PDF(Pubmed)
Abstract：
This paper explores the role of teledermatology (TD) in Mohs micrographic surgery (MMS) at various stages of patient care. The study aims to assess the benefits, limitations, and patient experiences surrounding TD integration into MMS practices. We conducted a PubMed search using keywords related to TD and MMS, categorizing selected articles into pre-operative, intra-operative, and post-operative stages of MMS. TD reduced waiting times (26.10 days for TD compared to 60.57 days for face-to-face [FTF]) and consultation failure rates (6% for TD vs. 17% for FTF) for MMS preoperative consultations. It also shortened time to treatment by two weeks and led to notable travel savings (162.7 min, 144.5 miles, and $60.00 per person). Telepathology facilitated communication and decision-making during MMS, improving accuracy and efficiency, especially in challenging cases requiring collaboration where physical presence of another surgeon or pathologist is not feasible. Telepathology definitively diagnosed benign lesions and malignant tumors in 81.8% of cases (18/22). Additionally, there was a 95% agreement between conventional light microscopy diagnosis and telepathology in tumors (19/20), and 100% agreement for all 20 Mohs frozen section consultations. For post-operative follow-up, telephone follow-up (TFU) and text messaging proved effective, cost-efficient alternatives with high patient satisfaction (94% in New Zealand and 96% in the U.K.) and early complication identification. This study underscores TD\'s multifaceted benefits in MMS: enhanced patient experience preoperatively, improved communication during surgery, and cost-effective postoperative follow-up. Limitations include the financial expense and technical issues that can arise with TD (connectivity problems, delays in video/audio transmission, etc.). Further studies are needed to explore emerging TD modalities in post-operative patient management. The integration of TD into MMS signifies a progressive step in dermatological care, offering convenient, cost-effective, and better solutions with the potential to enhance patient experiences and outcomes.
摘要：
本文探讨了远程皮肤病学（TD）在患者护理各个阶段在Mohs显微外科（MMS）中的作用。这项研究旨在评估收益，局限性,以及围绕TD集成到MMS实践的患者经验。我们使用与TD和MMS相关的关键字进行了PubMed搜索，将选定的文章分类为术前，术中,和MMS的术后阶段。TD减少了等待时间（TD为26.10天，面对面[FTF]为60.57天）和咨询失败率（TD为6%与17%为FTF)为MMS术前会诊。它还将治疗时间缩短了两周，并显著节省了旅行(162.7分钟，144.5英里,和每人$60.00）。心电病理学促进了彩信期间的沟通和决策，提高准确性和效率，特别是在具有挑战性的情况下，需要合作的另一个外科医生或病理学家的物理存在是不可行的。81.8%的病例(18/22)经心电病理学明确诊断为良性病变和恶性肿瘤。此外,在肿瘤的常规光学显微镜诊断和心程病理学之间有95%的一致性(19/20)，以及所有20个Mohs冻结部分咨询的100％协议。对于术后随访，电话跟进(TFU)和短信被证明是有效的，具有高患者满意度（94％在新西兰和96％在英国）和早期并发症识别成本效益的替代方案。这项研究强调了TD在MMS中的多方面益处：术前增强患者体验，改善手术期间的沟通，和具有成本效益的术后随访。限制包括TD可能出现的财务费用和技术问题(连接问题，视频/音频传输中的延迟，等。).需要进一步的研究来探索术后患者管理中新兴的TD模式。将TD整合到MMS中标志着皮肤病学护理的进步，提供方便，成本效益高,以及更好的解决方案，有可能增强患者的体验和结果。
