MUHC res­i­dent’s app can re­duce bed sores: study

Montreal Gazette - - FRONT PAGE - AARON DERFEL

Painful bed sores — the bane of ex­is­tence for many el­derly pa­tients in long-term care cen­tres — could be­come far less com­mon thanks to a smart­phone app that was de­vel­oped by a der­ma­tol­ogy med­i­cal res­i­dent now prac­tic­ing at the McGill Univer­sity Health Cen­tre. The app has al­ready proved to be highly ac­cu­rate in track­ing the heal­ing of foot ul­cers in pa­tients with di­a­betes. But new re­search has also shown that daily use of the app by nurses over the course of a year re­duced the in­ci­dence of bed sores by 77 per cent at a longterm care cen­tre in the United States. And Dr. Sheila Wang, who in­vented the Swift Skin and Wound app while in med­i­cal school at the Univer­sity of Toronto, is now test­ing it on Cree pa­tients in the far north of Que­bec for use as a po­ten­tial tool in telemedicine — the re­mote di­ag­no­sis and treat­ment of pa­tients through the in­ter­net. “It’s very ad­vanced ma­chine v i s i o n i n g t e c h n o l o g y, w h i c h was re­ally put into some­thing that is quite sim­ple,” Wang said, de­scrib­ing the app that was de­signed partly by an en­gi­neer who worked on the imag­ing soft­ware for NASA’s Mars Rover. “My goal was and still is to cre­ate a tool that is pow­er­ful but at the same time re­ally easy to use.” Un­til now, nurses and doc­tors have re­lied on an 18-mil­lime­tre paper ruler to mea­sure such wounds in peo­ple with di­a­betes. The ruler method is of­ten in­ex­act and doesn’t de­scribe the ir­reg­u­lar size of wounds or how some heal from the mid­dle. Di­a­betic pa­tients usu­ally don’t get to see images of their foot ul­cers, and there­fore they don’t know whether their wounds are truly heal­ing, Wang ex­plained. In con­trast, the app not only takes pic­tures of a wound but high­lights its evo­lu­tion in a time-lapsed video, show­ing dra­matic im­prove­ment that can mo­ti­vate pa­tients. The app is now be­ing used to mon­i­tor more than 100,000 pa­tients across North Amer­ica. Dr. Greg Berry, chief of or­tho­pe­dic surgery at the Mon­treal Gen­eral Hos­pi­tal, swears by the new tech­nol­ogy. “Many of my pa­tients are di­a­betic and are deal­ing with slow-heal­ing foot ul­cers,” he said in a state­ment.

“This app of­fers a way to clearly doc­u­ment and quan­tify the size of the ul­cer to en­sure it is ac­tu­ally heal­ing, and if it is not heal­ing, I can change strate­gies.” “I can con­cretely show them that what we are do­ing is work­ing,” Berry added. “They get on board and are more de­voted to the treat­ment plan be­cause they see it is suc­cess­ful.” In the U.S. long-term care cen­tre, nurses who used the app dis­cov­ered that they were able to spot bed sores at an early stage, be­fore the skin started to break. As a re­sult, the nurses per­formed “of­fload­ing,” mov­ing the pa­tient’s body more of­ten on a bed. “They were able to pick up on the pres­sure ul­cers be­fore they got re­ally bad,” Wang said. For now, the app is be­ing used in geri­atrics and en­docrinol­ogy. But the app has also at­tracted the at­ten­tion of a wide range of med­i­cal spe­cial­ists — from or­tho­pe­dics to ra­di­ol­ogy — sug­gest­ing that it may have many more clin­i­cal uses in the fu­ture.

MUHC

Dr. Sheila Wang, an MUHC der­ma­tol­ogy res­i­dent, says it’s highly valu­able to be able to ac­cu­rately track the pro­gres­sion of a pa­tient’s di­a­betic foot ul­cer.

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