Postoperative monitoring of flaps by digital camera and Internet link

WhatsApp messaging improves communication in an oral and maxillofacial surgery team

OBJECTIVE

Smartphones have become very popular among oral and maxillofacial surgeons. WhatsApp is an application that enables users to send voice, text, and multimedia messages using the group communication feature. The purpose of this study was to evaluate the efficiency of WhatsApp messaging as a mode of consultation within an oral and maxillofacial surgery team.

MATERIALS AND METHODS

A retrospective study on WhatsApp group conversations amongst oral and maxillofacial surgeons was performed between July 2015 and July 2016. A WhatsApp group consisting of senior and junior surgeons was created, and many consultations were recorded. Seven hundred fifty-six consultations were included in the study. In this study, the arrival and response times of messages, types of cases, timing of consultation's end, consultant locations, contents of multimedia messages, and the categories/types of messages were evaluated. During consultations, some cases were discussed with text messages via WhatsApp, and some cases with voice and image messages via WhatsApp, with or without WhatsApp text messages. In addition, several cases were discussed with video messages via WhatsApp. Thus, a total of 1747 messages reflecting four different message types were included in this study: 754 (43%) were text messages, 752 (43%) were photographic images, 213 (12%) were videos, and 28 (nearly 2%) were voice messages.

RESULTS

The most frequent consultations concerned impacted teeth (n = 363, 48.01%). Most consultations were resolved using WhatsApp (n = 306, 64.4%), and consultants were often not in the hospital during these consultations (n = 411, 54.3%). Most messages sent by consultants were conclusive (n = 306, 74.4%).

CONCLUSION

We conclude that WhatsApp is a simple, free, and practical application, which allows efficient consultation when consultants are not in the hospital.

Efficacy of communication amongst staff members at plastic and reconstructive surgery section using smartphone and mobile WhatsApp

Objective:

The objective of this study is to assess the efficacy of smartphone and its WhatsApp application as a communication method amongst the staff of plastic and reconstructive surgery section at tertiary care health facility.

Materials and Methods:

From January 2012 onwards, the authors used smartphones and its WhatsApp application as a communication method amongst their team for various aspects of patient management and as a tool for academic endorsements.

Results:

During the period of this study, there were 116 episodes regarding patient management, which were handled, in a timely fashion by using this application. In addition opinion of rotating residents in the section was sought regarding the efficacy of this method of communication. Overall majority of residents were satisfied with this mode of communication.

Conclusions:

This new method of communication is an effective method for clinical and academic endorsements. The method is cheap and quick and easy to operate.

Teleconsultation with digital camera images is useful for fracture care

Teleconsultation using digital camera images has not yet been proven useful in orthopaedic practice. We ascertained the validity and reliability of teleconsultation using digital camera images of 100 patients with nondisplaced or minimally displaced fractures and 50 healthy age-matched subjects. We used three sets of images from each patient: a digitized radiograph, digital clinical photographs of the injured site, and conventional analog radiographs. Assessments were made independently by three groups of assessors: four orthopaedic staff members, four senior residents, and four junior residents all of whom evaluated the digitized information via E-mail. Digitized radiographs, digitized radiographs supplemented with a clinical photograph, and conventional radiographs were assessed consecutively at 1-week intervals. We used clinical and radiographic followup data as a gold standard. The overall reliability (kappa), sensitivity, and specificity of digitized radiographs were 0.57, 83.2%, and 80.7%, respectively. Reliability, sensitivity, and specificity of the digitized radiographs were not decreased after transmitting via E-mail. The level of experience in radiographic interpretation was associated independently with fracture misdiagnosis. Teleconsultation using digital camera images was valid and reliable. We recommend sending clinical photographs with the digitized radiograph.

LEVEL OF EVIDENCE

Diagnostic study, level II. See the Guidelines for Authors for a complete description of levels of evidence.

Telemedicine in Oral Surgery and Maxillofacial Trauma: A Descriptive Account

Trauma patients presenting to emergency rooms (ER) in rural or remote locations have significantly less access to oral and maxillo-facial surgery (OMFS) specialists. In this case, OMFS services at four hospitals were rearranged to concentrate expertise, inpatients, and 24/7 cover on a single site. A Federation (managed clinical network) model was used that improved the management of inpatients and made better use of a small team of junior medical staff. New government standards limiting the on-call burden for U.K. junior doctors (The New deal) were met under this service model. Despite the success of the Federation, the loss of on-site OMFS support to the three peripheral ER departments was problematic. Sites that do not have OMFS support used a simple telephone referral to transfer patients to the OMFS center. The degree to which referrals were considered inappropriate led to operational and patient satisfaction difficulties. The introduction of an OMFS telemedicine system linking the three peripheral/"spoke" ER departments to the OMFS center/"hub" succeeded in increasing the appropriateness of patient transfers, developed the skills of the ER medical staff, and was believed to have led to an overall improvement in the early-stage management of this group of patients. The telemedicine system augmented the overall success of the Federation model. New uses for telemedicine within the OMFS service soon developed.

Teaching oral surgery to undergraduate students: a pilot study using a Web-based practical course

The Internet has been used in oral surgery teaching mainly to deliver learning material across the World Wide Web and to make use of online interactivity resources in everyday surgical practice, such as by e-mails, discussion groups, and chats. The aim of this paper is to describe and evaluate a Web-based practical course on oral surgery principles, which was applied to undergraduate students. This course was investigated as a distance learning simulation in which the student would be performing surgical activities at home, and the teacher and the school environment would be absent. A Web site was created containing the course material. For this study, the students participated in the Web-based course in a multimedia lab equipped with computers and Internet, internal sound system and TV circuits. In the event of significant mistakes by students, the TV circuit could be used to show the correct procedure for all the participants at the same time. Microcameras were used to monitor the student's actions during the Internet use. Students' impressions were determined by a questionnaire. Computer manipulation with ease and antiergonomic postures were observed. We concluded that distance learning courses with practical modules must be considered as a special type of educational modality, with reference to the relationship between the student and the computer.

The digital camera in clinical practice

The benefits of digital photography are certainly numerous and include rapid image production, easy and quick deletion of poor images, no need for film or its associated expenses, decreased costs for enlargements, ease of editing and image storage, effortless placement in presentations or publications. Many physicians believe that the benefits of digital images clearly outweigh any limitations that future technologic advances will minimize. Digital imaging allows for the seamless integration of all patient images (e.g., clinical, radiographic, pathologic) into the medical record. Additionally, manipulating these images with lighting, filters, of other processing techniques may encourage diagnostic advances (e.g., distinguishing between benign and malignant surface lesions). Some drawbacks, however, continue to exist, including cost of the hardware and software, continuously evolving technology, power consumption and battery usage, lower image resolution compared with 35-mm photography, and the need to have backup image files. With decreasing costs, improving resolutions, and enhanced capabilities, digital cameras will overcome these limitations rapidly.