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远程医疗:对于有地域障碍的患者来说,它是否是一种微血管乳房重建的途径?

Telehealth: Could It Be an Avenue to Microvascular Breast Reconstruction for Patients with Geographical Barriers?

机构信息

Department of Plastic and Reconstructive Surgery, The Johns Hopkins Hospital, Baltimore, Maryland.

Division of Plastic and Reconstructive Surgery, University of Colorado Hospital, Aurora, Colorado.

出版信息

J Reconstr Microsurg. 2021 Sep;37(7):597-601. doi: 10.1055/s-0041-1723821. Epub 2021 Feb 16.

Abstract

BACKGROUND

All women undergoing a mastectomy have the right to reconstruction. However, many women do not receive reconstruction and many more are not aware of all the reconstructive options available to them. Travel distance to a center that provides reconstruction and subsequent follow-up may be a contributing factor to this disparity especially among those who seek microsurgical options. Telehealth, which provides patients with remote video consultations and decreases the travel burden, may be a solution to optimize the accessibility of breast reconstruction for these patients. The purpose of this study was to discuss the efficacy and reliability of telehealth to overcome geographic barriers.

METHODS

Patients who received breast reconstruction and participated in video telehealth visits between February and May 2020 were included in this study. Patient demographics, comorbidities, and clinical outcomes were collected. Video telehealth encounters were reviewed to determine specific concerns and questions discussed during these encounters.

RESULTS

A total of 235 breast reconstruction surgery patient encounters were recorded for 4 plastic surgeons who offer microsurgical breast reconstruction. Eighty-eight patients (37.4%) were seen as telehealth visits, 20 (22.7%) of which were new patient visits. Eight (9.09%) patients were microsurgical breast reconstruction candidates and 25 (28.4%) were following-up after microsurgical breast reconstruction. The majority of telehealth visits included normally healing wounds in the postoperative patient.

CONCLUSION

Telehealth provides an avenue for premastectomy consultation, second opinion visits, and postoperative follow-up for patients who have geographical barriers precluding them from reaching plastic surgeons who perform all types of breast reconstruction.

摘要

背景

所有接受乳房切除术的女性都有权进行重建。然而,许多女性没有接受重建,更多的女性不知道所有可供选择的重建方法。前往提供重建和后续随访的中心的距离可能是造成这种差异的一个因素,尤其是对于那些寻求显微外科手术的患者来说。远程医疗为患者提供远程视频咨询,并减轻了旅行负担,可能是优化这些患者接受乳房重建机会的一种解决方案。本研究的目的是讨论远程医疗克服地理障碍的效果和可靠性。

方法

本研究纳入了 2020 年 2 月至 5 月期间接受乳房重建并参加视频远程医疗访问的患者。收集了患者的人口统计学、合并症和临床结果。对视频远程医疗就诊进行了回顾,以确定在这些就诊期间讨论的具体问题和问题。

结果

共有 4 位提供显微乳房重建的整形外科医生记录了 235 例乳房重建手术患者的就诊情况。88 名患者(37.4%)作为远程医疗就诊,其中 20 名(22.7%)为新患者就诊。8 名(9.09%)患者为显微乳房重建候选者,25 名(28.4%)为显微乳房重建后的随访。大多数远程医疗就诊包括术后患者正常愈合的伤口。

结论

远程医疗为有地理障碍的患者提供了一个途径,使他们能够进行乳房切除术前的咨询、第二意见就诊和术后随访,而这些障碍使他们无法接触到进行所有类型乳房重建的整形外科医生。

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