Effect of wound photography for remote postop assessment of SSIs

Editor's Note

Wound photography facilitates online postoperative wound assessment for surgical site infections (SSIs) but needs refinement to make sure critical issues aren’t missed, this study finds.

A total of 523 surgeons reviewed online clinical vignettes with or without wound photography to diagnose SSIs.

The addition of photography did not change accuracy (863 of 1,512 [57.1%] without vs 878 of 1,512 [58.1%] with photographs), and photographs decreased sensitivity but increased specificity.

The addition of wound photography changed the surgeons’ assessment from incorrect to correct in 14.2% and from correct to incorrect in 13.2% of patients.

Surgeons reported greater confidence when vignettes included photographs but were more likely to undertriage patients with photographs, regardless of whether they correctly diagnosed an SSI.

Widespread implementation of postoperative assessment with photography may require additional development of tools, training, and mechanisms to verify image quality, the researchers conclude.