Effects of a telehealth program for wound healing promotion on the wound healing level in patients with diabetes undergoing coronary artery bypass graft surgery: A randomized controlled trial
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Keywords

wound healing
telemedicine
coronary artery bypass
CABG
patient discharge
diabetes mellitus
smartphone
saphenous vein
multimedia
Thailand

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Sumrattana, S., Asdornwised, U., Wongkongkam, K., & Tantiwongkosri, K. (2023). Effects of a telehealth program for wound healing promotion on the wound healing level in patients with diabetes undergoing coronary artery bypass graft surgery: A randomized controlled trial. Belitung Nursing Journal, 9(5), 428–436. https://doi.org/10.33546/bnj.2775
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Accepted for publication: 2023-08-15
Peer reviewed: Yes

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Abstract

Background: Patients with diabetes undergoing coronary artery bypass graft (CABG) are at risk of delayed wound healing. The telehealth program for wound healing promotion (TPWHP) was developed to improve wound healing in patients with diabetes undergoing CABG in a university hospital.

Objective: This study aimed to examine the effects of the TPWHP on the healing of the sternal wound and saphenous vein graft (SVG) donor site in patients with diabetes undergoing CABG.

Methods: In this randomized controlled trial, the participants were randomly assigned to the intervention (n = 30) and control (n = 30) groups. The control group received routine nursing care, whereas the intervention group received routine nursing care along with the TPWHP, which provides education and wound monitoring using multimedia and a surgical wound care booklet and monitors the wound through the LINE application on a smartphone after hospital discharge. Data were collected from June to November 2020 at two university hospitals in Bangkok, Thailand, using the demographic and health-related data form and the Thai wound assessment inventory (WAI). Data were analyzed using the Chi-squared, Fisher’s exact, and Mann–Whitney U tests.

Results: The intervention group had significantly lower mean scores—indicating favorable wound healing—for SVG donor site wound healing level than the control group on days 14–21 after surgery (p = 0.012, mean = 0.58 ± 0.54 and 1.08 ± 0.82, respectively). No significant intergroup difference was observed in terms of the sternal wound healing level (p = 0.126); however, the intervention group showed lower mean scores—indicating good wound healing—than the control group.

Conclusion: The TPWHP promotes effective wound healing of the SVG donor site; however, its efficacy on sternal wound healing was uncertain. Therefore, nurses should implement the TPWHP in collaboration with a multidisciplinary team to improve wound healing after hospital discharge.

Trial registration: Thai Clinical Trials Registry (TCTR20211112002)

https://doi.org/10.33546/bnj.2775
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Supporting Agencies

This study is part of the Master of Nursing Science Program in Adult and Gerontological Nursing, Faculty of Nursing, Mahidol University. The researcher (SS) received a scholarship from the Thai Red Cross Society.

Copyright

Copyright (c) 2023 Siriporn Sumrattana, Usavadee Asdornwised, Kessiri Wongkongkam, Kriangkrai Tantiwongkosri

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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

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Declaration of Conflicting Interest

The authors declared no potential conflicts of interest with respect to the research, authorship, or publication of this article.

Acknowledgment

Thanks to the Thai Red Cross Society, Faculty of Nursing & Graduate Studies of Mahidol University, King Chulalongkorn Memorial Hospital, Siriraj Hospital, all advisers, participants, family, and colleagues, for supporting this research.

Authors’ Contributions

SS contributed to the study’s conceptualization, literature review, research design, data collection, data analysis, and conclusions, including manuscript writing. UA contributed to providing key concepts of the study, research methodology, sample selection, data analysis, and manuscript writing. KW and KT contributed to the sample selection and critical analysis of the study. All authors approved the final version to be published.

Data Availability

The datasets generated during and analyzed during the current study are not publicly available due to privacy and confidentiality concerns but are available from the corresponding author upon reasonable request.

Declaration of Use of AI in Scientific Writing

Nothing to declare.


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