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A Journal on Physiopathology and Therapy of Chronic Cutaneous Ulcers
Official Journal of the Italian Association for Cutaneous Ulcers
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Acta Vulnologica 2013 June;11(2):53-66
language: English, Italian
Complicated wounds in the age of web 2.0: new perspectives in patient management
Carbonari A. 1, Gioacchini M. 1, Bolletta E. 1, Pupita G. 2, Pierangeli M. 1, Grassetti L. 1, Di Benedetto G. 1, Scalise A. 1
1 Plastic and Reconstructive Surgery Clinic Ospedali Riuniti di Ancona, Ancona, Italy;
2 Cardiology Clinic, Ospedali Riuniti di Ancona Ancona, Italy
Aim: Chronic wounds carry a huge medical, social and economic burden. In Italy 2 million people, including 30000 children, suffer from skin ulcers, 50% of which are debilitating. Their treatment costs the Italian national health services 2 million euro annually. Currently, these patients receive treatment from hospital, outpatient and home care services. However, there are no integrated pathways to guarantee the continuity of care and their implementation is burdened by the need to integrate the work of many different professionals. International studies have shown the feasibility and advantage of data transmission of wound status for remote consultation. To improve continuity of care, we created a novel store and forward application: Wound-Manager 1.0. Wound Manager allows users to share information about the patient (including wound status) with operators in different care settings and store the data in a database.
Methods: In keeping with the multifactorial nature of chronic wounds, we structured the program in seven main areas for data entry during patient evaluation: master file; operation; wound; clinic visits; diagnostic tests; vacuum-assisted closure; dressing. The study population was 50 patients (63 chronic wounds) followed-up for 3 months by health providers using the Wound Manager. Wound status was evaluated according to PUSH tool 3.0. At the end of the study we asked users and operators to rate their satisfaction (on a scale from 1 to 5) with the project.
Results: At 90 days, 65% of wounds had improved, 20.6% were unchanged, and 14.2% had worsened. The majority of patients and operators stated that they were highly satisfied with the project. On the basis of these promising results, a double-blind study may be designed to correlate use of the tool and the clinical progress of wound healing.
Conclusion: Wound Manager is an innovative response to the problem of continuity of care for patients with chronic skin wounds. The tool offers numerous advantages: 1) improved telematic communication between hospital-community-home care-based services; 2) reduced waiting time, travel and costs for specialist consultation; 3) net database for clinical/experimental studies; 4) potential to extend its use to other Italian regions; 5) potential to reduce wound healing time by sharing information between health providers at different care levels.