Post-discharge surgical site infection surveillance using patient smartphones: a single-centre experience in cardiac surgery

Abstract

Background/Aims Surgical site infections following cardiac surgery pose significant risks and financial burdens to both patients and healthcare systems. This study aimed to explore the implementation and outcomes of a novel surgical wound monitoring system using patient smartphones for post-discharge surveillance. Methods The study was conducted at a London-based cardiothoracic tertiary referral centre, where 1358 patients undergoing cardiac surgery between January 2021 and March 2023 were enrolled onto the surgical wound monitoring system. Data were collected from the National Cardiac Audit Programme dataset, the monitoring system and Hospital Episode Statistics data. Comparisons between patients who did or did not respond to surveillance requests were performed. A nested confirmatory analysis assessed antibiotics reported by patients through the digital route compared with antibiotics given by GPs or in outpatients. Results The overall response rate for surgical wound monitoring using patient smartphones was 86.6%. Patients who were female, from areas of higher deprivation and lived closer to the hospital were less likely to engage with surgical wound monitoring. Although not statistically significant, the current study suggests that patients with surgical site infections who used smartphones for surgical wound monitoring were less likely to be re-admitted or have further surgery and had shorter readmission stays. The accuracy of antibiotic use for surgical site infections using the surgical wound monitoring system was 96.5%. Conclusions This study underscores the potential of digital technologies, particularly smartphones, in efficient and accurate post-surgical monitoring. The findings suggest that the use of digital monitoring systems may improve patient outcomes, with potential for wider system-level benefits.