pressure ulcer assessment via telemedicine

Conditions: Pressure Ulcers

Summary: a web-based telemedicine system for monitoring the status of patients with pressure ulcers has been developed. it consists of three major data collection components: (1) digital photograph of ulcer; (2) quantitative measurements of wound status (i.e., ulcer area and volume, skin elasticity); and (3) other wound and patient data collected by a nurse. data are collected via laptop computer and transmitted to a central database, where a computer program transforms the data into the necessary reporting format. the output is posted onto a world wide web page for access by the consulting physician. the system incorporates all data requirements for assessment recommended by ahcpr's clinical practice guideline, treatment of pressure ulcers.

background: a web-based telemedicine system for monitoring the status of patients with pressure ulcers has been developed. it consists of three major data collection components: (1) digital photograph of ulcer; (2) quantitative measurements of wound status (i.e., ulcer area and volume, skin elasticity); and (3) other wound and patient data collected by a nurse. data are collected via laptop computer and transmitted to a central database, where a computer program transforms the data into the necessary reporting format. the output is posted onto a world wide web page for access by the consulting physician. the system incorporates all data requirements for assessment recommended by ahcpr's clinical practice guideline, treatment of pressure ulcers. objectives: the primary objective of this pilot study was to evaluate the clinical accuracy of a telemedicine system for assessing the status of pressure ulcers, both chronic and those which have been surgically repaired. the principal hypotheses were: (1) use of the telemedicine system results in the same diagnoses as does in-person patient assessment; and (2) patients are satisfied with the telemedicine system. methods: two va medical centers and two specialties participated in the study: ann arbor (plastic surgery) and augusta (plastic surgery, physical medicine and rehabilitation). they contributed inpatients and outpatients with a pressure ulcer of stage ii, iii, or iv over a one-year enrollment period. all study patients were assessed both in-person (the "gold standard") and with the telemedicine system. the in-person and telemedicine physicians provided yes/no responses to four diagnostic questions concerning wound healing and infection, based on ahcpr guidelines, and they were blinded to each other�s assessments. patient satisfaction data were collected using a specially designed, self-administered questionnaire to measure perceptions regarding the burden of the telemedicine system, confidence in the evaluation, and absence of direct contact with a physician. status: completed

Eligibility criteria:
inclusion criteria: va inpatients, outpatients, or nursing home residents at the participating sites who have any of the following wounds: (1) chronic pressure ulcers at stage ii, iii or iv; (2) post-operative wound patients having undergone a skin flap procedure for a grade iii or iv pressure ulcer; (3) diabetic wounds; (4) arterial ulcers; or (5) chronic venous status ulcers. exclusion criteria: mentally incompetent patients. exclusion criteria: