title: Expert advice provided through telemedicine improves healing of chronic wounds: prospective cluster controlled study.
abstract: Telemedicine is widely considered as an efficient approach to manage the growing problem of chronic wounds. However, to date, there is no convincing evidence to support the clinical efficacy of telemedicine in wound management. In this prospective cluster controlled study, we tested the hypothesis that advice on wound management provided by a team of wound-care specialists through telemedicine would significantly improve the likelihood of wound healing compared with the best available conventional practice. A total of 90 chronic wound patients in home care met all study criteria and were included: 50 in the telemedicine group and 40 in the conventional group. Patients with pressure ulcers, surgical wounds, and cancer wounds were excluded. During the 1-year follow-up, complete wound healing was achieved in 35 patients (70%) in the telemedicine group compared with 18 patients (45%) in the conventional group. After adjusting for important covariates, offering advice on wound management through telemedicine was associated with significantly increased healing compared with the best available conventional practice (telemedicine vs. conventional practice: adjusted hazard ratio 2.19; 95% confidence interval: 1.15-4.17; P=0.017). This study strongly supports the use of telemedicine to connect home-care nurses to a team of wound experts in order to improve the management of chronic wounds.
authors.affiliation: Department of Dermatology, Roskilde Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Roskilde, Denmark. Electronic address: kian_zarchi@yahoo.com.
authors.forename: Kian
authors.initials: K
authors.lastname: Zarchi
authors.affiliation: Department of Dermatology, Roskilde Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Roskilde, Denmark.
authors.forename: Vibeke B
authors.initials: VB
authors.lastname: Haugaard
authors.affiliation: Department of Dermatology, Roskilde Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Roskilde, Denmark.
authors.forename: Deirdre N
authors.initials: DN
authors.lastname: Dufour
authors.affiliation: Department of Dermatology, Roskilde Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Roskilde, Denmark.
authors.forename: Gregor B E
authors.initials: GBE
authors.lastname: Jemec
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D016000:Cluster Analysis; D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D017216:Telemedicine; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology*; D014947:Wounds and Injuries / Q000503:physiopathology* / Q000628:therapy*