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The care and management of surgical incisional wounds continues to attract both interest and concern, due to continued high rates of surgical site infection (SSI) and morbidity. Novel approaches to objective wound assessment using noninvasive imaging modalities show promise in providing independent, objective wound assessment but only with the proviso that the wound is visible and can be 'seen' by the imaging detector. Methods: An online semi-structured questionnaire was distributed via Survey Monkey to tissue viability nurses. Data was summarised descriptively, with responses relating to participant demographics and use of wound dressings tabulated. Key variables were also cross tabulated to investigate possible associations between variables. An economic analysis was conducted to estimate average weekly costs associated with changing and applying dressings, including both staff and equipment costs. Conclusion: The largest type of dressing products currently in use were nonadherent. Dressing changes took place approximately twice per week: more frequently if wounds were assessed/diagnosed as infected. The majority of wound assessment and dressing changes were undertaken by band 5, 6 or 7 nurses. There is a potential role for non-invasive infrared thermography to stratify risk of later SSI based upon the temperature distribution across wound site and adjacent skin territories. Early and objective interventions for early wound infection can reduce hospital inpatient stay, community visits, antimicrobial usage, patient morbidity and healthcare costs related to wound infection. [ABSTRACT FROM AUTHOR]

Objectives: Photo at Discharge (PaD) is a nurse-led discharge strategy for enhanced wound care information for patients and healthcare providers. The purpose of this study is to describe implementation of PaD in three English cardiac centres. Methods: A prospective, cross-sectional design was used to evaluate implementation fidelity and sustainability of PaD on various geographical settings. Results: Three out of four hospitals (75%) approached agreed to complete surveys on implementation fidelity. Implementing the IT component took an average of 16 months (range 11–21 months). Across the three sites, 474 nursing staff have received training on PaD. Since implementing, a combined total of 9007 patients have received PaD. A 1-month compliance snapshot indicated mean of 96% (range 92–100%). Conclusions: PaD requires collaborative working, a change in behaviour and a change to the service. Despite these challenges, fidelity and sustainability scores across the sites were high. The findings from this study may help to increase implementation quality and dissemination of PaD. [ABSTRACT FROM AUTHOR]

Aim: Restoration of bowel continuity after Hartmann's procedure (RoH) can be challenging and associated with considerable morbidity. A technique using single-incision laparoscopic surgery through the stoma site (SIL RoH) has been shown to be feasible and safe. In this study, we compared clinical outcomes of SIL RoH with conventional laparoscopic surgery (CL) and open surgery (OS)., Methods: This was a retrospective analysis of a prospectively maintained database between 2007 and 2017 in a UK colorectal unit. The access technique was decided by the surgeon on a case by case basis., Results: A total of 106 patients underwent RoH. It was carried out for diverticular disease (n = 71, 67.6%), cancer (n = 19, 17.9%) and anastomotic leak (n = 4, 3.8%). The remainder (n = 12, 11.3%) were for miscellaneous reasons including trauma. Most RoHs were performed via OS (n = 87, 81.1%). The most common intended approaches for RoH were SIL (n = 56, 52.8%) and OS (n = 34, 32.1%) with fewer starting with CL (n = 16, 15.1%). Conversion to OS took place in five (8.9%) patients with SIL and six (37.5%) with CL (P = 0.005). Postoperative complications occurred in 17 (30.4%) for SIL, seven (43.8%) for CL and 17 (50.0%) for OS (P = 0.162). Median operating time for SIL was 146 min (range 44-389), 211 min (109-320) for CL and 211 min (85-420) for OS (P < 0.001). Median length of stay was 4 days (2-44) for SIL compared to 6 (3-34) for CL and 7 (4-34) for OS (P < 0.001). Discharge on or before day 5 was achieved in 41 (74.5%) patients for SIL compared to six (37.5%) for CL and seven (20.6%) for OS (P < 0.001)., Conclusion: Compared to OS and CL, SIL RoH appears to have shorter operating times and hospitalization, with no discernible difference in morbidity; this finding requires further evaluation in a randomized setting., (Colorectal Disease © 2019 The Association of Coloproctology of Great Britain and Ireland.)