[Telemonitoring of digital flaps using the Pixacare tool: A prospective implementation study].

Objective: The primary objective of this study is to assess the inter-observer agreement in the analysis of digital flap photos using the Pixacare application. The secondary objective is to evaluate the implementation of outpatient telemonitoring for these flaps via the Pixacare application.

Methodology: This is a prospective monocentric study conducted at SOS Main Lesquin from January 1st to July 1st, 2023. Patients who underwent a digital flap procedure were included in the study. Home care nurses were asked to send a weekly photo of the flap via the Pixacare application. The collected photo sequences were then analyzed by three observers and classified into two categories (normal healing/complication). Patient satisfaction with the follow-up was rated on a scale of 5.

Results: A total of 27 patients were included, with 76 photographic sequences collected via the application. Fleiss' Kappa coefficient, evaluating inter-observer agreement, was calculated at K=0.64, 95% CI [0.51; 0.77], with P<0.001, indicating strong agreement. The average patient satisfaction score was 4.63/5.

Conclusion: The follow-up of digital flaps using the Pixacare application appears promising in reducing the frequency of consultations, given the strong inter-observer agreement. While patient satisfaction is very high, the implementation of this telemonitoring system will require some adjustments to ensure strong adherence from paramedical staff to photographic follow-up.