Telemedicine Reports (May 2024)
Telemedicine in Burn Care: Assessing Surgeons' Proficiency
Abstract
Background: Early intervention by specialized burn surgeons is crucial in preventing wound progression and complications of deep burns. However, limited access to specialist burn centers remains a challenge. Telemedicine offers a potential solution by providing timely and high-quality access to burn experts. The study aims to compare the diagnostic accuracy of telemedicine for diagnosing burn depth by surgeons working in the field of burns. Method: This cross-sectional study included 15 actively practicing surgeons specializing in burn surgery, including general surgeons, burn surgery fellows, and plastic surgeons. The surgeons? work experience and areas of expertise were documented. The study presented 13 images of partial-thickness burn ulcers on patients? extremities and trunk, requiring participants to diagnose burn depth and assess the necessity of grafts. Results: Among the 15 participating surgeons, complete responses were obtained from 11 individuals, comprising 3 general surgeons, 4 burn surgery fellows, and 4 plastic surgeons. For deep burns, no significant difference in diagnostic accuracy was observed between general surgeons and burn surgery fellows (p = 0.152) or between burn surgery fellows and plastic surgeons (p = 0.193). However, plastic surgeons demonstrated significantly higher accuracy compared to general surgeons (p = 0.020). Regarding superficial burns, there were no statistically significant differences in diagnostic accuracy between general surgeons and burn surgery fellows (p = 0.567), but both general surgeons (p = 0.011) and burn surgery fellows (p = 0.043) exhibited significantly higher diagnostic accuracy than plastic surgeons. Furthermore, the analysis indicated that work experience did not significantly impact the accuracy of burn depth estimation. Conclusion: The study?s results confirm the reliability of utilizing photographs to evaluate superficial burns, but underscore the limitations in both validity and reliability when it comes to determining burn depth. In addition, the findings highlight that general surgeons exhibit greater proficiency in identifying superficial burns, whereas plastic surgeons demonstrate higher accuracy in diagnosing deep burns.
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