Surgery
escalate issues to the relevant healthcare professionals, ensuring that patients receive appropriate follow-up care. Most patients receive a response within one hour and high patient engagement rates (>80%) are maintained efficiently and easily using the platform.9
Wound healing outcomes In addition to patient engagement rates, trends are also recorded for patient-reported SSI, SWD and patient-reported new antibiotics since leaving the hospital. The ultimate goal is to apply insights gained from the data to prevent and manage wound complications. As part of this, using Isla, the team are able to monitor the impact of quality improvement projects, such as the introduction of new products, processes or practices. The GSTT SSI team were delighted to receive the 2025 OneTogether Gold Award on their confirmatory analysis of patient-reported antibiotics, which found that the accuracy of antibiotic use for SSI using the surgical wound monitoring system was 96.5%.13
This data
provides actionable insights to inform care and improve performance outcomes.
Equality and diversity This remote monitoring system also helps address health inequalities by providing access to care for patients who may face barriers to traditional follow-up visits, such as those with limited access to transportation or healthcare services. One key area of focus in our ongoing research is the use of demographic data to examine health inequalities, particularly in the context of surgical care.
Our findings suggest that distinct populations
within various surgical specialisms may face unique barriers to engagement, which require further investigation. For instance, after heart surgery, we observed that women and individuals experiencing higher levels of socioeconomic deprivation may be less likely to participate in remote wound monitoring programmes.13 Interestingly, while ethnicity did not appear to significantly affect engagement rates following cardiac surgery, our analysis of demographic data following Caesarean sections revealed that women from Black or mixed ethnic backgrounds
were significantly less likely to engage with the remote monitoring schemes.14
These initial
observations highlight a potential need for targeted interventions to raise awareness about the programme prior to discharge. To address these concerns more
comprehensively, we have already completed an EDI workshop, and we plan to conduct in-depth focus group studies to explore these findings in greater detail and identify effective solutions to improve engagement and reduce digital exclusion across diverse patient populations.
Artificial Intelligence Digital programmes often introduce a new workload for busy clinicians. As part of the Wound Imaging Software and Digital platform to detect and prioritise non-healing surgical wounds (WISDOM) study, with Isla, we are developing AI to help clinicians review and prioritise image submissions.15
Images will be
tagged for priority review if there is unexpected fluid or tissue, incisional dehiscence or if there are surgical clips or non-absorbable sutures present after three weeks. The WISDOM study includes a feasibility
randomised controlled trial examining digital post-discharge surveillance with patients from some hardly reached groups, for example patients without digital skills or resources. We provide training, mobile phones and data for patients who need this, and we are including hospitals with different geographical settings, such as rural locations.16
The results of the
By enabling patients to capture and send images of their surgical sites, as well as complete questionnaires about their healing process, healthcare providers can remotely assess wound recovery.
feasibility trial are expected to be published in 2026.
Next steps A key aspect for scaling and sustaining our new digital approach is the CDWH. The CDWH is excited to be providing remote wound monitoring for the UK’s largest surgical trial, the ROSSINI-Platform, a National Institute for Care and Research (NIHR) funded study. The multi- stage, multi-arm trial will test interventions to prevent SSI in six surgical specialisms (breast, neurosurgery, cardiac, vascular, major lower limb amputation and obstetrics). The study will include approximately 26,000 participants and one hundred hospitals over the next five years. Our GSTT team are hopeful that this will provide our ‘Gold Standard Plus’ surveillance using patient smartphones with an unprecedented opportunity to scale and sustain. In addition, in collaboration with GSTT’s Centre for Innovation, Transformation and Improvement, we are now commercialising our model, so that other organisations or integrated care boards can use our central workforce solution, alongside Isla, for a cost-effective surveillance service.
Conclusion Surgical wound complications, particularly SSIs, pose significant challenges to healthcare systems, increasing morbidity, mortality, and costs. Our GSTT proactive monitoring generates data that feeds into integrated care pathways, which enable timely and equitable action through inclusive access. Clinical judgement interprets and responds to this data, while antimicrobial monitoring ensures that treatment strategies are optimised and future protocols are informed by real-world outcomes. This interconnected structure ensures that the surveillance system remains responsive, patient-centred, and evidence-driven. The inclusion of our remote wound monitoring model
May 2025 I
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