Edinburgh study published on ‘surgery selfies’ and infection identification

A study by researchers at the University of Edinburgh, which has been published in npj Digital Medicine, has found that ‘surgery selfies’ – smartphone pictures taken of post-surgical wounds by patients, which are then assessed by clinicians – ‘can help with the early identification of infections’.

Experts say that, in the study, the ‘selfies’ were linked to a ‘reduced number of visits to GPs’ and also ‘improved access to advice’, among the patients who took them.

The University states that ‘death within 30 days of surgery is the third largest cause of death globally’ and ‘surgical wound infections are associated with more than a third of deaths after an operation’, while ‘on average, surgical wound infections cost the NHS an extra £10,000 per patient’ due to longer stays in hospital, readmissions and extra treatments.

Through a a randomised clinical trial involving 492 emergency abdominal surgery patients, researchers tried to find out whether a combination of smartphone photos and questions on symptoms would lead to early diagnosis of wound infections.

One group of 223 patients were contacted several times – three, seven and 15 days after surgery – and directed to an online survey, where they were asked about their wound, and any symptoms, and then instructed to take a photo and upload it securely. These pictures were then assessed by the surgical team before further follow-ups by researchers to find out if they had been diagnosed with any infection.

A second group of 269 people received the ‘routine’ care and were contacted 30 days after surgery to find out if they had been diagnosed with an infection.

Overall, it was found that there was ‘no significant difference between both groups in the overall time it took to diagnose wound infections in the 30-days after surgery’.

However, among the people who submitted smartphone photos and were asked questions about their symptoms, researchers found that the smartphone group were ‘nearly four times more likely to have their wound infection diagnosed within seven days of their surgery compared to the routine care group’ and that they also had a reduced number of GP visits and reported a better experience of accessing post-op care.

Professor Ewen Harrison, Professor of Surgery and Data Science at the University of Edinburgh, and study lead, said: “Our study shows the benefits of using mobile technology for follow-up after surgery. Recovery can be an anxious time for everybody. These approaches provide reassurance – after all, most of us don’t know what a normally healing wound looks like a few weeks after surgery.

“We hope that picking up wound problems early can result in treatments that limit complications. Using mobile phone apps around the time of surgery is becoming common – we are working to scale this within the NHS, given the benefits for patients in continuing to be directly connected with the hospital team treating them.”

While the follow-up study will focus on how to put the findings into practice for patients across the NHS, artificial intelligence is also expected to be used in future to help clinicians assess the possibility of wound infection.

Dr Kenneth McLeanClinical Research Fellow, University of Edinburgh and study co-lead, commented: “Since the COVID-19 pandemic started, there have been big changes in how care after surgery is delivered. Patients and staff have become used to having remote consultations, and we’ve shown we can effectively and safely monitor wounds after surgery while patients recover at home – this is likely to become the new normal.”

Find the full study here: McLean, K.A., Mountain, K.E., Shaw, C.A. et al. Remote diagnosis of surgical-site infection using a mobile digital intervention: a randomised controlled trial in emergency surgery patients. npj Digit. Med. 4, 160 (2021).