WHiST

Full title: Wound Healing in Surgery for Trauma

Aim: to compare Negative Pressure Wound Therapy (NPWT) with standard dressings for patients with surgical wounds associated with major trauma to the leg.

Background: ‘Major Trauma’ occurs when a patient sustains serious injuries to one part of the body or injuries to several parts of the body at the same time. It is often caused by road traffic accidents or falls from height. Most patients with major trauma have injuries to their legs, and many of these require surgery to fix broken bones.
In major trauma,the rate of infection in surgical wounds can be very high. This is because there is usually extensive damage to the muscles and other tissues in the leg due to the injuries. These damaged tissues are less able to resist the bacteria which cause infections. Deep infection around the bone can cause long-term problems for the patient. One of the factors which 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. New wound dressings are being developed which may reduce the risk of infection, but these are often introduced into the NHS without formal testing in research projects.
Negative Pressure Wound Therapy (NPWT) involves applying gentle suction through a dressing to the surface of the wound as it heals. NPWT has provided promising early results in patients with surgical wounds associated with major trauma, but there has been no formal research in the NHS to investigate whether there is a true benefit to using a NPWT dressing compared with a normal standard dressing.