Surgical site infection “This is empowering the patient to keep an
eye on this but it also ensures that the nurses understand what to expect,” she commented. “In Cumbria, we also use
Healthy.io, which is a digital imaging technology. It’s a really useful piece of kit – it is an App on a smartphone which is used to take photos on discharge. “We take photos on the ward, which are uploaded to share with our community colleagues. If a nurse is concerned, I can have a look in
Health.io at a scan of the wound and we can have a discussion about whether anything needs to be done. It allows us to monitor treatment and to share information across disciplines – it facilitates expert opinion.”
Antibiotic and antimicrobial stewardship Jane Todhunter further discussed the important topic of antibiotic prescribing: “One of the things we are often asked is when to initiate antibiotic therapy – systemic signs and symptoms guide that decision. If there is erythema >5cm from the incision with induration or necrosis, we absolutely should be thinking about antibiotic therapy. There should be a discussion with local microbiology, as these patients will have had multiple doses of antibiotics because of chronic wounds, as well as implantation of devices,” Jane Todhunter continued. She went on to talk about the importance of antimicrobial stewardship, including hand hygiene for clinicians, patients, family and carers. This may also include the use of topical antimicrobial dressings. But it is also important for community nurses to monitor
the patient’s home environment. There may be a need to keep a dressing on for a little longer, depending on the home environment.
Research Jane Todhunter added that that participation in research is also very important. She highlighted some helpful research to inform practice – including a study on groin wound infection after vascular exposure (GIVE), by Gwilym et al.2
She revealed that
a randomised control trial is also currently recruiting. DRESSINg is a two-arm parallel randomised controlled trial comparing dialkylcarbamoylchloride (DACC) impregnated dressings versus standard care in the primary prevention of SSI in lower limb vascular surgery. The trial is funded by the Healthcare Infection Society Major Research Grant.3
Further details
can be found at
https://clinicaltrials.gov/study/ NCT02992951
Conclusions
In her final comments, Jane Todhunter emphasised that SSIs are costly, both for patients and the health economy, and unwarranted variation in care is contributing to their incidence. Perioperative pathways based on evidence and shared decision making should be considered, while SSI surveillance should be embedded and supported by digital imaging and clinical pathways. “One of the first things we need to do is to embed SSI surveillance – this is a problem for vascular. Highlighting the rate of infection will start to reduce SSIs,” she concluded.
About IPC 2025
The Infection Prevention and Control Conference, organised by Knowlex, took place 29-30 April 2025, at the National Conference Centre, Birmingham. The event brought together leading experts, groundbreaking research, and the latest advancements to address key challenges in infection control, sepsis management, mental health infection prevention, and decontamination and sterilisation. To view this session online and other presentations from the conference, visit:
https://www.infectionpreventioncontrol.net/
CSJ
References 1. Arundel C, Mandefield L, Fairhurst C, Baird K, Gkekas A, Saramago P, Chetter I; SWHSI-2 Trial Investigators. Negative pressure wound therapy versus usual care in patients with surgical wound healing by secondary intention in the UK (SWHSI-2): an open-label, multicentre, parallel- group, randomised controlled trial. Lancet. 2025 May 10;405(10490):1689-1699. doi: 10.1016/ S0140-6736(25)00143-6. Epub 2025 Apr 15. PMID: 40250455; PMCID: PMC12062190.
2. Gwilym BL, Saratzis A, Benson R, Forsythe R, Dovell G, Dattani N, Lane T, Preece R, Shalhoub J, Bosanquet DC. Study protocol for the groin wound infection after vascular exposure (GIVE) audit and multicentre cohort study. Int J Surg Protoc. 2019 Jul 26;16:9-13. doi: 10.1016/
j.isjp.2019.06.001. PMID: 31897443; PMCID: PMC6921153.
3.
https://clinicaltrials.gov/study/NCT02992951
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