Telemedical wound care using a new generation of mobile telephones: a feasibility study.
BACKGROUND
Leg ulcers are an important cost factor in health care systems. It has been shown that a telemedical wound care consultation can improve quality of care and help reduce costs. In this study, we evaluated the feasibility of telemedical wound care using a new generation of mobile telephones with integrated cameras.


METHODS
Three physicians separately evaluated 61 leg ulcers for the following 9 variables: epithelialization, fibrin, necrosis, and granulation tissue at the center and normal border, erythema, cyanosis, eczema, and hyperpigmentation at the periphery. One physician performed the face-to-face consultation (gold standard), and 2 others performed the remote evaluation. The image was obtained with the mobile telephone and immediately sent via e-mail. To measure the agreement of the evaluation among the 3 physicians, we used Cohen kappa statistics. Overall, the agreement between the remote and face-to-face evaluations was very good, with kappa values of up to 0.94 The image quality was judged to be good in 36 cases (59%) and very good in 12 (20%). The participants felt comfortable making a diagnosis based on the pictures in 50 cases (82%).


CONCLUSIONS
Although this study was performed with the first generation of these devices, we were able to demonstrate the feasibility of such a telemedical wound care consultation.
Braun
Ralph Peter
RP
Department of Dermatology, University Hospital Geneva, Geneva, Switzerland. braun@melanoma.ch
Vecchietti
Jean L
JL
Thomas
Luc
L
Prins
Christa
C
French
Lars E
LE
Gewirtzman
Aron J
AJ
Saurat
Jean-Hilaire
JH
Salomon
Denis
D
D000328:Adult; D000368:Aged; D040421:Cell Phone; D002908:Chronic Disease; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007871:Leg Ulcer / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D019114:Remote Consultation / Q000379:methods*; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013557:Switzerland; D017216:Telemedicine / Q000295:instrumentation / Q000379:methods; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000175:diagnosis / Q000628:therapy*