Difficult skin lesions: how they can be treated with telemedicine

from Ruggiero Corcella

Chronic “sores” represent an exponentially growing pathology. In Italy there is no real network of centers and telemedicine can overcome this shortcoming

Feel free to call them by their classic name: sores. These are “difficult” skin lesions, those that do not heal in the usual times and ways; wounds that need special attention and therapeutic intensity. How are they formed?
Due to trauma of a different nature or due at surgical interventionsthe so-called ones acute. Related to other pathologies (such as
diabetes; rheumatoid arthritis or lupus; arterial and venous vascular disease
), those chronic. Sometimes they form in bedridden patients when they are not well cared for and are referred to as pressure sores, commonly known as
pressure ulcers
.

The social impact

«Chronic skin lesions represent an exponentially growing pathology of high social significance in terms of public welfare expenditure also due to the loss of working days in those affected. “They probably affect about 1-1.5% of the adult population and in particular the geriatric population, assuming particularly serious characteristics, so much so that they have been representing for a long time a major health problem and today it is a real social emergency », he underlines Giovanni Vito Coronadirector of the Unit of Territorial Critical Oncology and Palliative Care of the Health Authority of Potenza.

In the last ten years Vulnology (or wound care, in English)that is, the branch of medicine that deals with these cases has been ferried from an empirical phase to one in which they have established themselves certain scientific assumptions capable of producing appropriate, evidence-based treatments. At the same time, however, there has been no comparable growth in care models: the culture of “outpatient management” of the wound still prevails, which cannot be replaced by models capable of providing guarantees of clinical efficacy and appropriateness.

Reliable technology

Telemedicine could solve these problems

: the technology that supports it is now reliable and the legislation in this regard has clarified its role, attributing it, among other things, to targeted funding just waiting to be used appropriately. “There is also no need to explain what telemedicine can do for wound care,” stresses the professor Sergio Pillon, coordinator of digital transformation at the Frosinone local health authority. Just think ofidentikit of patients with difficult wounds.

Fragile patients

“They are rightly definable “Fragile” because this pathology mostly affects the elderly, the disabled, patients with chronic diseases often immobilized or with reduced mobility and the disease also determines an additional condition of reduced mobility – adds Pillon, for ten years head of the telemedicine operating unit of the San Camillo Forlanini hospital in Rome -. Treatment of difficult wounds requires dressing every two days in most caseswhich involve the movement of specialized personnel or the patient himself, finally it is often necessary to activate multi-specialized skills(vascular surgeon and plastic surgeon, diabetologist, angiologist, infectious disease specialist, nephrologist …) “.

A network of specialized centers is missing

Italy still has a long way to go in organizing dedicated services and assistance, but it doesn’t really start from scratch. Over time some excellent experiences have been activated, but not a real network of centers. “At San Camillo in Rome, thanks to the collaboration between doctors and patients in sharing photos of the area to be treated, through daily tools such as e-mail addresses, training caregivers and providing medication material, a reduction in patient management costs by 37% for the healthcare facility.

” The patient it benefits not only from a logistical point of view (not having to go to hospital frequently) even from the physical onethe lesion is in fact treated with greater consistency and care up to complete recoverythat in telemedicine takes placefrom our data, in 93% of cases and without telemedicine in 75%. Today the experience continues in the Asl of Frosinone, with Dr. Alessandro Greco.
Telemedicine allows information to move and not patients
. In one of the longest-lived countries in the world, like ours, it is worthwhile to think of the new expressions of medicine as a necessary investment ”concludes Pillon.

May 23, 2022 (change May 23, 2022 | 19:39)

#Difficult #skin #lesions #treated #telemedicine

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