Mobile Application for Ulcer Detection
1. INTRODUCTION
According to the World Health Organization
(WHO), diabetes affected 422 million adults
worldwide as reported in 2014, and this
number is expected to increase [1] . DFU
is a symptom of Type 2 diabetes at its
advanced stages [2] . Normally around 15%
to 25% of diabetic patients suffer from foot
complications at a later stage of the disease [3] .
These complications are normally attributed
to the peripheral ischemia, foot ulceration,
and infection [4, 5] . Foot ulcers are mainly
caused by peripheral neuropathy, which in
turn affects the ability of the patient to sense
and feel his foot. As a result, any injury in the
foot of the diabetic patient can go unnoticed
[6]. Some of the signs of foot ulcers include
abundant callus formation, fissures, blisters,
and elevated temperature of the ulcer’s region.
Normally, these symptoms are analyzed and
checked by physicians to make the diagnosis
[7]
. Most cases of DFU’s are too late to recover
the condition, and patients lose their foot or
a large portion of it. Therefore, it is crucial to
look for early prevention of DFU using early
detection techniques to help save the lives
of diabetic patients [8] . DFU can be avoided
or delayed if adequately treated at an early
stage. Currently, the assessment of such foot
complications is done frequently by clinicians
through analyzing blood circulations,
plantar foot pressure, and foot neuropathy
[9, 10]
. Moreover, specialist clinicians usually
assess lower extremity vascular status using
Doppler ultrasound. This allows the possibility
of getting accurate analysis regarding the
current situation of foot ulcers and its risks
[11]
. However, patients are forced to go for
frequent visits to doctors for diabetic foot
assessment, which is considered intrusive
18
Pedorthic Footcare Association | www.pedorthics.org
"Today, technologies
exist that can help
determine the
presence of ulcers
in a diabetic foot."
and costly. In addition, self-assessment is
considered difficult because it depends on
the knowledge of patients with this disease,
and on the usage of medical equipment.
The treatments for such complications are
commonly associated with therapeutic
footwear, foot education, and normal foot care
[2]
. For example, a modified walking apparatus
is used to provide consistent pressure relief at
the diabetic patient’s foot. Thus, the prevention
of more developed stages of current foot
complications situation can be maintained and
even healed [12] .
Several studies indicate that temperature
change is a clear precursor to DFU [3, 21, 22] .
However, the temperature differences for DFU
regions are small and hard to monitor and
determine using analog means. The process of
determining ulcerous regions in a diabetic foot
with the help of an infrared thermometry has
gained ground and has piqued the interest of
several researchers [13, 14] .
Early detection techniques work best when
the diabetic patient applies these techniques
immediately after experiencing discomfort/
pain is his/her foot. DFU causes extreme pain
and discomfort while walking. The patient
will have a time frame of one to two weeks
before the DFU turns into a full-blown health
issue [2, 8] . Thermal infrared thermometry can