Marek A Paul1,2, Parisa Kamali1, Ahmed M S Ibrahim3, Caroline Medin1, Bernard T Lee1, Samuel J Lin1. 1. 1 Division of Plastic Surgery, Beth Israel Deaconess Medical Center , Harvard Medical School, Boston, Massachusetts. 2. 2 Department of Plastic Surgery, T. Marciniak Lower Silesian Specialist Hospital , Wroclaw, Poland . 3. 3 Division of Plastic and Reconstructive Surgery, Louisiana State University Health Sciences Center , New Orleans, Louisiana.
Abstract
BACKGROUND: Close, multidisciplinary collaboration with burn experts is the essential strategy to achieve the best functional and esthetic outcomes in burn wound treatment. Management of minor burn injuries, where no specialized care is available, might be challenging. One concept to achieve a fast and timely result is the application of telemedicine. The objective of this study was to assess and develop a simple telemedicine protocol, which can be applied globally. MATERIAL AND METHODS: We present a pilot study based on a pediatric population of four patients with minor burns. Based on the severity and burn area, two cases of ambulant pediatric patients (mean 1% total body surface area, superficial and deep 2° burn) with minor burn injuries met study criteria and were enrolled. A pediatrician performed the initial assessment, followed by plastic surgery video consultation, using telephone's digital camera. Treatment protocols were designed to optimize outcomes. After the initial treatment phase, which took place at a nonteaching local hospital in Poland from January 1, 2014, to December 31, 2014, clinical follow-up was performed by a plastic surgeon via smartphone in the United States. RESULTS: We have achieved complete burn wound resolution, in all patients, with no scarring and only minor discoloration. A simple, reproducible treatment protocol was designed to include dressing changes and additional outpatient visits. CONCLUSIONS: Implementation of a telemedicine protocol allows for easy access to burn consultations, helps multidisciplinary collaboration, eases follow-ups, and shortens specialists' consult wait times. Real-time evaluation provides fast and flexible treatment, without long distance travels, for patients and their families. Telemedicine increases the frequency of follow-up, contributes to the esthetic outcome, and together with improved cost-effectiveness is beneficial for both the patient and healthcare system.
BACKGROUND: Close, multidisciplinary collaboration with burn experts is the essential strategy to achieve the best functional and esthetic outcomes in burn wound treatment. Management of minor burn injuries, where no specialized care is available, might be challenging. One concept to achieve a fast and timely result is the application of telemedicine. The objective of this study was to assess and develop a simple telemedicine protocol, which can be applied globally. MATERIAL AND METHODS: We present a pilot study based on a pediatric population of four patients with minor burns. Based on the severity and burn area, two cases of ambulant pediatric patients (mean 1% total body surface area, superficial and deep 2° burn) with minor burn injuries met study criteria and were enrolled. A pediatrician performed the initial assessment, followed by plastic surgery video consultation, using telephone's digital camera. Treatment protocols were designed to optimize outcomes. After the initial treatment phase, which took place at a nonteaching local hospital in Poland from January 1, 2014, to December 31, 2014, clinical follow-up was performed by a plastic surgeon via smartphone in the United States. RESULTS: We have achieved complete burn wound resolution, in all patients, with no scarring and only minor discoloration. A simple, reproducible treatment protocol was designed to include dressing changes and additional outpatient visits. CONCLUSIONS: Implementation of a telemedicine protocol allows for easy access to burn consultations, helps multidisciplinary collaboration, eases follow-ups, and shortens specialists' consult wait times. Real-time evaluation provides fast and flexible treatment, without long distance travels, for patients and their families. Telemedicine increases the frequency of follow-up, contributes to the esthetic outcome, and together with improved cost-effectiveness is beneficial for both the patient and healthcare system.