Use of Smartphone Photography for Clinical Decision-Making in Wound Surgery: Is It Reliable?

Background: Smartphone photography may play a role in various aspects of clinical practice in wound surgery. Its accuracy as a tool for wound assessment and clinical decision-making is yet to be proven. Moreover, data regarding the magnitude of its use in practice are lacking.

Methods: Eleven board-certified plastic surgeons performed 79 wound observations and completed a questionnaire regarding wound properties and decisions regarding management. Wounds were photographed using smartphones at the time of initial wound observation. At least 3 months later, photographs of the wounds were anonymously presented to the same surgeons who completed the questionnaires again. Statistical analysis was used to compare the results. In addition, an online survey was used to assess the magnitude and manner of smartphone photography use among plastic surgeons.

Results: Comparison of bedside and photographic wound evaluation found no statistically significant differences in nearly all descriptive wound parameters and aspects of clinical decision-making. Statistically significant differences were found for periwound subcutaneous space assessment (P=.02) and recommendation for operative wound closure (P=.035). Seventy-four plastic surgeons replied to the online survey, and 93% of them stated that they use smartphone photography in their daily practice, with the majority using it equally for patient follow-up, consulting other physicians, and communication with patients.

Conclusions: Smartphone photography seems to play a major role in present-day clinical practice. According to the findings of this study, assessment of wounds via smartphone photography can be safely used as an adjunct for clinical decision-making when used as a consultation aid between wound surgeons.