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Med."],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Surgical site infections (SSI) cause substantial morbidity and pose a burden to acute healthcare services after surgery. We aimed to investigate whether a smartphone-delivered wound assessment tool can expedite diagnosis and treatment of SSI after emergency abdominal surgery. This single-blinded randomised control trial (NCT02704897) enroled adult emergency abdominal surgery patients in two tertiary care hospitals. Patients were randomised (1:1) to routine postoperative care or additional access to a smartphone-delivered wound assessment tool for 30-days postoperatively. Patient-reported SSI symptoms and wound photographs were requested on postoperative days 3, 7, and 15. The primary outcome was time-to-diagnosis of SSI (Centers for Disease Control definition). 492 patients were randomised (smartphone intervention: 223; routine care: 269). There was no significant difference in the 30-day SSI rate between trial arms: 21 (9.4%) in smartphone vs 20 (7.4%, <jats:italic>p<\/jats:italic>\u2009=\u20090.513) in routine care. Among the smartphone group, 32.3% (<jats:italic>n<\/jats:italic>\u2009=\u200972) did not utilise the tool. There was no significant difference in time-to-diagnosis of SSI for patients receiving the intervention (\u22122.5 days, 95% CI: \u22126.6\u22121.6, <jats:italic>p<\/jats:italic>\u2009=\u20090.225). However, patients in the smartphone group had 3.7-times higher odds of diagnosis within 7 postoperative days (95% CI: 1.02\u221213.51, <jats:italic>p<\/jats:italic>\u2009=\u20090.043). The smartphone group had significantly reduced community care attendance (OR: 0.57, 95% CI: 0.34\u22120.94, <jats:italic>p<\/jats:italic>\u2009=\u20090.030), similar hospital attendance (OR: 0.76, 95% CI: 0.28\u22121.96, p\u2009=\u20090.577), and significantly better experiences in accessing care (OR: 2.02, 95% CI: 1.17\u22123.53, <jats:italic>p<\/jats:italic>\u2009=\u20090.013). Smartphone-delivered wound follow-up is feasible following emergency abdominal surgery. This can facilitate triage to the appropriate level of assessment required, allowing earlier postoperative diagnosis of SSI.<\/jats:p>","DOI":"10.1038\/s41746-021-00526-0","type":"journal-article","created":{"date-parts":[[2021,11,18]],"date-time":"2021-11-18T11:06:20Z","timestamp":1637233580000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":56,"title":["Remote diagnosis of surgical-site infection using a mobile digital intervention: a randomised controlled trial in emergency surgery patients"],"prefix":"10.1038","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6482-9086","authenticated-orcid":false,"given":"Kenneth A.","family":"McLean","sequence":"first","affiliation":[]},{"given":"Katie E.","family":"Mountain","sequence":"additional","affiliation":[]},{"given":"Catherine A.","family":"Shaw","sequence":"additional","affiliation":[]},{"given":"Thomas M.","family":"Drake","sequence":"additional","affiliation":[]},{"given":"Riinu","family":"Pius","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0448-3719","authenticated-orcid":false,"given":"Stephen R.","family":"Knight","sequence":"additional","affiliation":[]},{"given":"Cameron J.","family":"Fairfield","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5151-8342","authenticated-orcid":false,"given":"Alessandro","family":"Sgr\u00f2","sequence":"additional","affiliation":[]},{"given":"Matt","family":"Bouamrane","sequence":"additional","affiliation":[]},{"given":"William A.","family":"Cambridge","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8062-0685","authenticated-orcid":false,"given":"Mathew","family":"Lyons","sequence":"additional","affiliation":[]},{"given":"Aya","family":"Riad","sequence":"additional","affiliation":[]},{"given":"Richard J. 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