title: Remote real-time monitoring of free flaps via smartphone photography and 3G wireless Internet: a prospective study evidencing diagnostic accuracy.
abstract: This prospective study was designed to compare the accuracy rate between remote smartphone photographic assessments and in-person examinations for free flap monitoring. One hundred and three consecutive free flaps were monitored with in-person examinations and assessed remotely by three surgeons (Team A) via photographs transmitted over smartphone. Four other surgeons used the traditional in-person examinations as Team B. The response time to re-exploration was defined as the interval between when a flap was evaluated as compromised by the nurse/house officer and when the decision was made for re-exploration. The accuracy rate was 98.7% and 94.2% for in-person and smartphone photographic assessments, respectively. The response time of 8 ± 3 min in Team A was statistically shorter than the 180 ± 104 min in Team B (P = 0.01 by the Mann-Whitney test). The remote smartphone photography assessment has a comparable accuracy rate and shorter response time compared with in-person examination for free flap monitoring.
authors.affiliation: Department of Hand, Plastic, and Reconstructive Surgery, Burn Center, BG Trauma Center, Ludwigshafen, Department of Plastic and Hand Surgery, University of Heidelberg, Germany.
authors.forename: Holger
authors.initials: H
authors.lastname: Engel
authors.forename: Jung Ju
authors.initials: JJ
authors.lastname: Huang
authors.forename: Chung Kan
authors.initials: CK
authors.lastname: Tsao
authors.forename: Chia-Yu
authors.initials: CY
authors.lastname: Lin
authors.forename: Pan-Yu
authors.initials: PY
authors.lastname: Chou
authors.forename: Eric M
authors.initials: EM
authors.lastname: Brey
authors.forename: Steven L
authors.initials: SL
authors.lastname: Henry
authors.forename: Ming Huei
authors.initials: MH
authors.lastname: Cheng
mesh_terms: D000293:Adolescent; D000328:Adult; D000369:Aged, 80 and over; D040421:Cell Phone / Q000706:statistics & numerical data*; D015331:Cohort Studies; D019317:Evidence-Based Medicine; D005260:Female; D058752:Free Tissue Flaps; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*; D010781:Photography; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D017216:Telemedicine / Q000379:methods*; D055815:Young Adult