The Use of Smartphone Applications (Apps) for Enhancing Communication With Surgical Patients: A Systematic Review of the Literature.

BACKGROUND: The widespread use and development of smartphones and mHealth apps has the potential to overcome communication deficiencies in health care. OBJECTIVE: To carry out a literature review of studies that evaluate patients' experience on the use of perioperative mHealth apps. METHODS: An up-to-date systematic review on studies assessing patients' use of mHealth apps for communicating with the health care team in the perioperative period was performed following the PRISMA statement. RESULTS: Ten studies (in 11 articles) were identified: 8 feasibility studies and 2 randomized controlled trials. Nine studies included apps used for postoperative monitoring while 1 study also provided preoperative guidance. DISCUSSION: An analysis of barriers and motivations of patients and health care professionals to the use of perioperative mHealth apps was performed. Barriers included patients' lack of confidence when using apps and potential lack of time from health care professionals to monitor information submitted by patients. Motivations included patients' sense of being looked after and potential cost-effectiveness and increased efficiency of health care services. This analysis led to the concept of the "ideal app" that would need to be developed following adequate protocols and security standards. Features of the ideal app include preoperative advice on medications and investigations, information on surgery, and a remote follow-up tool to improve safety and to minimize unnecessary clinic appointments and associated costs. CONCLUSION: There is an overall positive impression of the use of perioperative mHealth apps. However, further studies are required to assess the impact that they have on patients' care and healthcare professional services.

Tissue expansion reconstruction of head and neck burn injuries in paediatric patients - A systematic review.

Tissue expansion reconstruction in clinical practice has existed for over half a century. The technique was initially used for breast reconstruction but later found its use in reconstruction of excisional defects resulting from a variety of causes including surgery for post-burn/post-traumatic deformities, congenital giant naevi, skin cancer, etc. It offers an improved matching of skin colour and texture, and avoids the high infrastructure requirements of microsurgery for free flap transfers. We present a systematic literature review of 35 worldwide English language articles with representative cases of paediatric tissue expansion reconstruction of burn injuries of the head and neck. The review identified 68 children of an average age of 11.3 years. The most common burn aetiology was flame burn injury. The average area to be reconstructed was of 206 cm2 and patients went through expansion processes for an average of 99.7 days. Three articles included cases in which patients had more than one expansion session. Supportive techniques provide examples of developments in the area of tissue expansion reconstruction such as self-inflating expanders and endoscopic approaches. Further studies focussing on particular indications, age groups and anatomical locations of tissues to be expanded are required in order to improve the understanding of this technique's limitations and continue its development.