Wound-edge protection devices to reduce surgical site infection

Pinkney, Thomas David (2017). Wound-edge protection devices to reduce surgical site infection. University of Birmingham. M.D.

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This thesis provides an overview of the design, conduct and analysis of a multicentre phase III trial exploring the clinical effectiveness of a novel in-theatre intervention to try to reduce rates of post-operative surgical site infection (SSI). The pitfalls inherent in the conduct of research into SSI are discussed, along with measures to try and overcome these. The wound-edge protection device (WEPD) intervention is defined and the published evidence assessing its clinical effectiveness systematically appraised. Clinical surgical research and its difficulties are described, and the paradigm-shift bought about by the new trainee-led research collaborative model introduced.
The design considerations involved creating a pragmatic and simple trial within the complex intervention that is surgery are explored in the context of the creation of the ROSSINI trial. This trial successfully recruited ahead of time and target and robustly proved that WEPDs are not clinically effective in reducing SSI. It also demonstrated the power and ability of this new collaborative model, as witnessed by both the citations of the results paper and the exponential growth in similar collaborative ventures. Finally, lessons learned about SSI research and clinical surgical research are summarised, and plans for future research presented.

Type of Work: Thesis (Higher Doctorates > M.D.)
Award Type: Higher Doctorates > M.D.
College/Faculty: Colleges (2008 onwards) > College of Medical & Dental Sciences
School or Department: Institute of Cancer and Genomic Sciences
Funders: None/not applicable
Subjects: R Medicine > RC Internal medicine
URI: http://etheses.bham.ac.uk/id/eprint/7588


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