Wound teleconsultation in patients with chronic leg ulcers.
BACKGROUND
The treatment of chronic leg ulcers requires frequent assessments of local wound status and adjustment of therapy. The availability of reasonably priced photographic equipment and quick electronic transfer of high-quality digital images should make it possible that the assessment of wound status can be made by remote experts.


OBJECTIVE
This study examines the feasibility of using teledermatology for wound assessment and therapeutic suggestions for patients with chronic leg ulcers.


METHODS
One hundred ten chronic leg ulcers of different origins were examined in face-to-face consultations. The examining doctor assessed the wound, made therapeutic recommendations and took 1-4 photographs of the wound using a digital camera. The digital images and relevant clinical information were then transmitted via a web application to an expert in wound care, who provided an independent teledermatological assessment of wound status and therapeutic recommendations.


RESULTS
In our study, a high accordance between direct consultations and electronic consultations was found in the assessment of chronic leg ulcers, especially for important features like slough (concordance: 84.6%), necrosis (concordance: 98.2%) and granulation tissue formation (concordance: 76.4%). Furthermore, the teledermatologist generally felt confident in recommending further treatment strategies and in planning further wound assessments via the internet.


CONCLUSIONS
Our results suggest that teledermatology offers great potential for the future in chronic wound care. By reducing the need to travel long distances to the hospital or to consult a physician with expertise in wound care, wound teleconsultation might lower health care costs and improve the quality of life for patients with chronic wounds, while still maintaining a high quality of wound care.
Salmhofer
Wolfgang
W
Department of Dermatology, University of Graz, Graz, Austria. wolfgang.salmhofer@meduni-graz.at
Hofmann-Wellenhof
Rainer
R
Gabler
Gerald
G
Rieger-Engelbogen
Karin
K
Gunegger
Dieter
D
Binder
Barbara
B
Kern
Thomas
T
Kerl
Helmut
H
Soyer
H Peter
HP
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001317:Austria; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007871:Leg Ulcer / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D019114:Remote Consultation / Q000379:methods*; D012815:Signal Processing, Computer-Assisted; D019113:Telepathology / Q000379:methods