Bluebelle pilot randomised controlled trial of three wound dressing strategies to reduce surgical site infection in primary surgical wounds

Autor: Samir Pathak, Barnaby Reeves, Jane Blazeby, Madeleine Clout, Kathryn Lee, Thomas Pinkney, Natalie Blencowe, Lazaros Andronis, James Glasbey, Laura Magill, Piriyankan Ananthavarathan, Melanie Calvert, Joanna Coast, Vijay Korwar, Benjamin R. Waterhouse
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Adult
Male
medicine.medical_specialty
Cost-Benefit Analysis
Psychological intervention
Pilot Projects
030501 epidemiology
wound dressing
law.invention
03 medical and health sciences
0302 clinical medicine
Randomized controlled trial
Quality of life
RZ
law
medicine
Humans
Surgical Wound Infection
030212 general & internal medicine
Trial registration
Aged
Wound Healing
integumentary system
business.industry
tissue adhesive as a dressing
Incidence
pilot study
Surgical wound
General Medicine
Middle Aged
surgical site infection
Bandages
United Kingdom
3. Good health
Wound dressing
Practice Guidelines as Topic
Quality of Life
Physical therapy
Feasibility Studies
Surgery
Female
0305 other medical science
business
human activities
Surgical site infection
randomised controlled trial
Abdominal surgery
Zdroj: Blazeby, J M & Blencowe, N S 2020, ' Bluebelle pilot randomised controlled trial of three wound dressing strategies to reduce surgical site infection in primary surgical wounds ', BMJ Open, vol. 10, no. 1, e030615 . https://doi.org/10.1136/bmjopen-2019-030615
BMJ Open
ISSN: 4932-8913
2044-6055
Popis: ObjectiveSurgical site infection (SSI) affects up to 25% of primary surgical wounds. Dressing strategies may influence SSI risk. The Bluebelle study assessed the feasibility of a multicentre randomised controlled trial (RCT) to evaluate the effectiveness and cost-effectiveness of different dressing strategies to reduce SSI in primary surgical wounds.DesignA pilot, factorial RCT.SettingFive UK hospitals.ParticipantsAdults undergoing abdominal surgery with a primary surgical wound.InterventionsParticipants were randomised to ‘simple dressing’, ‘glue-as-a-dressing’ or ‘no dressing’, and to the time at which the treatment allocation was disclosed to the surgeon (disclosure time, before or after wound closure).Primary and secondary outcome measuresFeasibility outcomes focused on recruitment, adherence to randomised allocations, reference assessment of SSI and response rates to participant-completed and observer-completed questionnaires to assess SSI (proposed primary outcome for main trial), wound experience and symptoms, and quality of life (EQ-5D-5L).ResultsBetween March and November 2016, 1115 patients were screened; 699 (73.4%) were eligible and approached, 415 (59.4%) consented and 394 (35.3%) were randomised (simple dressing=133, glue=129 and ‘no dressing’=132). Non-adherence to dressing allocation was 2% (3/133), 6% (8/129) and 15% (20/132), respectively. Adherence to disclosure time was 99% and 86% before and after wound closure, respectively. The overall rate of SSI (reference assessment) was 18.1% (51/281). Response rates to the Wound Healing Questionnaire and other questionnaires ranged from >90% at 4 days to 68% at 4–8 weeks.ConclusionsA definitive RCT of dressing strategies including ‘no dressing’ is feasible. Further work is needed to optimise questionnaire response rates.Trial registration number49328913; Pre-results.
Databáze: OpenAIRE