Bolton Laura
Department of Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ.
Wounds. 2019 Apr;31(4):114-116.
Chronic ulcers greatly add to the clinical, economic, and patient burden on health care, increasing visits that challenge patients and strain overworked clinical centers. Telemedicine (TM) facilitates interprofessional collaboration and patient education and enables specialist bedside consults for clients without adding to their transfer and travel risks. Evidence supports improved postoperative monitoring, access to experts, and cost savings for TM-managed patients with acute or chronic wounds in a variety of settings. Despite its limitations, including likely overdiagnosis and dependence on functioning technology, TM has been validated for surgical site infection (SSI) surveillance, reducing post vascular surgery SSI-related readmissions, and was at least as safe and effective as in-person consults during postoperative wound care in general. The 2 following studies illustrate the value of TM in managing patients with diabetic foot ulcers (DFUs), pressure ulcers,6 and a variety of leg ulcers.
慢性溃疡极大地增加了临床、经济以及患者对医疗保健的负担，导致就诊次数增多，这对患者构成挑战，也使不堪重负的临床中心压力增大。远程医疗（TM）促进了跨专业协作和患者教育，能够为患者提供专家床边会诊，同时不会增加患者的转运和出行风险。有证据表明，在各种环境中，对于由远程医疗管理的急慢性伤口患者，术后监测得到改善，能获得专家指导，且成本降低。尽管存在局限性，包括可能过度诊断以及对技术功能的依赖，但远程医疗已被证实可用于手术部位感染（SSI）监测，减少血管手术后与SSI相关的再入院情况，并且在术后伤口护理期间，总体上至少与面对面会诊一样安全有效。以下两项研究说明了远程医疗在管理糖尿病足溃疡（DFU）、压疮以及各种腿部溃疡患者方面的价值。
