TELEMONITORING AS A STRATEGY FOR THE MANAGEMENT OF COMPLEX WOUNDS: SCOPING REVIEW PROTOCOL

Complex wounds are a public health problem, with impact on morbidity and quality of life, as well as on health systems sustainability. According to Menoita (2015) and Parreira and Marques (2017), complex wounds include pressure ulcers, leg ulcers, and diabetic foot ulcers, characterized by prolonged healing and a high risk of complications, requiring continuous monitoring and individualized interventions. Parreira and Marques (2017) emphasize that regular wound monitoring and decision-making based on objective criteria are essential to optimize healing and quality of care. The National Strategic Plan for Telehealth 2019–2022 establishes telemonitoring as a strategic priority to improve access, continuity, and efficiency of care for people with chronic diseases (Martins et al., 2019). When applied to complex wounds, telemonitoring enables remote follow-up, facilitates the sharing of clinical data, and allows the early detection of signs of deterioration, supporting more timely therapeutic decision-making. In this context, Pereira, Jarnalo, and Rocha (2013) suggest that systematic monitoring strategies combined with decision-support technologies may contribute to improved management of complex wounds. However, the available evidence remains fragmented and unsystematic, justifying the need for a scoping review to map the existing knowledge on this topic. The objective is to map the existing scientific evidence regarding the use of telemonitoring in the management of complex wounds. A scoping review will be conducted in accordance with the methodology proposed by the Joanna Briggs Institute (JBI) and will be reported following the PRISMA-ScR guidelines, in order to ensure transparency, methodological rigor, and reproducibility of the process. The review protocol has been registered on the Open Science Framework (OSF) platform. Preliminary research of scoping reviews published in the last three years did not identify any studies that comprehensively mapped this topic, supporting the relevance of this review. The guiding question will be: “What evidence is available on the use of telemonitoring in the management of complex wounds?” The search strategy will combine controlled descriptors (MeSH) and free free-text keywords related to telemonitoring and complex wounds. The search equations will be adapted to the specificities of each database — PubMed, EBSCO (CINAHL/MEDLINE), and JBI Database of Systematic Reviews — incorporating terms such as “Remote Patient Monitoring,” “Telemedicine,” “Pressure Ulcer,” “Leg Ulcer,” “Diabetic Foot,” and “Foot Ulcer,” as well as free keywords such as “Wound Care” and “Wound Management.” The search equation will be structured as follows: (“Remote Patient Monitoring” OR ‘Telemedicine’) AND (“Pressure Ulcer” OR “Leg Ulcer” OR “Diabetic Foot” OR “Foot Ulcer” OR “Wound Care” OR “Wound Management”). Studies published between January 1, 2021, and December 31, 2025, in Portuguese, English, or French, with free full-text access, will be considered. Primary studies (quantitative, qualitative, and mixed), reviews, and relevant gray literature will be included. Eligibility criteria will be defined based on the PCC model: •Population: people with complex wounds (pressure ulcers, leg ulcers, diabetic foot, and other hard-to-heal wounds); •Concept: telemonitoring as a strategy for clinical surveillance, monitoring wound progression, and supporting therapeutic decision-making; •Context: any healthcare setting (hospitals, primary care, home care, and long-term care facilities). Study selection will be conducted by two independent reviewers using Rayyan® software in two stages: (1) screening of titles and abstracts and (2) full-text review. In case of disagreement, a third reviewer will be consulted to reach a final decision. Data extraction will be performed using a structured grid in Microsoft Excel®, including study characteristics, type of telemonitoring intervention, technology used, clinical context, role of healthcare professionals, reported outcomes, benefits, limitations, and implementation challenges. Data synthesis will be conducted through descriptive analysis and thematic mapping, enabling the identification of patterns, trends, and gaps in the existing literature. This review is expected to map telemonitoring models used in the management of complex wounds, identifying the technologies employed, application contexts, and existing knowledge gaps, thereby supporting future research and evidence-based practice. This scoping review may support the development of evidence-based clinical protocols and help guide telehealth programs and policies focused on people with complex wounds.