Photography for Wound Management 6. Receiving a request for photography When a request is made for clinical photography of a patient’s wound to be carried out, a convenient time for photography to take place is normally discussed. Whilst it is not always possible to stick stringently to the time agreed (due to additional unforeseen and often urgent requests for photography that are usually dealt with straight away (photography in the emergency department or the operating theatre etc.) as well as possible limited staffing at times), it is best practice to attend at the agreed time, especially if dressings are being removed in preparation for photography.
Delaying the photography session may pose an infection risk to the wound, which may be exposed waiting for the photographer to attend. It could also add to the patient’s discomfort as they may be positioned specifically for photography (e.g. lying on a side to expose the sacrum). Ideally, photographs should be arranged to be taken at a time that coincides with a dressing change. This will lessen the impact upon the patient and nursing staff whilst also potentially reducing costs associated with additional dressing changes. Following a request for wound photography, checks should be carried out to see whether the patient has had previous photography.
If they have, effort should be made to repeat the views that were taken previously so that the images have comparative value. The camera settings may be checked by viewing the metadata of the images 7. The photographic session 7.1 Preparing to photograph the patient All necessary camera equipment and supporting accessories such as measurement scales, measuring probe and background should be prepared and ready to use before the patient is placed into position for photography. Extraneous clothing should be removed by the patient (or healthcare staff).
Often wound photography can involve the sacral and genital areas and it is preferable to remove briefs, however the patient’s dignity should not be compromised. The wound and the surrounding area (particularly the perineum) should be cleaned before photography, otherwise there may be confusion as to the condition and extent of the wound. Occasionally, for teaching purposes, wounds are photographed before and after cleaning or debridement. This is typical in the recording of burns, which may be photographed before and after the blisters are removed. All effort should be made to ensure images taken before and after cleaning are comparable (Figure 21 and 22).
7.2 Manual handling Due to the physical demands of many healthcare work-related activities, NHS staff are at a particularly high risk of experiencing musculoskeletal injuries. When carrying out any type of clinical photography, it is essential to minimise the risk of injury from manual handling tasks and difficult working positions, for all staff involved in the photography session. For patients with little or no significant mobility issues, it is recommended that they are asked to stand/sit/lie in a suitable position so that photography can be achieved without staff members having to compromise their own clinical photography, design and video in healthcare page 17