PE R IOPE RAT IVE PRACT ICE
big shift and represents a huge change and quality improvement in surgical patient care with a reduction in SSIs. Mark Collier, nurse consultant and associate lecturer in tissue viability, followed with a comprehensive review of the complexities of normal wound healing. As an academic and expert in his field, Mark took delegates along at a pace. It is recognised in surgery, that the moment an incision is created, the process of wound healing begins. There is also an integrated response to the wound by the patient; success is dependent on many factors including co- morbidities, medication regime and lifestyle. Pre-assessment prior to surgery should look at these aspects of post-operative care, as well as the immediate perioperative elements. It is all about returning the patient to optimal post-operative health and to ensuring they have a proper skin barrier restored.
The next session was given by Victoria
Murray, the 3M MSD regional scientific affairs manager on wound dressings for the prevention wounds of SSI and management of surgical wounds. Victoria introduced delegates to the extraordinary burden of wounds, researched and published by Julian Guest and colleagues, which is often
invisible to healthcare staff in the acute sector.
She also identified a recent Government document which outlines the National Wound Care Strategy Programme, developed to address sub-optimal wound care. One of the clinical workstreams, which will develop a national strategy for England, is focused on surgical wounds – together with
lower limb ulcers and pressure ulcers. The surgical wounds workstream is focusing on the challenge of wounds, which heal by secondary intention, and is working closely with the “Getting It Right First Time team”, who are already exploring SSI. It is expected that the workstreams will make fundamental changes to the way in which wounds are dressed and managed. Victoria Murray says
‘Surgery selfies’ could spot serious infections early
Smartphone pictures of post-surgical wounds taken by patients and then assessed by clinicians could help with the early identification of infections, a study has found. Researchers discovered these so-called ‘surgery selfies’ were linked with a reduced number of visits to GPs and improved access to advice among patients who took them. The practice could help manage surgical patients’ care while they recover and reduce pressure on the NHS, experts say.
Death within 30 days of surgery is the third largest cause of death globally. Surgical wound infections are associated with more than a third of deaths after an operation. On average, surgical wound infections cost the NHS an extra £10,000 per patient because of longer stays in hospital, readmissions after going home and the extra treatments needed. Researchers from the University of Edinburgh ran a randomised clinical trial involving 492 emergency abdominal surgery patients to see if photos from smartphones and questions on symptoms of infection could be used to diagnose wound infections early. One group of 223 patients were contacted on days three, seven and 15 after surgery and directed to an online survey.
The group were asked about their wound and any symptoms they were experiencing. They were then asked to take a picture of their wound and upload it to the secure website. A member of the surgical team assessed the photographs and patients’ responses were assessed for signs of wound infection. They followed up with patients 30 days after surgery to find out if they had been subsequently diagnosed with an infection. A second group of 269 received the routine level of care and were contacted 30 days after surgery to find out if they had been diagnosed with an infection. Researchers found no significant difference between both groups in the overall time it took to diagnose wound infections in the 30-days after surgery. However, the smartphone group were nearly four times more likely to have their wound infection diagnosed within seven days of their surgery compared to the routine care group. The smartphone group were found to have a reduced number of GP visits compared with routine care. The smartphone group also reported a better experience of trying to access post-operative care. The research team are now conducting a follow- up study to determine how this can be best put into practice for surgical patients around the country. Artificial intelligence will also be used to help the clinical team in assessing
16 l
WWW.CLINICALSERVICESJOURNAL.COM
the possibility of wound infection. Professor Ewen Harrison, Professor
of Surgery and Data Science, who led the research said: “Our study shows the benefits of using mobile technology for follow-up after surgery. Recovery can be an anxious time for everybody. These approaches provide reassurance – after all, most of us don’t know what a normally healing wound looks like a few weeks after surgery. We hope that picking up wound problems early can result in treatments that limit complications. “Using mobile phone apps around the time of surgery is becoming common – we are working to scale this within the NHS, given the benefits for patients in continuing to be directly connected with the hospital team treating them.” Dr. Kenneth McLean, who co-led the research said: “Since the COVID-19 pandemic started, there have been big changes in how care after surgery is delivered. Patients and staff have become used to having remote consultations, and we’ve shown we can effectively and safely monitor wounds after surgery while patients recover at home – this is likely to become the new normal.”
The findings have been published in NPJ Digital Medicine.
JANUARY 2022
©Tobilander -
stock.adobe.com
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84
