According to the American College of Surgeons, surgical site infections (SSIs) are the most common form of hospital-acquired infection and the most frequent cause for readmission after surgery. In addition to their frequency, SSI readmissions are costly; the average readmission costs nearly $30,000. This adds up to $3 to $10 billion each year. The professional organization issued a press release about a smartphone app to help with post-surgical wound care.
Wisconsin Institute of Surgical Outcomes Research (WiSOR) team members from the University of Wisconsin, Madison, Department of Surgery developed the WoundCheck app. The app enables post-surgical wound patients to take and send images captured with a smartphone camera.The patients also answer questions about each image. The images and patient responses are transmitted by the phone to the patient’s surgical care team. The WiSOR researchers published the results of a study with WoundCheck and 40 vascular wound patients in the Journal of the American College of Surgeons.
After surgery, the patients in the study were trained how to use WoundCheck before their discharge from the hospital. The team provided each patient with an iPhone 5S. The patients also had visual reference guides for further assistance. Technology access and knowledge were key factors that resulted in a high compliance rate, according to the WiSOR team. On the patient side of the study, there was an overall 90.2% data submission rate. The care team reviewed the submissions within an average of 9.7 hours. Seven wound complications and one false negative were identified during the study. According to the team, both the patients and the nurse practitioners who reviewed the submissions were pleased with the app. The nurses did note that it was difficult to find time to review the submissions in addition to their existing clinical workloads.
The WiSOR study doesn’t prove the WoundCheck app is more effective than other forms of care. There were no controls and no numbers with which to compare the catches made with the 40 patients’ submissions. The greatest significance of the program was testing its potential for complex, high-risk patients, often older adults with no previous smartphone experience. The researchers concluded that with proper training and access to the technology, a diverse patient group used the app successfully. The team believes the protocols for distribution, training, reporting, and reviewing the submissions apply to other patient populations as well. In the case of wound surgery follow-up, the study concluded that the care side of the process needs dedicated transitional staff who don’t have to squeeze image and response submission review in along with their normally full workload.