Nurses' and surgeons' views and experiences of surgical wounds healing by secondary intention: a qualitative study

TY - JOUR

T1 - Nurses' and surgeons' views and experiences of surgical wounds healing by secondary intention

T2 - a qualitative study

AU - McCaughan, Dorothy

AU - Sheard, Laura

AU - Cullum, Nicky

AU - Dumville, Jo

AU - Chetter, Ian

N1 - © 2020 The Authors.

PY - 2020/4/23

Y1 - 2020/4/23

N2 - AIMS AND OBJECTIVES: To explore surgeons' and nurses' perspectives of managing surgical wounds healing by secondary intention.BACKGROUND: Every year, more than 10 million surgical operations are performed in the NHS in the UK. Most surgical wounds heal by primary intention, where the edges of the wound are brought together with staples, sutures, adhesive glue or clips. Sometimes wounds are deliberately left open to heal, from the base up, known as 'healing by secondary intention'. These wounds are often slow to heal, prone to infection, and complex to manage.DESIGN: A qualitative, descriptive approach, using semi-structured interviews.METHODS: Interviews with five (general, vascular and plastic) surgeons and 7 nurses (3 tissue viability nurses, 2 district and 1 community nurse, and 1 hospital nurse) working in hospital and community care settings in two locations in the north of England. Data analysis followed the recommended sequential steps of 'Framework' approach. Consolidated criteria for reporting qualitative research guided the study report.RESULTS: Participants reported that the main types of wounds healing by secondary intention that they manage are extensive abdominal cavity wounds; open wounds relating to treatment for pilonidal sinus; large open wounds on the feet of patients with diabetes; and axilla and groin wounds, associated with removal of lymph nodes for cancer. Infection and prolonged time to healing were the main challenges. Negative pressure wound therapy was the most favoured treatment option.CONCLUSIONS: Negative pressure wound therapy was advocated by professionals despite a lack of research evidence indicating clinical or cost-effectiveness. Our findings underscore the need for rigorous evaluation of negative pressure wound therapy, and other wound care treatments, through studies that include economic evaluation.RELEVANCE FOR CLINICAL PRACTICE: Clinical decision making in wound care could be optimised through further robust studies to inform practitioners about the cost-effectiveness of available treatments.

AB - AIMS AND OBJECTIVES: To explore surgeons' and nurses' perspectives of managing surgical wounds healing by secondary intention.BACKGROUND: Every year, more than 10 million surgical operations are performed in the NHS in the UK. Most surgical wounds heal by primary intention, where the edges of the wound are brought together with staples, sutures, adhesive glue or clips. Sometimes wounds are deliberately left open to heal, from the base up, known as 'healing by secondary intention'. These wounds are often slow to heal, prone to infection, and complex to manage.DESIGN: A qualitative, descriptive approach, using semi-structured interviews.METHODS: Interviews with five (general, vascular and plastic) surgeons and 7 nurses (3 tissue viability nurses, 2 district and 1 community nurse, and 1 hospital nurse) working in hospital and community care settings in two locations in the north of England. Data analysis followed the recommended sequential steps of 'Framework' approach. Consolidated criteria for reporting qualitative research guided the study report.RESULTS: Participants reported that the main types of wounds healing by secondary intention that they manage are extensive abdominal cavity wounds; open wounds relating to treatment for pilonidal sinus; large open wounds on the feet of patients with diabetes; and axilla and groin wounds, associated with removal of lymph nodes for cancer. Infection and prolonged time to healing were the main challenges. Negative pressure wound therapy was the most favoured treatment option.CONCLUSIONS: Negative pressure wound therapy was advocated by professionals despite a lack of research evidence indicating clinical or cost-effectiveness. Our findings underscore the need for rigorous evaluation of negative pressure wound therapy, and other wound care treatments, through studies that include economic evaluation.RELEVANCE FOR CLINICAL PRACTICE: Clinical decision making in wound care could be optimised through further robust studies to inform practitioners about the cost-effectiveness of available treatments.

U2 - 10.1111/jocn.15279

DO - 10.1111/jocn.15279

M3 - Article

C2 - 32279371

SN - 0962-1067

JO - Journal of clinical nursing

JF - Journal of clinical nursing

ER -