The Use of Telemedicine in the Management of Diabetes-Related Foot Ulceration: A Pilot Study

Wilbright, Wayne; Birke, James A.; Patout, Charles A.; Varnado, Myra F.; Horswell, Ron

doi:10.1097/00129334-200406000-00012

Cited by 63 publications

(111 citation statements)

References 19 publications

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“…A nonrandomized study by Wilbright et al (20) showed no significant difference between the telemedical group and the control group in time to complete healing of diabetic ulcers. The present results also demonstrate no difference with respect to healing and amputation and thus suggest that telemedicine is at least as good as standard clinic visits.…”

Section: Discussionmentioning

confidence: 94%

“…A number of randomized controlled trials have investigated the potential and feasibility of telemedicine in ulcer care (14)(15)(16)(17)(18)(19), but only two of these present clinical outcomes (15,18). Only one nonrandomized study focused specifically on diabetic foot ulcers and telemedicine (20). The aim of the present study was to compare telemedical and standard outpatient monitoring in the care of patients with diabetic foot ulcers with a focus on ulcer healing and amputation.…”

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confidence: 99%

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A Randomized Controlled Trial Comparing Telemedical and Standard Outpatient Monitoring of Diabetic Foot Ulcers

et al. 2015

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OBJECTIVEThe role of telemedical monitoring in diabetic foot ulcer care is still uncertain. Our aim was to compare telemedical and standard outpatient monitoring in the care of patients with diabetic foot ulcers in a randomized controlled trial. RESEARCH DESIGN AND METHODSOf the 736 screened individuals with diabetic foot ulcers, 401 met the eligibility criteria and were randomized between October 2010 and November 2014. The per-protocol telemedical monitoring consisted of two consultations in the patient's own home and one consultation at the outpatient clinic. Standard practice consisted of three outpatient clinic visits. The three-visit cycle was repeated until study end point. The study end points were defined as complete ulcer healing, amputation, or death. RESULTSOne hundred ninety-three individuals were randomized to telemedical monitoring and 181 to standard care. Demographics were similar in both groups. A causespecific Cox proportional hazards model showed no difference in individuals monitored through telemedicine regarding wound healing (hazard ratio 1.11 [95% CI 0.87, 1.42], P = 0.42) or amputation (0.87 [0.54, 1.42], P = 0.59). We found a higher mortality incidence in the telemedical monitoring group compared with the standard outpatient monitoring group (8.68 [6.93, 10.88], P = 0.0001). CONCLUSIONSThe findings of no significant difference regarding amputation and healing between telemedical and standard outpatient monitoring seem promising; however, for telemedical monitoring, a higher mortality throws into question the role of telemedicine in monitoring diabetic foot ulcers. Further studies are needed to investigate effects of telemedicine on mortality and other clinical outcomes and to identify patient subgroups that may have a poorer outcome through telemedical monitoring.Diabetes currently affects .387 million people worldwide, and this number is expected to rise to .592 million individuals worldwide by 2035 (1). In Denmark, 320,545 people suffer from diabetes, and it is estimated that a further 200,000 individuals are undiagnosed; a further 750,000 have impaired glucose tolerance (2). Approximately 7-15% of the population with diabetes will have one or several foot ulcers during a lifetime, and up to 70% of these ulcers will recur during a 5-year period (3). Diabetic foot ulcers lead to ;500 major amputations every year in

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Section: Discussionmentioning

confidence: 94%

mentioning

confidence: 99%

A Randomized Controlled Trial Comparing Telemedical and Standard Outpatient Monitoring of Diabetic Foot Ulcers

et al. 2015

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“…Preliminary results of the studies by Wilbright et al 3 and Debray et al 4 suggest that clinical images together with additional data from the patient's history are usually sufficient for a correct diagnosis and appropriate therapy of diabetes-related foot ulcers and wounds in elderly patients.…”

Section: For Editorial Comment See Page 1581mentioning

confidence: 99%

Teledermatological Monitoring of Leg Ulcers in Cooperation With Home Care Nurses

Binder¹,

Hofmann‐Wellenhof²,

Salmhofer³

et al. 2007

Arch Dermatol

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“…Because providers in some communities may not have ready access to specialists, they may consider consultation via electronic or telephonic arrangements (sometimes referred to as telemedicine) [71,72]. Although using high-resolution optical equipment may be optimal [73], even standard or video telephones have allowed expert consultation from a distance [74].…”

Section: Evidence Summarymentioning

confidence: 99%

Risk Factors of Methicillin-Resistant Staphylococcus Aureus and Pseudomonas Infection in Diabetic Foot Ulcers in Korea

Lee

Son

Han

2017

J Wound Management Res

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The Use of Telemedicine in the Management of Diabetes-Related Foot Ulceration: A Pilot Study

Abstract: These data appear to support the effectiveness of real-time interactive telemedicine consultation in the management of diabetes-related forefoot ulceration.

Cited by 63 publications

References 19 publications

A Randomized Controlled Trial Comparing Telemedical and Standard Outpatient Monitoring of Diabetic Foot Ulcers

A Randomized Controlled Trial Comparing Telemedical and Standard Outpatient Monitoring of Diabetic Foot Ulcers

Teledermatological Monitoring of Leg Ulcers in Cooperation With Home Care Nurses

Risk Factors of Methicillin-Resistant Staphylococcus Aureus and Pseudomonas Infection in Diabetic Foot Ulcers in Korea

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