Feasibility and safety of surgical wound remote follow-up by smart phone in appendectomy: A pilot study

- A system to provide follow-up after surgery without the need of physical examination.
- Using a cell phone and a mail address follow-up is achieved.
- Feasibility and security of this system was assessed.
- E-mail follow-up achieved high sensibility and specificity rates compared to face-to-face follow-up.
- Patients were satisfied with telemedicine follow-up and preferred it to face-to-face regular examinations.

IntroductionThe objective of the present study is to assess the safety and feasibility of the use of telemedicine-based services for surgical wound care and to measure patient satisfaction with telemedicine-based follow-up.Material and methods24 patients were included, they were provided with a corporate mail address. On day 7 after surgery patients sent, via email, an image of their surgical wound together with a completed questionnaire in order to obtain an early diagnosis. Two independent physicians studied this information and the histologic analysis of the specimen. On day 8, all patients underwent face-to-face office examination by a third physician and all of them completed a satisfaction questionnaire at the end of the study.ResultsThe use of telemedicine-based services showed a sensitivity of 100%, a specificity of 91.6%, a positive predictive value of 75% and a negative predictive value of 100%.Degree of concordance between the two physicians, as regards the necessity of face-to-face follow-up yielded a kappa coefficient of 0.42 (standard error 0.25 and confidence interval 95% (0.92-0.08), which means a moderate agreement between the two evaluations.94% of patients were satisfied with telemedicine-based follow-up and 93% showed their preference for this procedure over conventional methods.ConclusionsThe telemedicine-based follow-up, has proven to be feasible and safe for the evaluation of early postoperative complications. Patients reported high levels of satisfaction with the procedure. Telemedicine-based follow-up could become standard practice with the development of a specific mobile application.