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A Feasibility Study

Ralph Peter Braun, MD; Jean L. Vecchietti, MD; Luc Thomas, MD; Christa Prins, MD; Lars E. French, MD; Aron J. Gewirtzman; Jean-Hilaire Saurat, MD; Denis Salomon, MD

Arch Dermatol. 2005;141:254-258.

Background  Leg ulcers are an important cost factor in health care systems. It has been shown that a telemedical wound care consultation can improve quality of care and help reduce costs. In this study, we evaluated the feasibility of telemedical wound care using a new generation of mobile telephones with integrated cameras.

Observations  Three physicians separately evaluated 61 leg ulcers for the following 9 variables: epithelialization, fibrin, necrosis, and granulation tissue at the center and normal border, erythema, cyanosis, eczema, and hyperpigmentation at the periphery. One physician performed the face-to-face consultation (gold standard), and 2 others performed the remote evaluation. The image was obtained with the mobile telephone and immediately sent via e-mail. To measure the agreement of the evaluation among the 3 physicians, we used Cohen statistics. Overall, the agreement between the remote and face-to-face evaluations was very good, with values of up to 0.94 The image quality was judged to be good in 36 cases (59%) and very good in 12 (20%). The participants felt comfortable making a diagnosis based on the pictures in 50 cases (82%).

Conclusion  Although this study was performed with the first generation of these devices, we were able to demonstrate the feasibility of such a telemedical wound care consultation.

Author Affiliations: Department of Dermatology, University Hospital Geneva, Geneva, Switzerland.

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