Implementation and evaluation of telemedicine in burn care: Study of clinical safety and technical feasibility in a single burn center

Monte-Soldado, Alejandra; López-Masrramon, Bernat; Aguilera-Sáez, Jorge; Domènech, Jordi Serracanta; Delfa, José Manuel Collado; Ramos, Carlos Moreno; Nerín, Juan Pedro Barret

doi:10.1016/j.burns.2020.04.027

Cited by 11 publications

(9 citation statements)

References 22 publications

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“…As technology is increasingly ubiquitous as most individuals have access to mobile phone services, remote phone applications are a promising technology for engaging patients outside of traditional in-office appointments. Leveraging telemedicine programs in burn care has been highly effective in streamlining initial patient triage, improving resource management, and promoting higher quality of care for patients [ 13 ]. While certainly many barriers to the implementation of telemedicine exist, including technical limitations, it represents a realistic opportunity to address a need in burn medicine for increased patient access to care resources.…”

Section: Discussionmentioning

confidence: 99%

“…As delayed wound healing, burn wound infection, pain, and hypertrophic scarring are commonly encountered after burn trauma, follow-up appointments are essential for identifying problems and intervening early [ 11 ]. Continuous communication and follow-up care through patient telecommunication or regular appointments have been shown to improve patient-reported quality of life as well as self-reported physical and psychological health [ 12 , 13 ]. In this case report, we describe a case of polymicrobial wound infection with Providencia rettgeri in a burn patient that led to significant morbidity and was complicated by inadequate access to transportation.…”

Section: Introductionmentioning

confidence: 99%

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Providencia rettgeri Infection Compromising Post-Burn Recovery: A Lesson in the Importance of Follow-Up Care

Huff¹,

Blome-Eberwein²

2022

Cureus

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Early burn excision and skin grafting have been essential to improving patient outcomes following a burn injury. However, there remain significant barriers to recovery for burn patients, especially in the post-discharge period, as follow-up care is essential to the timely identification of complications. While the infection is a common complication of a post-burn wound, Providencia rettgeri is an uncommon bacterial pathogen that rarely causes wound infections. Although P. rettgeri has been infrequently reported as a cause of wound infections, it is a pathogen with growing clinical significance due to innate and acquired mechanisms of antimicrobial resistance that may complicate patient treatment. While our report describes the clinical outcome of a patient with a wound infection with Providencia rettgeri , it also represents a case that underscores the importance of social determinants of health in the care of burn patients. This is a case report of an elderly male who sustained burns to his bilateral arms and back and was subsequently readmitted to our burn unit for graft loss associated with a Providencia rettgeri wound infection. His readmission required multiple operations to resect necrotic tissue and nonviable graft due to delayed wound healing and incomplete graft take. Inadequate access to transportation led to significantly delayed follow-up for this patient.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Providencia rettgeri Infection Compromising Post-Burn Recovery: A Lesson in the Importance of Follow-Up Care

Huff¹,

Blome-Eberwein²

2022

Cureus

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“…The role of telemedicine for burns has been discussed and evaluated in many settings. A recent study evaluating telemedicine at a burn unit demonstrated its usefulness in triaging, reducing the burden on tertiary care burn centre, and optimising resources in terms of time and cost [40] . Other evidence demonstrated very high sensitivity for diagnosing and triaging burn patients via teleconsultation as compared to face-to-face consultation [41] .…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 and containment measures on burn care: A qualitative exploratory study

Keshri

Peden

Jain

et al. 2022

Burns

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“…2,6 This leads mostly to overestimation of the burn size and thereby unnecessary transfers. 3,4,7,11,12 The COVID-19 pandemic has challenged the health care systems worldwide. The outbreak rapidly transformed the health care system to virtual health where possible by integrating TM.…”

Section: Discussionmentioning

confidence: 99%

“…1,3,7-9 TM and the use of smartphones in the medical field have contributed significantly to the diagnosis, need for referral, treatment, and follow-up of patients especially in limited-resource environments. 8,[10][11][12] Furthermore, the global spread of coronavirus disease 2019 (COVID-19) affected health care providers worldwide. In the current COVID-19 crisis and future outbreaks, we do not know yet implement TM to optimize pediatric health care delivery.…”

Section: Introductionmentioning

confidence: 99%

Telemedicine for the management of pediatric burn patients admitted to emergency services

Esberk

Daş

2021

J Telemed Telecare

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Introduction Telemedicine when properly implemented can be used to facilitate consultations from physicians with little or no burn experience by providing access to qualified physicians in burn care to reduce the workload in emergency departments or elsewhere. In this study, the role of telemedicine in the management and triage of pediatric burn patients admitted to the emergency department of a tertiary care hospital is investigated. Methods This cross-sectional study was conducted between 1 January 2019 and 31 December 2020 and a total of 210 patients were enrolled in the study. Patients were initially evaluated in the emergency room by a pediatrician and consulted by an experienced burn specialist using lesion images. An in-person assessment of the patients was performed by another burn specialist according to the clinical decision made via telemedicine. The data of both assessments and clinical data of the patients were examined. Results The mean age of our patients was 3.35 ± 3.7 years. Most of the burns were scalds with hot liquids (71%). After the consultations, 73 patients were discharged from the emergency room. The rest were decided as follow-up at the burn outpatient clinic ( n = 99) or hospitalization ( n = 35) and in-person assessment was performed for these patients. The inter-rater reliability value for “clinical decision” was almost perfect (Cohen's kappa value is 0.923). Also, the level of concordance between the two assessments was very high for burned total body surface area (interclass correlation coefficient = 0.999). Conclusion In the management and triage of pediatric burn patients admitted to the emergency department, telemedicine and in-person examination resulted in almost perfect agreement in terms of clinical decision and total body surface area. Legal arrangements and regulatory changes are essential to support the safe and wide adoption of telemedicine, which is a reliable method in emergency room settings.

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Implementation and evaluation of telemedicine in burn care: Study of clinical safety and technical feasibility in a single burn center

Cited by 11 publications

References 22 publications

Providencia rettgeri Infection Compromising Post-Burn Recovery: A Lesson in the Importance of Follow-Up Care

Providencia rettgeri Infection Compromising Post-Burn Recovery: A Lesson in the Importance of Follow-Up Care

Impact of COVID-19 and containment measures on burn care: A qualitative exploratory study

Telemedicine for the management of pediatric burn patients admitted to emergency services

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