Improving Automated Wound Assessment Using Joint Boundary Segmentation and Multi-Class Classification Models

Abstract

Accurate wound classification and boundary segmentation are essential for guiding clinical decisions in both chronic and acute wound management. However, most existing AI models are limited, focusing on a narrow set of wound types or performing only a single task (segmentation or classification), which reduces their clinical applicability. This study presents a deep learning model based on YOLOv11 that simultaneously performs wound boundary segmentation (WBS) and wound classification (WC) across five clinically relevant wound types: burn injury (BI), pressure injury (PI), diabetic foot ulcer (DFU), vascular ulcer (VU), and surgical wound (SW). A wound-type balanced dataset of 2,963 annotated images was created to train the models for both tasks, with stratified five-fold cross-validation ensuring robust and unbiased evaluation. The models trained on the original non-augmented dataset achieved consistent performance across folds, though BI detection accuracy was relatively lower. Therefore, the dataset was augmented using rotation, flipping, and variations in brightness, saturation, and exposure to help the model learn more generalized and invariant features. This augmentation significantly improved model performance, particularly in detecting visually subtle BI cases. Among tested variants, YOLOv11x achieved the highest performance with F1-scores of 0.9341 (WBS) and 0.8736 (WC), while the lightweight YOLOv11n provided comparable accuracy at lower computational cost, making it suitable for resource-constrained deployments. Supported by confusion matrices and visual detection outputs, the results confirm the model's robustness against complex backgrounds and high intra-class variability, demonstrating the potential of YOLOv11-based architectures for accurate, real-time wound analysis in both clinical and remote care settings.