title: The use of telemedicine in the management of diabetes-related foot ulceration: a pilot study.
abstract: OBJECTIVE
  To determine if the management of forefoot ulcerations through telemedicine is medically equivalent to ulcer care at a diabetes foot program.
  
  
  METHODS
  Nonrandomized comparison of forefoot ulcer healing rates.
  
  
  METHODS
  The Louisiana State University Health Sciences Center Diabetes Foot Program, Baton Rouge, LA, and Lallie Kemp Medical Center, Independence, LA.
  
  
  METHODS
  Twenty consecutive patients with diabetes were treated for neuropathic forefoot ulcerations via telemedicine consultation and 120 consecutive patients with diabetes were treated face-to-face at a diabetes foot program.
  
  
  METHODS
  Management of forefoot ulcers by a certified wound care nurse trained in the use of a staged management approach algorithm and alternative off-loading methods, supported by real-time interactive telemedicine consultation.
  
  
  METHODS
  Forefoot ulcer healing time in days, percentage of wounds healed in 12 weeks, and healing time ratio (adjusted for age, gender, ulcer duration, location, size, crossover, and grade).
  
  
  RESULTS
  No differences were found between the telemedicine and diabetes foot program groups in the average forefoot ulcer healing time (43.2 + 29.3 vs. and 45.5 + 43.4 days, P =.828), the percent of forefoot ulcers healed in 12 weeks (75 % vs. 81%, P =.546) and the adjusted healing time ratio (1.40 vs 1.00, P =.104).
  
  
  CONCLUSIONS
  These data appear to support the effectiveness of real-time interactive telemedicine consultation in the management of diabetes-related forefoot ulceration.
authors.affiliation: Medical Informatics and Telemedicine Program, School of Public Health and Preventive Medicine, Louisiana Health Sciences Center, New Orleans, LA, USA.
authors.forename: Wayne A
authors.initials: WA
authors.lastname: Wilbright
authors.forename: James A
authors.initials: JA
authors.lastname: Birke
authors.forename: Charles A
authors.initials: CA
authors.lastname: Patout
authors.forename: Myra
authors.initials: M
authors.lastname: Varnado
authors.forename: Ron
authors.initials: R
authors.lastname: Horswell
mesh_terms: D000465:Algorithms; D017719:Diabetic Foot / Q000451:nursing*; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008145:Louisiana; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D019114:Remote Consultation; D019035:Rural Health Services; D014945:Wound Healing