Evaluation of remote digital postoperative wound monitoring in routine surgical practice.
Evaluation of remote digital postoperative wound monitoring in routine surgical practice.
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DOI：
10.1038/s41746-023-00824-9
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发表时间：
2023-05-05
影响因子：
15.2
通讯作者：
Harrison, Ewen M.
中科院分区：
文献类型：
--
作者：
McLean, Kenneth A.;Sgro, Alessandro;Brown, Leo R.;Buijs, Louis F.;Daines, Luke;Potter, Mark A.;Bouamrane, Matt-Mouley;Harrison, Ewen M.
远程数字化术后伤口监测提供了加强术后社区护理和最大限度减少手术部位感染(SSI)负担的机会。这项研究的目的是试行远程数字化术后伤口监测服务，并评估在常规临床实践中实施的准备情况。这是一项在英国两家三级护理医院(理想阶段2b，临床试验网站：NCT05069103)进行的远程数字术后伤口监测的单臂试验性实施研究。研究人员招募了接受腹部手术的成年人，并在术后30天内接受了智能手机交付的伤口评估工具。患者接受为期30天的术后随访，包括远程健康可用性问卷(TuQ)。根据世卫组织监测和评价数字卫生干预措施的框架，使用了专题混合方法。200名患者入选，其中115名(57.5%)接受了紧急外科手术。总体而言，30天SSI率为16.5%(n = 33/200)，其中72.7%(n = 24)在出院后确诊。干预的使用率为83.0%(n = 166/200)，随后完成74.1%(n = 123/166)。没有关于技术可行性的报道，可靠性(3.87，95%CI：3.73-4.00)和接口质量很高(4.18，95%：4.06-4.30)。在易用性(4.51，95%CI：4.41-4.62)、满意度(4.27，95%CI：4.13-4.41)和有效性(4.07，95%CI：3.92-4.23)方面，患者接受度同样较高。尽管希望更频繁和个性化的互动，但大多数人认为干预措施比常规的术后护理提供了有意义的好处。远程数字化术后伤口监测成功地展示了在技术、可用性和医疗保健流程改进方面的实施准备情况。
Remote digital postoperative wound monitoring provides an opportunity to strengthen postoperative community care and minimise the burden of surgical-site infection (SSI). This study aimed to pilot a remote digital postoperative wound monitoring service and evaluate the readiness for implementation in routine clinical practice. This was a single-arm pilot implementational study of remote digital postoperative wound monitoring across two tertiary care hospitals in the UK (IDEAL stage 2b, clinicaltrials.gov: NCT05069103). Adults undergoing abdominal surgery were recruited and received a smartphone-delivered wound assessment tool for 30-days postoperatively. Patients received 30-day postoperative follow-up, including the Telehealth Usability Questionnaire (TUQ). A thematic mixed-methods approach was used, according to the WHO framework for monitoring and evaluating digital health interventions. 200 patients were enroled, of whom 115 (57.5%) underwent emergency surgical procedures. Overall, the 30-day SSI rate was 16.5% (n = 33/200), with 72.7% (n = 24) diagnosed post-discharge. Usage of the intervention was 83.0% (n = 166/200), with subsequently 74.1% (n = 123/166) TUQ completion. There were no issues reported with feasibility of the technology, with the reliability (3.87, 95% CI: 3.73–4.00) and quality of the interface rated highly (4.18, 95%: 4.06–4.30). Patient acceptance was similarly high with regards to ease of use (4.51, 95% CI: 4.41–4.62), satisfaction (4.27, 95% CI: 4.13–4.41), and usefulness (4.07, 95% CI: 3.92–4.23). Despite the desire for more frequent and personalised interactions, the majority viewed the intervention as providing meaningful benefit over routine postoperative care. Remote digital postoperative wound monitoring successfully demonstrated readiness for implementation with regards to the technology, usability, and healthcare process improvement.
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影响因子：
15.2
作者：
Knight SR;Ng N;Tsanas A;Mclean K;Pagliari C;Harrison EM
通讯作者：
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105.7
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