Telemedicine consultations for treatment of diabetic patients with foot ulcers

Diabetes may cause deep foot ulcers that are both difficult and time-consuming to heal. To spare the patient of numerous visits to the hospital with related transport time, the Region of Southern Denmark offers to treat the patients at home by means of telemedicine.

When treated with telemedicine, only every third control consultation of the diabetic foot ulcers takes place at the hospital, and the two remaining consultations take place at home. A municipal nurse, who has specialised in complex foot ulcers, treats the patient’s ulcer at home and sends pictures of the ulcer to an electronic journal. Afterwards, specialists from the centre for ulcers at the hospital can view the pictures in the journal and guide and supervise continued care and treatment. As a result, the patient does not have to come to the hospital as often as previously.

When launching telemedicine consultations for foot ulcers, in which the images of the ulcers combined with manual measures of the size of the ulcer essential for the treatment, the idea emerged to develop a special camera which couples regular pictures with 3D technology and thereby provide accurate information about both size and depth.  Consequently, the PhD project on the development of a special 3D scanner in collaboration with a local company was initiated.

 

AIM

The aim of the PhD project was to develop a 3D imaging ulcer scanner for use in ulcer treatment and to present a new fast method for determination of wound area and volume. The 3D scanner was hoped to identify the size and depth of the foot ulcer faster and more accurately than the existing manual measuring methods.

The patients in the project received conventional wound treatment according to clinical standards. In addition to treatment, all wounds were assessed with the 3D ulcer scanner, a conventional 2D camera and VISI-TRAK. A comparison of 2D and 3D area will be performed, along with a methodical examination of tissue classification, volume (wound healing), and complexity of use.

 

RESULTS

The 3D ulcer scanner should provide a valid expression of volumetric data and surface area data.
The scanner will improve photo quality in Telemedical wound treatment and offer more accurate diagnosis and referral of patients.

The results of the projects showed that the prototype of the 3D scanner provided high accuracy in relation to the size and surface of the foot ulcer. It proved to be a useful method to document development or healing of the foot ulcer. Especially in relation to the tele-treatment of foot ulcers, the 3D scanner has the potential to ensure a more accurate diagnosis and referral of patients.

Odense University Hospital and Teccluster are still working on developing the prototype to a solution ready for marketing, and a consecutive PhD study on the next version of the scanner and the clinical effect of introducing the technology into the ulcer treatment has been completed.

 

ASSESSMENT

In collaboration with PhD student Benjamin S. Rasmussen, the clinical, organisational and economic effects were studied in a randomized study based on the MAST model.

Kristian Kidholm 

PROJECT PERIOD

Start: 2012
End: 2015

The project was a PhD project by Benjamin Schnack Rasmussen.

See Benjamin’s publications.

Hælsår 1

PARTNERS

The 3D camera was developed in collaboration with the company Teccluster.

CONTACT

Benjamin Schnack Rasmussen

Benjamin Schnack Rasmussen

Post Doc, MD | (+45) 6077 4050 | [email protected]

Kristian Kidholm

Kristian Kidholm

Head of Research, Professor | (+45) 3058 6477 | [email protected]

Knud Bonnet Yderstræde

Knud Bonnet Yderstræde

Senior Researcher | (+45) 6541 3427 | [email protected]