotic tissue (black)
fibrinous tissue (yellow)
granulation tissue (red)
The blue color percentage indicates the amount of unrecognized tissue area of the whole mask. This could be caused by corruption of the image, light effects, flash reflections, etc. (figure 6).
Tissue classification from color images could be different between photo and photo or among different devices. The causes could be various. Among the elements that could corrupt image color analysis are: illumination, flash reflection, resolution, jpg codec and more. For example, differences have been observed between the jpg codec in some Smart-
Edit lesion parameters
Necessary condition for the software to show the appropriate therapeutic treatment for analyzed tissues is to indicate:
Presence of Infection;
Presence of Hemorrhage;
If the lesion is deep;
These parameters must be set by the professional operator (Figure 7)
Calculation of the size of lesion
Manual without blue marker
After work area was defined (MASK AREA) and the lesion parameters have been set, the operator has to measure the real size of the lesion with a tape measure (or a ruler) directly on the patient. With the plus and minus buttons the operator sets the size of the surrounding rectangle accordingly. At this instance MOWA is able to calculate the real area of the lesion expressed in cm2. This calculated area is actually the area of the mask scaled properly, not that of the surrounding rectangle. The area can be computed in lesions from 2 mm up to 300 mm (30 cm) in the largest dimension (width or height).
Automatic with blue marker
If the blue marker is found on the image, the program scales the dimensions of the mask automatically and the plus and minus buttons are not shown. If the user considers that there is an error in the calculated dimensions, he/she can change the values pressing the Manual button to have access to the plus and minus buttons.
The automatic scale only works if you use the predefined blue markers (blue circles with diameter of 25 mm).
Using Info -
Prescription and therapeutic treatment
The last stage of the process consists in the therapeutic treatment. Suggested on the base of the therapeutic effects that are carried out by the active priciples of the dressing, drugs, etc.. (vedi Figure 10).
Image analysis report
The final report will be saved or sent as a PDF document insuring the report portability. (Figure 11). Send the file to PDF and JPG files with the send button (Figure 12).
Buy MOWA on iTunes;
Install MOWA on the device;
Start the application pushing MOWA's Icon;
Acquire lesion's image: through the camera or select an image from the database with Gallery Button;
Draw the Mask: use the Pen or Finger tool, fill the injuried area and when finish push Analyze button (fig. 5);
Lesion area analysis, press User Setting to continue (fig.6);
Specify lesion characteristics (exudate, infection, Hemorrhage, deep) and press Measure button (fig. 7);
Calculate lesion area by measuring manual with a ruler the lesion's width. Use as reference the quadrangle around the lesion's image and set the measurements in centimeters using -
Final data processing, therapeutic treatment advices (fig. 10) view pdf document pushing PDF. (fig. 11);
MOWA archive folders
After installing the software creates a folder archive "MOWA".
Appfolder/Documents/Mowa/ : main archive directory
Appfolder/Documents/Mowa/Masks/ : mask file archive directory
Limitations and proper use of MOWA
This software was created with the aim to support the health care worker in the analysis and treatment of pressure ulcers and to provide a tool for archiving photographs of pressure ulcers
This software analyzes only the pressure ulcer bed and not the surrounding skin
This software analyzes pressure ulcers from Stage II onwards (classification EPUAP-
This software must be used for educational, informational and for objective comparisons
This software contains information about the treatment of pressure ulcers as, at the time of publication, are appropriate to the LG-
This software provides generic names of products for wound treatment.
This software is able to calculate pressure ulcer from 2 mm to 300 mm in width.
The calculation of the pressure ulcer is conditioned by the precision with which the operator measure the width of the lesion and draws the mask.
The deepness influence the treatment not the calculated area
Identification of tissues in the wound bed (necrotic, fibrin, granulation) is influenced by the quality of the photo.
Security & Privacy
The access to the use of the application is not conditional upon the inclusion sensitive data.