Is the red-yellow-black scheme suitable to classify donor site wounds? An inter-observer analysis

Anne M Eskes; Louise A A Gerbens; Chantal M A M van der Horst; Hester Vermeulen; Dirk T Ubbink

doi:10.1016/j.burns.2010.12.019

Is the red-yellow-black scheme suitable to classify donor site wounds? An inter-observer analysis

Anne M Eskes, Louise A A Gerbens, Chantal M A M van der Horst, Hester Vermeulen, Dirk T Ubbink

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND: The red-yellow-black-scheme (RYB) is a well-known and validated scheme to classify chronic and acute wounds, based on wound color and moistness. We investigated whether this RYB-scheme is also useful to classify donor site wounds uniformly (DSW).

METHODS: Twenty-three digital photographs of DSWs in various stages of wound healing were presented to internationally renowned wound scientists (n=11), surgical doctors (n=31), specialized wound nurses (n=55), and surgical nurses (n=28). These observers classified the color and moistness of the wound according to the RYB-scheme, yielding seven wound categories. Inter-observer agreement (IOA) was expressed as a kappa (κ) value.

RESULTS: IOA's among specialized wound nurses were moderate when based on wound color and moistness (κ=0.41; 95% CI 0.33-0.49), wound color only (κ=0.41; 95% CI 0.29-0.53), or moistness only (κ=0.54; 95% CI 0.45-0.64). However, these IOA's tended to be better than those among the scientists, doctors and nurses. Scientists showed the lowest agreement (k-values between 0.17 and 0.25). Doctors scored slightly better than nurses.

CONCLUSION: Clinicians and scientists have difficulty with classifying DSWs by means of the RYB-scheme. Therefore, this scheme does not appear useful to classify donor site wounds in a uniform manner.

Original language	English
Pages (from-to)	823-7
Number of pages	5
Journal	Burns : journal of the International Society for Burn Injuries
Volume	37
Issue number	5
DOIs	https://doi.org/10.1016/j.burns.2010.12.019
Publication status	Published - Aug 2011
Externally published	Yes

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@article{5700f29f05054bc4ae60dd3da623918c,

title = "Is the red-yellow-black scheme suitable to classify donor site wounds? An inter-observer analysis",

abstract = "BACKGROUND: The red-yellow-black-scheme (RYB) is a well-known and validated scheme to classify chronic and acute wounds, based on wound color and moistness. We investigated whether this RYB-scheme is also useful to classify donor site wounds uniformly (DSW).METHODS: Twenty-three digital photographs of DSWs in various stages of wound healing were presented to internationally renowned wound scientists (n=11), surgical doctors (n=31), specialized wound nurses (n=55), and surgical nurses (n=28). These observers classified the color and moistness of the wound according to the RYB-scheme, yielding seven wound categories. Inter-observer agreement (IOA) was expressed as a kappa (κ) value.RESULTS: IOA's among specialized wound nurses were moderate when based on wound color and moistness (κ=0.41; 95% CI 0.33-0.49), wound color only (κ=0.41; 95% CI 0.29-0.53), or moistness only (κ=0.54; 95% CI 0.45-0.64). However, these IOA's tended to be better than those among the scientists, doctors and nurses. Scientists showed the lowest agreement (k-values between 0.17 and 0.25). Doctors scored slightly better than nurses.CONCLUSION: Clinicians and scientists have difficulty with classifying DSWs by means of the RYB-scheme. Therefore, this scheme does not appear useful to classify donor site wounds in a uniform manner.",

keywords = "Adult, Color, Exudates and Transudates, Female, Humans, Male, Middle Aged, Observer Variation, Photography, Wound Healing, Wounds and Injuries, Journal Article",

author = "Eskes, {Anne M} and Gerbens, {Louise A A} and {van der Horst}, {Chantal M A M} and Hester Vermeulen and Ubbink, {Dirk T}",

year = "2011",

month = aug,

doi = "10.1016/j.burns.2010.12.019",

language = "English",

volume = "37",

pages = "823--7",

journal = "Burns : journal of the International Society for Burn Injuries",

issn = "0305-4179",

publisher = "Elsevier",

number = "5",

}

TY - JOUR

T1 - Is the red-yellow-black scheme suitable to classify donor site wounds? An inter-observer analysis

AU - Eskes, Anne M

AU - Gerbens, Louise A A

AU - van der Horst, Chantal M A M

AU - Vermeulen, Hester

AU - Ubbink, Dirk T

PY - 2011/8

Y1 - 2011/8

N2 - BACKGROUND: The red-yellow-black-scheme (RYB) is a well-known and validated scheme to classify chronic and acute wounds, based on wound color and moistness. We investigated whether this RYB-scheme is also useful to classify donor site wounds uniformly (DSW).METHODS: Twenty-three digital photographs of DSWs in various stages of wound healing were presented to internationally renowned wound scientists (n=11), surgical doctors (n=31), specialized wound nurses (n=55), and surgical nurses (n=28). These observers classified the color and moistness of the wound according to the RYB-scheme, yielding seven wound categories. Inter-observer agreement (IOA) was expressed as a kappa (κ) value.RESULTS: IOA's among specialized wound nurses were moderate when based on wound color and moistness (κ=0.41; 95% CI 0.33-0.49), wound color only (κ=0.41; 95% CI 0.29-0.53), or moistness only (κ=0.54; 95% CI 0.45-0.64). However, these IOA's tended to be better than those among the scientists, doctors and nurses. Scientists showed the lowest agreement (k-values between 0.17 and 0.25). Doctors scored slightly better than nurses.CONCLUSION: Clinicians and scientists have difficulty with classifying DSWs by means of the RYB-scheme. Therefore, this scheme does not appear useful to classify donor site wounds in a uniform manner.

AB - BACKGROUND: The red-yellow-black-scheme (RYB) is a well-known and validated scheme to classify chronic and acute wounds, based on wound color and moistness. We investigated whether this RYB-scheme is also useful to classify donor site wounds uniformly (DSW).METHODS: Twenty-three digital photographs of DSWs in various stages of wound healing were presented to internationally renowned wound scientists (n=11), surgical doctors (n=31), specialized wound nurses (n=55), and surgical nurses (n=28). These observers classified the color and moistness of the wound according to the RYB-scheme, yielding seven wound categories. Inter-observer agreement (IOA) was expressed as a kappa (κ) value.RESULTS: IOA's among specialized wound nurses were moderate when based on wound color and moistness (κ=0.41; 95% CI 0.33-0.49), wound color only (κ=0.41; 95% CI 0.29-0.53), or moistness only (κ=0.54; 95% CI 0.45-0.64). However, these IOA's tended to be better than those among the scientists, doctors and nurses. Scientists showed the lowest agreement (k-values between 0.17 and 0.25). Doctors scored slightly better than nurses.CONCLUSION: Clinicians and scientists have difficulty with classifying DSWs by means of the RYB-scheme. Therefore, this scheme does not appear useful to classify donor site wounds in a uniform manner.

KW - Adult

KW - Color

KW - Exudates and Transudates

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Observer Variation

KW - Photography

KW - Wound Healing

KW - Wounds and Injuries

KW - Journal Article

U2 - 10.1016/j.burns.2010.12.019

DO - 10.1016/j.burns.2010.12.019

M3 - Article

C2 - 21345594

VL - 37

SP - 823

EP - 827

JO - Burns : journal of the International Society for Burn Injuries

JF - Burns : journal of the International Society for Burn Injuries

SN - 0305-4179

IS - 5

ER -

Is the red-yellow-black scheme suitable to classify donor site wounds? An inter-observer analysis

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