Digital health interventions (DHIs) are an important consideration for the future of wound care, especially when considering evolving models such as mobile wound management. One research review helped to contribute to the body of current knowledge about these types of interventions and what role they may play in the world of wound healing. 

Design & Population 
The systematic review included a meta-analysis of 25 studies (2004–2023; n=8,125 adults): 14 RCTs, 6 cohort, 5 quasi-experimental. Settings spanned China, Europe (Denmark, Norway, France, UK, Sweden), North America (US, Canada), Australia, and Israel. Chronic wound etiologies included pressure injuries, diabetic foot ulcers, venous ulcers, arterial ulcers, and mixed types. Digital health interventions comprised telemedicine (video/web; 60%), digital platforms (28%), and telephone/email follow-up (12%); comparators were usual care across outpatient, primary care, home, community, and inpatient contexts. Follow-up ranged 3–35 months. 

Primary Outcomes 

• Wound healing (~1 year): Pooled 9 studies showed no significant difference between DHIs and usual care (RR 1.15, 95% CI 0.94–1.40; p=0.17; I²=85%). By design: RCTs (RR 1.02, 0.93–1.12; p=0.67; I²=12%); cohorts (RR 1.32, 0.90–1.95; p=0.15; I²=81%). 
• Wound healing (3 months): 3 studies favored DHIs numerically but not significant (RR 1.44, 0.51–4.05; p=0.49; I²=75%). 
• Modality subgroup (≈1 year): Digital platforms were superior to usual care (RR 2.19, 1.35–3.56; p=0.002; I²=82%), whereas telemedicine showed no significant effect (RR 1.15, 0.91–1.45; p=0.24; I²=86%). 

Secondary Outcomes 

• Healing time: Mixed; some studies showed earlier improvement with DHIs (eg, day 21 vs day 77 in controls), and shorter times across wound sizes in one trial (p<0.05), but others were neutral. 
• Wound size/volume: Limited data (2–3 studies); one reported greater depth reduction with DHIs; another found similar ulcer volume reductions (79% vs 85%; p=0.32). 
• All-cause mortality (~1 year): No difference (RR 1.17, 0.70–1.96; p=0.54; I²=40%); consistent in RCTs and cohorts, and by DHI subtype (telemedicine and telephone/email both non-significant). 
• Adverse events (infection, amputation): All RCTs combined: NS (RR 0.56, 0.29–1.11; p=0.10; I²=77%). Excluding one RCT that attributed no AEs to the intervention: fewer AEs with DHIs (RR 0.44, 0.22–0.89; p=0.02; I²=41%). 
• Reporting/quality metrics: Digital platforms increased pressure injury reporting accuracy and improved PUSH scores in several studies. 
• Costs: 8 studies reported costs; 5 showed lower total costs (eg, shorter length of stay; reduced transport by ≈US$650/person), while 2 reported higher costs (greater baseline severity; technology/assistive device expenses). 
• Patient satisfaction: Improved in 2 studies; no difference in 1. 

Clinical Relevance 
For chronic wound management, DHIs overall appear non-inferior to usual care on healing and mortality at ~1 year, with signals for fewer adverse events in sensitivity analyses and benefit of digital platforms (particularly for inpatients and pressure injury monitoring). Practical gains include access, tracking, decision support, and potential cost reductions. 

Limitations 
High clinical heterogeneity (intervention content, frequency, comparators, follow-up), variable bias risk (notably limited blinding), inconsistent wound staging reporting, mixed technology quality, and inclusion of non-RCTs alongside RCTs. Publication bias appeared low for mortality (Egger p=0.37), but power was limited for several outcomes. 

Next Steps 
Per this review, future actions include a need to prioritize well-designed RCTs stratified by wound etiology and care setting, with standardized DHI taxonomies, blinded outcome assessment (software-based when feasible), and explicit reporting of staging, healing time, AEs, patient-centered outcomes, and costs. It is also important to evaluate age, digital literacy, and equity factors, and further test scalable digital platforms integrating real-time tracking and automated analytics for pressure injuries. 

Reference 

1. Bai X, Zhang H, Jiao Y, Yuan C, Ma Y, Han L. Digital Health Interventions for Chronic Wound Management: A Systematic Review and Meta-Analysis. J Med Internet Res. 2024;26:e47904 
doi: 10.2196/47904PMID: 39012684PMCID: 11289581