INCORPORATING TELEMEDICINE INTO A SURGICAL PRACTICE

Imagine presenting to the hospital for your planned cesarean section, a time of great anxiety and joy. During the procedure you unfortunately have a complication and an enterotomy (cut into the intestines) is made but missed at the time. Hours later you develop increasing abdominal pain and a rash spread quickly across your abdomen. Your healthcare providers explain you have an infection called necrotizing fasciitis and this requires further surgery to treat the condition. The individual then wakes up possibly weeks later with most of their abdominal wall, upper thigh skin, some muscle layers missing of both the abdomen and thigh, as well as stool draining from the middle of the wound.

The individual is informed they have an enterocutaneous fistula that will likely not be able to be repaired for several months to a year. This person is finally able to transition home with their newborn, a gaping abdominal wound, stool draining from the wound, not allowed to have anything to eat or drink, and are attached to intravenous nutrition twenty-four hours a day. This would be overwhelming for the most health literate patient, much less an individual with limited resources and low health literacy.