Death within 30 days of surgery is the third largest cause of death globally and surgical wound infections are associated with more than 30% of these deaths. Having a patient take smartphone pictures of post-surgical wounds that are then assessed by the surgeon however can increase early detection of infections, a new study finds.
The new study, “Remote diagnosis of surgical-site infection using a mobile digital intervention: a randomized controlled trial in emergency surgery patients,” was published online on November 18, 2021 in npj Digital Medicine.
The researchers said that these selfies were associated with BOTH a reduced number of visits to the doctors and improved access to advice to patients.
Serious surgical infections can lead to increased costs, longer hospital stays and readmissions. The use of the selfies to spot these infections earlier, they said, could help doctors better manage surgical patients’ care and reduce pressure on health systems.
The randomized controlled trial enrolled patients who had had emergency abdominal surgery. Although these patients had a specific type of surgery, the findings can be applied to all surgical patients, including orthopedics.
The intervention group consisted of 223 patients who were contacted on days 3, 7 and 15 after surgery and asked to complete an online survey which included uploading a photo of their surgical wound. They were also asked to relate their symptoms.
Then a member of the surgical team would assess the photo and the patient’s answers to the survey to look for signs of wound infection. They followed up with patients at 30 days post-surgery to see if they had been subsequently diagnosed with an infection.
The control group of 269 patients received standard post-surgical care and were also contacted 30 days after their surgery. There was no significant difference between the two groups in the overall time it took to diagnose wound infections in the 30-days after surgery.
The patients in the selfie group, however, were almost four times more likely to have their wound infection diagnosed within 7 days of surgery compared to the patients who received standard care.
Ewen Harrison, professor of Surgery and Data Science at the University of Edinburgh, said in a statement: “Our study shows the benefits of using mobile technology for follow-up after surgery. Recovery can be an anxious time for everybody. These approaches provide reassurance—after all, most of us don’t know what a normally healing wound looks like a few weeks after surgery. We hope that picking up wound problems early can result in treatments that limit complications.”
“Using mobile phone apps around the time of surgery is becoming common—we are working to scale this within the NHS, given the benefits for patients in continuing to be directly connected with the hospital team treating them.”
Dr. Kenneth McLean of the University of Edinburgh added: “Since the COVID-19 pandemic started, there have been big changes in how care after surgery is delivered. Patients and staff have become used to having remote consultations, and we’ve shown we can effectively and safely monitor wounds after surgery while patients recover at home—this is likely to become the new normal.”
The researchers said they are now conducting a follow-up study on how to implement this practice across the country. They plan on also using artificial intelligence to assess the possibility of wound infections.
The study authors included Kenneth A. McLean, Katie E. Mountain, Thomas M. Drake, Rinnu Pius, Stephen R. Knight, Cameron J. Fairfield, Alessandro Sgrò, Matt Bouamrane, William A. Cambridge, Mathew Lyons, Ava Riad, Richard J. E. Skipworth, Stephen J. Wigmore, and Ewen M. Harrison of the University of Edinburgh, TWIST Collaborators and Mark A. Potter of Western General Hospital in Edinburgh.
