Structured Wound Assessment during Home Visits as a Component of Postoperative Follow-Up
Hlynka Liubomyr
Citation: Hlynka Liubomyr, "Structured Wound Assessment during Home Visits as a Component of Postoperative Follow-Up", OAS Journal of Surgery, Volume 01, Issue 01.
Copyright: This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Postoperative follow-up has shifted toward the home, where the surgical wound becomes the central focus of a visit conducted without a surgeon present. This practice-informed narrative review examines how structured wound assessment during home visits functions when the visiting specialist has authority to observe and document but not to intervene. Published work on wound assessment instruments, remote surgical wound monitoring, structured clinical handover, and scope of practice in home health was synthesized with first-hand observations from home visits in New York State and from earlier direct surgical ward work in the Czech Republic. The assessment–intervention gap is introduced as the distance between what a visiting specialist can establish at the bedside and what that specialist may do about it. Where the gap is wide, the clinical product of the visit consists of the transmitted assessment and the timeliness of the escalation decision. Most visual and measurable elements of standard wound instruments remain feasible at home, whereas probing, revision, and prescribing require personnel with intervention authority. A structured wound report, built on the Situation, Background, Assessment, Recommendation framework, is proposed for handover, and illustrative triggers for the three possible visit outcomes are aligned with published surveillance criteria. Comparison of two professional roles in two jurisdictions shows how the same assessment sequence changes its clinical meaning once the intervention authority is removed. Caregiver gatekeeping and unstable connectivity emerge as non-clinical determinants of the timeliness of escalation, and both are among the conditions for safe postoperative follow-up at home.
Keywords: Clinical Handover, Escalation of Care, Home Health Care, Home Visits, Postoperative Care, Scope of Practice, Surgical Wound, Telemedicine, Wound Assessment, Wound Documentation.
References:
1. Candon, M., Bergman, A., Rose, A., Song, H., David, G., & Spetz, J. (2023). The relationship between scope of practice laws for task delegation and nurse turnover in home health. Journal of the American Medical Directors Association, 24(11), 1773–1778.e2. https://doi.org/10.1016/j.jamda.2023.07.023
2. Dalcól, C., Tanner, J., & de Brito Poveda, V. (2024). Digital tools for post-discharge surveillance of surgical site infection. Journal of Advanced Nursing, 80(1), 96–109. https://doi.org/10.1111/jan.15830
3. Dudley, N., Miller, J., Breslin, M. L., Chapman, S. A., & Spetz, J. (2021). The impact of nurse delegation regulations on the provision of home care services: A four-state case study. Medical Care Research and Review, 78(1_suppl), 47S–56S. https://doi.org/10.1177/1077558720960902
4. Ko, J. S., El-Toukhy, S., Quintero, S. M., Wilkerson, M. J., Nápoles, A. M., Stewart, A. L., & Strassle, P. D. (2023). Disparities in telehealth access, not willingness to use services, likely explain rural telehealth disparities. The Journal of Rural Health, 39(3), 617–624. https://doi.org/10.1111/jrh.12759
5. Kohli, K., Wang, S., Chou, C., Jain, B., Shah, K. M., Kohli, M., Dee, E. C., & Palakodeti, S. (2026). Healthcare unplugged: Disparities in broadband internet and health facility access among US counties. PLOS Digital Health, 5(7), e0000732. https://doi.org/10.1371/journal.pdig.0000732
6. Macefield, R. C., Blazeby, J. M., Reeves, B. C., King, A., Rees, J., Pullyblank, A., & Avery, K. (2023). Remote assessment of surgical site infection (SSI) using patient-taken wound images: Development and evaluation of a method for research and routine practice. Journal of Tissue Viability, 32(1), 94–101. https://doi.org/10.1016/j.jtv.2023.01.001
7. McLean, K. A., Sgrò, A., Brown, L. R., Buijs, L. F., Daines, L., Potter, M. A., Bouamrane, M.-M., & Harrison, E. M. (2023). Evaluation of remote digital postoperative wound monitoring in routine surgical practice. npj Digital Medicine, 6, 85. https://doi.org/10.1038/s41746-023-00824-9
8. Mohammed, H. T., Fraser, R. D. J., McCabe, T., & Cassata, A. (2026). Clinical and operational outcomes associated with the adoption of a digital wound care solution in home health settings. Healthcare, 14(10), 1387. https://doi.org/10.3390/healthcare14101387
9. NIHR Global Health Research Unit on Global Surgery, & GlobalSurg Collaborative. (2023). Use of telemedicine for postdischarge assessment of the surgical wound: International cohort study, and systematic review with meta-analysis. Annals of Surgery, 277(6), e1331–e1347. https://doi.org/10.1097/SLA.0000000000005506
10. Rasiya, A., & Raheem, U. A. (2026). Shift transition communication among nurses: A systematic review of ISBAR and SBAR-based structured handover tools. Nursing Open, 13(7), e70655. https://doi.org/10.1002/nop2.70655
11. Smet, S., Probst, S., Holloway, S., Fourie, A., Beele, H., & Beeckman, D. (2021). The measurement properties of assessment tools for chronic wounds: A systematic review. International Journal of Nursing Studies, 121, 103998. https://doi.org/10.1016/j.ijnurstu.2021.103998
