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基于图像的移动医疗协议用于术后伤口监测的可行性。

Feasibility of an Image-Based Mobile Health Protocol for Postoperative Wound Monitoring.

机构信息

Wisconsin Institute of Surgical Outcomes Research, Department of Surgery, University of Wisconsin, Madison, WI.

Wisconsin Institute of Surgical Outcomes Research, Department of Surgery, University of Wisconsin, Madison, WI.

出版信息

J Am Coll Surg. 2018 Mar;226(3):277-286. doi: 10.1016/j.jamcollsurg.2017.12.013. Epub 2018 Jan 19.

Abstract

BACKGROUND

Surgical site infection (SSI) is the most common nosocomial infection and the leading cause of readmission among surgical patients. Many SSIs develop in the postdischarge period and are inadequately recognized by patients. To address this, we developed a mobile health protocol of remote wound monitoring using smartphone technology. The current study aims to establish its feasibility among patients and providers.

STUDY DESIGN

We enrolled vascular surgery patients during their inpatient stay. They were trained to use our mobile health application, which allowed them to transmit digital images of their surgical wound and answer a survey about their recovery. After hospital discharge, participants completed the application daily for 2 weeks. Providers on the inpatient team reviewed submissions daily and contacted patients for concerning findings.

RESULTS

Forty participants were enrolled. Forty-five percent of participants submitted data every day for 2 weeks, with an overall submission rate of 90.2%. Submissions were reviewed within an average of 9.7 hours of submission, with 91.9% of submissions reviewed within 24 hours. We detected 7 wound complications with 1 false negative. Participant and provider satisfaction was universally high.

CONCLUSIONS

Patients and their caregivers are willing to participate in a mobile health program aimed at remote monitoring of postoperative recovery, and they are able to complete it with a high level of fidelity and satisfaction. Preliminary results indicate the ability to detect and intervene on wound complications.

摘要

背景

手术部位感染(SSI)是最常见的医院获得性感染,也是外科患者再入院的主要原因。许多 SSI 在出院后发生,患者无法充分识别。为了解决这个问题,我们开发了一种使用智能手机技术的远程伤口监测移动医疗协议。本研究旨在确定其在患者和医务人员中的可行性。

研究设计

我们在住院期间招募了血管外科患者。他们接受了使用我们移动医疗应用程序的培训,该应用程序允许他们传输手术伤口的数字图像并回答有关恢复情况的调查。出院后,参与者每天使用该应用程序完成 2 周的治疗。住院团队的提供者每天审查提交的内容,并在发现异常时与患者联系。

结果

共纳入 40 名参与者。45%的参与者每天提交数据 2 周,总提交率为 90.2%。提交内容的平均审查时间为提交后的 9.7 小时,91.9%的提交内容在 24 小时内得到审查。我们发现了 7 例伤口并发症,其中 1 例为假阴性。患者和提供者的满意度普遍很高。

结论

患者及其护理人员愿意参与旨在远程监测术后恢复的移动医疗计划,并且能够高度一致地完成该计划,满意度也很高。初步结果表明能够检测和干预伤口并发症。

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