Feasibility study of home care wound management using telemedicine.
OBJECTIVE
Evaluate the effectiveness of telemedicine (TM) with digital cameras in treating wounds in a home care setting.


METHODS
Randomized controlled study.


METHODS
One hundred three subjects with 160 pressure ulcers (PrUs) or nonhealing surgical wounds referred to a metropolitan Visiting Nurse Agency.


METHODS
Subjects were randomly assigned to 1 of 3 groups. Group A (n = 40): weekly visits with TM and wound care specialist (WCS) consults; group B (n = 28): weekly visits with weekly consults with WCSs; and group C (n = 35): usual and customary care.


METHODS
Outcome measures were time to heal, costs, length of stay (LOS), nursing visits, wound status, and change in size.


RESULTS
There was a similar distribution of subject characteristics in all 3 groups, but group A had disproportionally larger and more numerous PrUs and larger nonhealing surgical wounds. Group A had increased time to heal, LOS, costs, and visits compared with groups B and C; wound status was similar in all groups.


CONCLUSIONS
Uneven distribution of severity and type of wounds among groups, with greatest percentage of large wounds in TM group. Larger wounds consume more resources. TM is a useful communication tool in wound management but with limited power when randomization does not include wound size or type. Two important benchmarks were established for home care. First, it took 51 days, on average, to heal or improve PrUs and 34 days to heal or improve surgical wounds regardless of group. Second, nearly 90% of wounds improved or healed.
Terry
Margaret
M
MedStar Health Visiting Nurse Association, Calverton, Maryland, USA.
Halstead
Lauro S
LS
O'Hare
Patricia
P
Gaskill
Cheryl
C
Ho
Pei Shu
PS
Obecny
Joan
J
James
Carol
C
Lauderdale
Manon E
ME
D004219:District of Columbia; D005240:Feasibility Studies; D006305:Health Status Indicators; D006701:Home Nursing; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008396:Maryland; D009733:Nursing Diagnosis; D003668:Pressure Ulcer / Q000451:nursing / Q000628:therapy*; D013530:Surgical Wound Infection / Q000451:nursing / Q000628:therapy*; D055817:Telenursing; D014481:United States; D014768:Virginia; D014945:Wound Healing