title: Teledermatology may play a role in reducing severity of pressure ulcers in both rural and urban settings.
abstract: BACKGROUND
  Teledermatology is already thought to be a valuable tool for patients in rural areas due to their lack of easy access to specialty care providers. This study explored the benefit of teledermatology for bedridden patients living in both rural and urban areas.
  
  
  METHODS
  The following 4 studies were evaluated: 1) evaluation of conditions of 83 patients who had developed pressure ulcers before being admitted to the hospital; 2) evaluation of the circumstances of 53 patients with pressure ulcers who received home care; 3) survey of 321 home care nurses regarding their concerns about wound care; and 4) results of a teledermatology system aiming at early intervention for chronic wound treatment.
  
  
  RESULTS
  1) Sixtythree percent of patients who developed pressure ulcers were over 70 years old, 84% of them were bedridden, and 66% developed at home. 2) Seventy-four percent of patients who received home care and developed pressure ulcers lived alone or with an elderly spouse, and only 19% consulted a specialist. 3) A survey of 321 home care nurses revealed that they have difficulties with consulting a specialist, with their complaints against home care doctors amounting to 70% of their responses. 4) Seventeen consultations were sent to a new teledermatology system, 82% by patients, families, and home care nurses. About half of these patients were bedridden, and 82% were currently living at home. Twelve cases (70.6%) were from urban areas.
  
  
  CONCLUSIONS
  Because of the potential for teledermatology to prevent the worsening of ulcers, teledermatological wound consultations should be utilized by all bedridden patients who have a wound.
authors: Department of Plastic and Reconstructive Surgery, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan.
authors: Kenji
authors: K
authors: Hayashida
authors: Department of Plastic and Reconstructive Surgery, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan; and Department of Plastic and Reconstructive Surgery, Nagasaki University, Nagasaki, Japan; email:mfujioka@nmc.hosp.go.jp.
authors: Masaki
authors: M
authors: Fujioka
authors: Department of Plastic and Reconstructive Surgery, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan.
authors: Chikako
authors: C
authors: Senju