Reliability and Validity of the Revised Photographic Wound Assessment Tool on Digital Images Taken of Various Types of Chronic Wounds

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The objective of this study was to examine the validity and reliability of the revised Photographic Wound Assessment Tool (revPWAT) on digital images taken of various types of chronic, healing wounds.


This multicenter trial was performed in a variety of settings where chronic wounds are assessed.


A total of 206 different photographs taken of 68 individuals with 95 chronic wounds of various etiologies were reviewed in this study. Wound etiologies included people with venous/arterial leg wounds (n = 13), diabetic foot wounds (n = 18), pressure ulcers (n = 32), and wounds of other etiologies (n = 5).


An initial wound assessment using the revPWAT was performed at the bedside, and 3 digital photographs were taken—2 within 72 hours when no change had occurred, and a third was taken 3.5 to 6 weeks later.


The revPWAT scores derived from photographs assessed by the same rater on different occasions and by different raters showed moderate to excellent intrarater intraclass correlation coefficients (ICCs) (ICC = 0.52–0.93), as well as test-retest (ICC = 0.86-0.90) and interrater (ICC = 0.71) reliability. There was excellent agreement between bedside assessments and assessments using photographs (ICC = 0.89).


The revPWAT is a valid and reliable tool to assess chronic wounds of various etiologies where digital images are viewed.

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