Over the years, I’ve seen wounds that looked smaller on paper—surface area shrinking in cm²—while the cavity underneath was actually getting deeper. On planimetry alone, they appeared to be improving. Clinically, they were stalling.
That’s when I stopped asking, “Is it smaller?”
And started asking, “Is it filling?”
The most reliable way I’ve found to track true wound progress is volumetric measurement, using nothing more than a syringe and a transparent film dressing.
Here’s the concept—simple and powerful:
A transparent film (like Tegaderm) is sealed over the wound to create an airtight surface. Saline is gently instilled with a syringe to fill the wound cavity, then aspirated back. The volume withdrawn equals the wound volume in cm³.
The real value comes at follow-up.
When the volume decreases over time, you’re seeing objective evidence that the wound is filling with granulation tissue and moving upward toward closure—even if the surface dimensions haven’t changed much yet.
That’s information a ruler can never give you.
⚠️ One important caveat: this technique works best for contained wounds. Significant tunneling or undermining allows saline to escape, which compromises accuracy.
After years, this is what I know for sure:
If you don’t measure depth and volume, you can miss failure early.
3D assessment separates real healing from false progress.
Indicative Refs
Plassmann P, Melhuish JM, Harding KG. Methods of measuring wound size: a comparative study. Ostomy Wound Manage. 1994 Sep;40(7):50-2, 54, 56-60. PMID: 7546091.
Shah A, Wollak C, Shah JB. Wound Measurement Techniques: Comparing the Use of Ruler Method, 2D Imaging and 3D Scanner. J Am Coll Clin Wound Spec. 2015 Feb 27;5(3):52-7. doi: 10.1016/j.jccw.2015.02.001. PMID: 26199893; PMCID: PMC4495754.
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