gms | German Medical Science

Background: Postoperative wound infections are among the most common postoperative complications in general surgery. With the increase of diabetes mellitus, vascular and cancer diseases in the elderly people, incidence of wound complications and the demand for documentation and visitation might increase. We supposed a reduction of the length of visitation and documentation by developing a standardized report, which gives a short and structured summary of the patient history, last visitation and current therapy. Since wound procedures are mostly septic, we used a wearable and voice-commandable data goggle for visualization and documentation.

Materials and methods: The software “WoundTrack” was developed for integrating and visualizing patient data on the Google Glass™ (Google Inc., USA). The software provided a structured report, which reduced the patient history to relevant information. To evaluate the system, surgical residents were enrolled in a study, had to perform specific tasks and were presented with a standard questionnaire. Residents had to assess silicone wound phantoms developed from 3D scans, decide for a therapy and document them with a photograph. Patient history was developed from anonymized patient data. The WoundTrack software was compared to the documentation process on a desktop PC, as it is the status quo of most surgical clinics. Time to perform the tasks were measured. Participants were asked to grade work contentment on a scale from 1 (best) to 6 (worst). Provision of information, hardware and software features were evaluated through a Likert scale (1 “strongly agree” to 4 “strongly disagree”).

Results: 14 surgical residents and surgeons were included. 79% (11/14) of participants had diagnostic and therapeutic experience with >50 wounds. 71 % (5/7) had no experience with the Google Glass™. All participants (14/14) certified subjective realism of the test environment.

With the WoundTrack software, time to complete the requested task was significantly reduced (median 21 min vs. median 18 min) and all participants (7/7) saw their work faster. The software led the user through the visitation according to their workflow (83%, 5/6). Grading of work contentment did not differ greatly (2.67±0.8 for the desktop documentation, 2.5±0.8 for the WoundTrack software). 71% (5/7) of Google Glass™ user had enough information for a therapy decision, in comparison with 86% (6/7) of desktop users. The voice control was fluent, but the frame of the goggle was problematic among those wearing spectacles.

Conclusion: Structured reporting reduced time to assess and document three postoperative wounds by reducing information load to relevant patient data. However, subjective knowledge of patient history and current therapy decreased. The WoundTrack software did not increase work contentment, but succeeded to resemble the surgical workflow. Controlling the software by speech commands was successful and might accelerate documentation while performing septic procedures. The software will, now, be improved and evaluated in a clinical trial.