Adjunct Associate Professor, Department of Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ.
Wounds. 2020 Dec;32(12):350-352.
With the increasing global presence of and reliance on smartphones, featuring high-resolution digital photography and wireless, high-speed Internet, patients with wounds and point-of-care wound professionals are increasingly engaged in remote wound management and surveillance. Twenty years ago, home wound care professionals, advised by remote experts using telemedicine, were achieving sterling chronic wound outcomes. Mobile technology has sharply reduced transportation costs compared with clinic visits. Registered nurses using smartphones to access a web-based surgical infection site (SIS) surveillance algorithm based on validated Centers for Disease Control and Prevention guidelines, extended reliable, valid SIS surveillance into the first month of home care as recommended in the guidelines. This improved timely SIS identification and management while generating a registry that motivated patients and caregivers. The SARS-CoV-2 pandemic accelerated needs for evidence-based care delivered by telemedicine, empowering wound care professionals to deliver quality care while limiting risks associated with patient contact. This installment of Evidence Corner reviews 2 randomized clinical trials (RCTs) that used telehealth in varying ways to improve health care delivery and outcomes. One reported use of a telehealth application is to improve patient knowledge and outcomes of diabetic foot care. The second compared clinical and economic outcomes for patients with complex wounds whose local clinicians delivered home care guided by remote experts using telemedicine with those of similar patients managed without expert advice in the home or patients who attended wound clinics.
随着智能手机在全球的普及和依赖程度不断提高,其具备高分辨率的数字摄影功能和无线高速互联网,使得患者和即时护理伤口的专业人员越来越多地参与远程伤口管理和监测。二十年前,在家中接受伤口护理的专业人员在远程专家使用远程医疗的指导下,取得了卓越的慢性伤口治疗效果。与去诊所就诊相比,移动技术大大降低了交通成本。注册护士使用智能手机访问基于经验证的疾病控制与预防中心 (CDC) 指南的基于网络的手术感染部位 (SIS) 监测算法,根据指南建议,将可靠且有效的 SIS 监测延长到家庭护理的第一个月。这提高了及时发现和管理 SIS 的能力,同时生成了一个登记册,激励了患者和护理人员。SARS-CoV-2 大流行加速了远程医疗提供循证护理的需求,使伤口护理专业人员能够在限制与患者接触相关风险的同时提供优质护理。本期《证据角》回顾了两项使用远程医疗以不同方式改善医疗服务和结果的随机临床试验 (RCT)。其中一项报告了使用远程医疗应用程序来提高糖尿病足护理患者的知识和结果。第二项比较了接受远程专家通过远程医疗指导的家庭护理的复杂伤口患者的临床和经济结果,以及那些没有专家建议的家庭护理或在伤口诊所就诊的类似患者的结果。