THE MEANING OF LIVING WITH AN OPEN SURGICAL WOUND

Abstract

Background: Complex wounds are a common, long-term and serious global health issue. Existing research shows that a considerable number of people live with complex wounds. Furthermore, it has shown that complex wounds have a negative impact on peoples physical, psychological, social and financial well-being. Reviews of research show that there is a global lack of evidence on the epidemiology, nature and treatments of open surgical wounds. Furthermore there is a global lack of research about peoples perspective of having open surgical wounds. Aim: This research had three main aims. Firstly, to explore and scope the existing qualitative research on peoples experiences of living with complex wounds. Secondly, to investigate the number, characteristics, management and unpleasant symptoms of open surgical wounds in Slovenia. Thirdly, to explore the meaning of living with open surgical wounds over time. Methods: A three-stage project was designed. Study 1 was a scoping review of existing qualitative studies exploring peoples perspectives of living with all types of complex wound. Study 2 was a multi-service, cross-sectional survey of open surgical wounds affecting people living in Ljubljana, Slovenia. Study 3 was a longitudinal qualitative study exploring the meaning of living with open surgical wounds. Results: The findings of Study 1 highlighted the nature and extent of the current evidence base related to peoples perspectives of living with complex wounds. A large proportion (35.6%) of the studies focus on people with venous leg ulcers. Findings from the scoping review also demonstrated that there is a lack of research about living with arterial leg ulcers, malignant fungating wounds and open surgical wounds; the latter in particular are under-researched. Study 2 identified a point prevalence of open surgical wounds in Slovenia of 0.38 per 1,000 of the population (95% CI: 0.33 to 0.44; most of these wounds were planned to heal by secondary intention, pre-operatively (76/110, 69%). 83% (92/110) of open surgical wounds were treated with wound dressings, and 6% were treated with negative pressure wound therapy. Study 3 found that the meaning of living with open surgical wounds is shaped by five subthemes: enduring healing, life disruption, adapting to a new reality, striving for healing and returning to normal life, all under an overarching theme of negotiating a new normality. Findings from this study emphasise that open surgical wounds are a chronic condition with a typical chronicity trajectory. Conclusion: This study has addressed the deficit in knowledge by undertaking in-depth research on open surgical wounds. The complementary approach of undertaking three studies has provided essential information about the nature and extent of qualitative research related to perspectives of living with wounds, essential information about the extent, nature, treatment and unpleasant symptoms of open surgical wounds in Slovenia, and in-depth description and interpretation of meaning of living with an open surgical wound. All three studies have contributed to knowledge about open surgical wounds both locally and globally. The results from these studies could be used for planning future research, health resources management, improving clinical practice and policy development.

Date of Award	1 Aug 2021
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Jane Griffiths (Supervisor) & Nicola Cullum (Supervisor)