# WoundFormer: Multi-Scale Spatial Feature Fusion for Multi-Class Wound Tissue Segmentation

arXiv: https://arxiv.org/abs/2605.19868 · HTML: https://mlsanity.com/paper/2605.19868/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 14 of its 27 references that are in the map.
- First posted on arXiv 19 May 2026.

## Builds on (most cited first, 14 of 14)

- [End-to-End Object Detection with Transformers](https://mlsanity.com/paper/2005.12872/) (2020)
- [Mask R-CNN](https://mlsanity.com/paper/1703.06870/) (2017)
- [SegFormer: Simple and Efficient Design for Semantic Segmentation with Transformers](https://mlsanity.com/paper/2105.15203/) (2021)
- [Rethinking Atrous Convolution for Semantic Image Segmentation](https://mlsanity.com/paper/1706.05587/) (2017)
- [SegNet: A Deep Convolutional Encoder-Decoder Architecture for Image Segmentation](https://mlsanity.com/paper/1511.00561/) (2015)
- [Swin UNETR: Swin Transformers for Semantic Segmentation of Brain Tumors in MRI Images](https://mlsanity.com/paper/2201.01266/) (2022)
- [HarDNet: A Low Memory Traffic Network](https://mlsanity.com/paper/1909.00948/) (2019)
- [TransNeXt: Robust Foveal Visual Perception for Vision Transformers](https://mlsanity.com/paper/2311.17132/) (2023)
- [FUSeg: The Foot Ulcer Segmentation Challenge](https://mlsanity.com/paper/2201.00414/) (2022)
- [FUSegNet: A Deep Convolutional Neural Network for Foot Ulcer Segmentation](https://mlsanity.com/paper/2305.02961/) (2023)
- [Image Based Artificial Intelligence in Wound Assessment: A Systematic Review](https://mlsanity.com/paper/2009.07141/) (2020)
- [Wound Tissue Segmentation in Diabetic Foot Ulcer Images Using Deep Learning: A Pilot Study](https://mlsanity.com/paper/2406.16012/) (2024)
- [Deep Learning for Wound Tissue Segmentation: A Comprehensive Evaluation using A Novel Dataset](https://mlsanity.com/paper/2502.10652/) (2025)
- [WoundAmbit: Bridging State-of-the-Art Semantic Segmentation and Real-World Wound Care](https://mlsanity.com/paper/2504.06185/) (2025)

## Abstract (arXiv)

Chronic wounds such as diabetic foot ulcers and pressure injuries require accurate tissue-level assessment to guide treatment planning and monitor healing progression. While deep learning methods have advanced automated wound analysis, most existing approaches focus on binary segmentation and inadequately model heterogeneous tissue composition due to high intra-class variability and limited annotated data. Multi-class wound tissue segmentation, therefore, remains a challenging and clinically relevant problem. We propose WoundFormer, a transformer-based framework that enhances hierarchical spatial feature fusion for multi-class wound tissue segmentation. Specifically, we replace the standard SegFormer decoder with a spatially-preserving multi-scale aggregation head that maintains feature topology during cross-scale integration and strengthens contextual interactions through convolutional fusion. This design improves boundary localization and discrimination between visually similar tissue categories while preserving transformer efficiency. We evaluate WoundFormer on the WoundTissueSeg dataset (147 images, six tissue classes) and a second benchmark (DFUTissue dataset). The proposed method achieves an overall Dice score of 81.9%, outperforming strong CNN- and transformer-based baselines by up to 4.3 Dice points on the WoundTissueSeg benchmark, with consistent improvements across minority tissue classes. These results indicate that explicit modeling of hierarchical spatial interactions enhances transformer representations for heterogeneous wound tissue segmentation and supports more reliable quantitative wound assessment.