Abstract
BACKGROUND: Postoperative wound care is critical for recovery after discharge, but the COVID-19 pandemic limited access to follow-up. Mobile health applications may bridge this gap. This study evaluated the usability and acceptability of an app for postoperative wound monitoring. METHODS: Patients undergoing hernia repair or abdominal surgery between 2020 and 2022 were enrolled. Through the app, patients uploaded wound images and received professional feedback. The study period was divided into non-COVID-19 and COVID-19 phases based on local outbreak severity. Usability was assessed by the System Usability Scale (SUS; score >68 considered usable). Acceptability was evaluated using the Net Promoter Score (NPS; range -100 to +100). Multivariable linear regression identified factors associated with SUS and NPS. RESULTS: Sixty patients were included (mean age: 65.0 years; 53.3% male). Of these, 20 underwent hernia repair and 40 abdominal surgery; 31 were enrolled in the non-COVID-19 period and 29 in the COVID-19 period. Mean SUS and NPS were 79.6 ± 4.2 and 80.9 ± 3.8, respectively. Scores were higher during the COVID-19 period (SUS: 82.7 vs. 76.8; NPS: 83.4 vs. 78.5; both P < 0.001). Regression analysis showed that COVID-19-period enrollment and rural residence were independently associated with higher SUS and NPS (P < 0.001). CONCLUSIONS: The app was highly usable and acceptable for postoperative wound care. Greater reliance on remote care during the pandemic and among rural patients was linked to higher scores. These findings support integrating digital health into surgical practice to improve access.