Quantitative Spatial Analysis of Matrix Remodelling in Wounds Using Digital Pathology and Fractal Analysis

Histological Wound Index (HWI) derived from digital pathology and fractal analysis is highest in normal skin and lowest in wound centre, with intermediate proximal-edge values.

• Why it matters: Qualitative histology struggles to capture spatially heterogeneous extracellular matrix remodeling across wound regions, limiting quantitative comparisons with unwounded skin.
• What they did: Four normal-skin and six wound sections were analyzed by QuPath, ImageJ/FracLac, and Python, using matched ~500 x 500 micrometer ROIs and linear mixed-effects models to quantify collagen, mucin, necrosis, and collagen fractal dimension/lacunarity.
• The result: Unwounded skin had high collagen coverage and fractal dimension with low lacunarity, mucin, and necrosis, while wound-centre tissue showed low collagen coverage and fractal dimension with higher mucin and necrosis, enabling a reproducible regional ECM framework pending validation in larger longitudinal datasets.

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