Open surgical wounds: characterising the problem and identifying effective treatments

This National Institute of Health Research (NIHR) Programme Grant for Applied Research is being conducted by Hull University Teaching Hospitals NHS Trust in collaboration with researchers from the Universities of York, Manchester and Bristol and clinicians from Hull and Leeds (Hull University Teaching Hospitals NHS Trust, City Health Care Partnership CIC; Humber NHS Foundation Trust; Leeds Teaching Hospitals NHS Trust and Leeds Community Healthcare NHS Trust).

What are open surgical wounds?

Most surgical wounds heal in a straightforward way. After an operation the edges of the surgical incision are brought together and closed by staples or stitches and the closed wound is left to heal: this is sometimes called healing by primary intention. However, some surgical wounds are left open to heal ‘from the bottom upwards’ (sometimes called healing by secondary intention). These open surgical wounds might deliberately be left open following surgery or result from closed wounds that split open due to infection, tissue loss or other factors that mean they cannot be stitched or stapled closed again.  There is very little information about open surgical wounds — for example we do not know how many people have these wounds, how they impact on patients and the NHS, how best to treat these wounds and how long they take to heal.

The aim of this research programme is to develop a better understanding of open surgical wounds: in particular, we want to find out the number, extent, costs and outcomes of open surgical wounds and to better understand the impact of these wounds upon patients’ lives. We will do this by:

  • Learning more about how many people have open surgical wounds,
  • Understanding what type of treatments people with open surgical wounds receive and which treatments might be effective,
  • Finding out how open surgical wounds impact upon patients’ lives and
  • Listening and capturing patients’, carers’ and health professionals’ views on having and treating open surgical wounds.

This research is organised into four overlapping workstreams:

Workstream 1: will investigate how many people have open surgical wounds, what type of surgeries they have had, what treatments people receive and how long it takes for these wounds to heal.

Workstream 2: will investigate the clinical and cost effectiveness of treatments used for open surgical wounds

Workstream 3: will explore with people with open surgical wounds how these impact on their lives and determine the most relevant patient- and NHS-level outcomes for measuring the effects of treatments on open surgical wounds.

Workstream 4: is closely linked to Workstream 2 and aims to assess what future research on open surgical wounds is likely to be the most worthwhile. 

Workstream 5: is closely linked to Workstream 4 and aims to assess whether a larger study, to compare negative pressure wound therapy with dressings to treat open surgical wounds, could be conducted. 

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