Patient-centered wound teleconsultation for cutaneous wounds: a feasibility study.

Abstract

The purpose of this study was to investigate the feasibility of patient-centered teleconsultation for various cutaneous wounds by using store-and-forward technology. From July 2011 to November 2011, 53 patients with various wound conditions were enrolled in this study. The patients took their own wound images shortly before face-to-face consultations with a plastic surgeon, and the images were sent via e-mail to another 3 remote plastic surgeons along with brief medical information. All 4 surgeons completed a standard questionnaire individually, which addressed questions regarding the presence of wound conditions (gangrene, necrosis, erythema, and cellulitis/infection), as well as suggested clinical treatment with antibiotics and debridement. The evaluations were compared among the 3 remote surgeons as well as the remote and onsite surgeons. The 53 wounds included in our study exhibited different causative mechanisms and locations on the body. The concordances between the remote and onsite surgeons were 92%, 79%, 83%, and 85% regarding the presence of gangrene, necrosis, erythema, and cellulitis/infection, respectively. The agreement rates regarding the treatment suggestion with antibiotic use and debridement between the remote surgeons and the onsite surgeon were both 83%. The remote surgeons reported high specificity, at least 84%, in all parameters of wound descriptions or treatment suggestions. The patient-centered teleconsultation system based on store-and-forward technology is a feasible tool for wound management, and it shows promises in future clinical applications by decreasing clinic visits.