Background: New methods of defining an early grade of pressure ulcer could have great economic benefit to both patient and health service.

Objectives: The objective of the study was to find out whether pressure ulcers can be assessed and classified by using computer image analysis of hue, saturation and intensity (HSI) in order to make a prognostic assessment of early skin damage.

Aims: To determine whether different grades of pressure ulcers exhibit specific hues. To develop a consensus of opinion from four experts on the grade of pressure ulcers which can be compared with hue.

Methods: Data was analysed from 141 patients from a previous randomised controlled trial. All grade 2 pressure ulcers and above were photographed and a computerised image analysis made to measure the hue, saturation and intensity of ulcers and the skin tone of the subject’s adjacent healthy skin. This data was analysed against two classifications of pressure ulcers — the National Pressure Ulcer Advisory Panel and Stirling plus digits — and a consensus panel of experts.

Results: It was shown that the mean and standard deviations of the recorded HSIs could discriminate between normal skin, grade 2a and grade 2b pressure ulcers. #

Conclusions: The computer could identify early pressure ulcer formation with reasonable accuracy. A second comparison with the consensus panel demonstrated a positive correlation between the computerised model and the panel’s grades of pressure ulcers.

Conflict of interest: None.