Expert Advice Provided through Telemedicine Improves Healing of Chronic Wounds: Prospective Cluster Controlled Study

Abstract

Telemedicine is widely considered as an efficient approach to manage the growing problem of chronic wounds. However, to date, there is no convincing evidence to support the clinical efficacy of telemedicine in wound management. In this prospective cluster controlled study, we tested the hypothesis that advice on wound management provided by a team of wound-care specialists through telemedicine would significantly improve the likelihood of wound healing compared with the best available conventional practice. A total of 90 chronic wound patients in home care met all study criteria and were included: 50 in the telemedicine group and 40 in the conventional group. Patients with pressure ulcers, surgical wounds, and cancer wounds were excluded. During the 1-year follow-up, complete wound healing was achieved in 35 patients (70%) in the telemedicine group compared with 18 patients (45%) in the conventional group. After adjusting for important covariates, offering advice on wound management through telemedicine was associated with significantly increased healing compared with the best available conventional practice (telemedicine vs. conventional practice: adjusted hazard ratio 2.19; 95% confidence interval: 1.15-4.17; P=0.017). This study strongly supports the use of telemedicine to connect home-care nurses to a team of wound experts in order to improve the management of chronic wounds.

A telemedicina alkalmazása a bőrgyógyászatban: a teledermatológia

“…Emellett egyes műtéteket vagy kezelést követően a betegek álla-potának követésére is alkalmas a módszer. A szakirodalomban leírták a teledermatológia jelentőségét többek között krónikus sebek kezelése esetén [8], illetve egyes terápiák hatásának ellenőrzésére [9], csökkentve a szük-séges személyes kontrollvizsgálatok számát. A telemedi-cina alkalmazásának bármelyik alapelve szerint történhet, általában a store-and-forward módszert alkalmazzák.…”

“…Szá-mos klinikai kutatás vizsgálta a teledermatológia orvosi alkalmazásának megbízhatóságát [1,8,28,33,[34][35][36][37][38].…”

“…A teledermatológia szubjektív megítélése általában mind a betegek, mind az orvosok körében pozitív [1,8,28]. A betegek szempontjából kényelmes ez a fajta távellátás, időt, energiát és pénzt spórolnak a felesleges utazás elhagyásával, és elégedettek az ellátás minőségével.…”

Teledermatology: current perspectives

“…There were similar proportions of both sexes when the studies were pooled. In most studies, the participants included were in the adult age, with the following exceptions: the mean age of participants was >65 years in two studies, 20,26 one included adolescents and adults, 16 one only children, and one with groups of children patients/parents of children and adult patients. 22 Four studies focused on psoriasis lesions, 12,14,15,17 three on atopic dermatitis, 11,13,22 two on patients with acne, 16,23 two on pressure ulcer, 20,21 and two on chronic skin lesions.…”

“…[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] All studies were from high income countries. Six studies (seven articles) were from the United States, 11,15,18,21,[23][24][25] two from the Netherlands, 17,22 and one from each of the following countries: Austria, 16 Canada, 20 Denmark, 26 Italy, 12 Norway, 13 Singapore, 19 and United Kingdom.…”