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Professor of Orthopaedic Trauma Surgery, Matt Costa has been awarded a new trial starting this January 2016, on wound healing in trauma.

Reducing the rate of infection in trauma surgery

The £1.6m trial will address key research questions and aims to improve care and reduce the socioeconomic burden of trauma worldwide.

The Wound Healing In Surgery for Trauma (WHIST) trial will compare wound healing and costs associated with different types of wound dressing for major trauma surgery.

"Infection following surgery for traumatic injuries is a major problem for patients; it can lead to permanent disability and even amputation." says Professor Costa. "The WHIST Trial is funded by the National Institute for Health Research and will investigate new types of wound dressing which may help to reduce the risk of infection.

 

Infection following surgery for traumatic injuries is a major problem for patients; it can lead to permanent disability and even amputation. - Professor Costa

 

"This is one of the largest surgical trials ever performed in the UK. Delivering such a large trial in the context of emergency surgery is challenging but thanks to the NIHR Musculoskeletal Trauma Trials Network, and specifically the Trauma Trainees Collaborative, we are confident we can successfully deliver this important project."

Major trauma is the leading cause of death in people under 45 years and a significant cause of short and long-term disability. It occurs when a patient sustains very serious injuries to one part of the body or injuries to several parts of the body at the same time.

It is estimated major trauma costs the health service between £0.3 and £0.4 billion a year in early hospital treatment, however as it affects primarily young working people the cost to society due to lost economic output is between £3.3 billion and £3.7 billion.

These patients often require surgery, but face infection rates in surgical wounds as high as 40% because the damaged muscle and tissue from the injury are less able to resist the bacteria that cause infections.

With deep infection around the bone causing long-term problems for the patient, often requiring repeated operations and potentially leading to amputation of the lower limbs, it is crucial to improve infection rates for major trauma patients.

One of the factors that may reduce the risk of infection in the surgical wounds of major trauma patients is the type of dressing applied over the wound at the end of the operation.

Negative pressure wound therapy (NPWT) is a type of dressing that involves applying gentle suction to the surface of the wound as it heals and has provided promising early results in patients with surgical wounds associated with major trauma.

WHIST will compare NPWT with standard dressings for patients with surgical wounds associated with major trauma to the lower limb, through a large randomised clinical trial.