Teleconsultation with the mobile camera-phone in remote evaluation of replantation potential

The purpose of the present study was to investigate the feasibility of teleconsultation with the mobile camera-phone to transfer clinical images and communicate on line for evaluation of replantation potential in completely amputated fingers.

Teleconsultations including clinical images of the amputated portion and stump as well as patient information were transmitted between the physicians in the emergency room and the consultant phlstic surgeon through Panasonic camera-phones, which had a built-in 110,000-pixel digital camera and a 65,536 colors display. The digital images displayed on the screen were further evaluated by three remote plastic surgeons individually and the evaluations were compared with the decision made according to onsite inspection by the consultant surgeon.

The study population consisted of 35 patients with a total of 60 digital injures occurring between January to October 2003. The ability to identify the amputation location and status of amputation kwel from remote diagnosis was demonstrated by all three surgeons in 90% and 87% of these sixty amputated digits respectively. Of the 42 digits that were considered to have replantation potential during onsite evaluation, 38 (90%) digits were considered to be so by all three surgeons in group agreement during remote diagnosis. Of the 18 digits that were not considered to be replantable during onsite evaluation, 15 (83%) digits were also deemed without replantation potential, thus making the sensitivity and specificity of recognizing digital replantation potential, 90% and 83_'O re,_1pectively.

The camera-phone is a feasible tool for remote evaluation regarding the replantation potential of completely amputated fingers and it holds significant promise in avoiding unnecessary patient transfer by providing useful information.