• Ishan Radotra, David Yousefi Azimi, and Wareth Maamoun.
• Department of Plastic Surgery, University Hospital North Midlands (UHNM), Newcastle Road, Stoke on Trent, ST4 6QG, United Kingdom. Electronic address: ishan.radotra1@nhs.net.
• Injury. 2022 Jun 1; 53 (6): 2028-2034.

IntroductionBAPRAS/BOAST 4 guidelines recommend the use of medical photography for peri-operative management of open fractures. Smartphones are a common commodity for the modern day plastic surgeon and there is evidence their utilization improves guideline compliance at Major Trauma Centres (MTCs).AimTo capture national data assessing the prevalence and intricacies of smartphone app-based photography systems used for open fractures in plastic surgery units at MTCs in England.MethodA structured questionnaire survey was used to collate and analyze the responses of plastic surgeons and trainees at all MTCs in England. The survey included participant demographics, type and use of medical photography systems, and opinions on the usefulness of integrating a dedicated app in practice. We later explore the background, costs, download process, functionality and NHS governance applicability of each application.ResultsThe most popular clinical imaging modalities included professional photographers (65%) and departmental cameras (60%). Only 6 (26%) of MTCs use the following four smartphone app-based photography systems: Oxford University Hospital FotoApp, Medical Data Solutions and Services, Haiku and Secure Clinical Image Transfer. All systems are GDPR compliant and three systems auto upload images onto hospital databases. Five units report using messaging apps (Forward, Siilo, Whatsapp) with photography functionality. All participants agreed that a dedicated imaging smartphone app would be useful in open fracture management.ConclusionPlastic surgery is a highly visual specialty and clinical photography complements patient care. In the era of COVID-19 where resources are finite and professional photography not always available, this national survey highlights a demand for integrating smartphone app-based photography to improve guideline compliance, inter- and intra-disciplinary team communication and patient care.Copyright © 2022. Published by Elsevier Ltd.

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