SIPS
Surgical Interventions to treat Severe Pressure
Ulcers
Chief Investigator
|
Institution
|
Dates
|
Funding Stream
|
Grant Ref
|
Amount
|
|
Prof Barney Reeves
|
University of Bristol
|
01/11/2019 - 30/04/2022 (24 months) + 6 months
extension
|
NIHR Health Technology Assessment (HTA)
|
NIHR127850
|
£461,149
|
Summary
Being immobile for too long can lead to discomfort, for example
pins and needles or pain. These sensations prompt us to move and
this avoids poor blood flow which can lead to pressure ulcers
(sometimes called bed sores). Pressure ulcers mainly affect older
people confined to a bed or chair. However, younger or seriously
ill patients with limited movement, for example due to a spinal
injury, can be affected.
Pressure ulcers are a serious problem for patients and their
carers. They range in severity from red skin (Stage 1) to deep
wounds through muscle to bone (Stage 4). Pressure ulcers have a
major impact on quality of life; they may heal slowly and become
infected and increase the risk of dying in older people. They are
also a costly problem for the NHS. People with pressure ulcers are
usually treated in the community but may need hospital care.
Common treatments for pressure ulcers include pressure relief,
dressings and encouraging movement and change of position. Surgery
can be used to try and close deep pressure ulcers but in the UK
this treatment is not common. When we talked to people affected by
pressure ulcers, finding out whether surgery works as a treatment
was very important to them. We want to answer this question but at
the moment it is not clear which patients with pressure ulcers may
benefit from an operation and which of the different ways of doing
the surgery seems best.
We propose to find out more about how best to conduct research
in this area in three ways:
Firstly, we will ask for the opinions and experiences of
doctors, nurses and patients about the range of ways in which
people with deep pressure ulcers are treated. We will then formally
survey a larger group of health professionals who treat severe
pressure ulcers to find out whether they use surgery and, if so, on
which patients and what other treatments they use.
Secondly, we will analyse data collected routinely in the NHS
over the last 5-7 years. We will describe the care that has been
provided in England to patients with severe pressure ulcers, the
kinds of patients who have been treated in different ways and
examine how care is different in different places. To inform
whether surgical treatments should be more widely available, we
will identify patients who were similar when admitted to hospital
with a severe pressure ulcer and compare health outcomes (such as
going back to hospital and death) among those who did and did not
have surgery.
Thirdly, we will hold meetings with experienced health care
professionals and patients to review the survey findings and the
data analyses. We will use an established method to reach agreement
about which treatments are appropriate for whom. These steps are
vital to ensure relevant future research.
The opinions and experiences of people affected by pressure
ulcers are very important in ensuring the value of our results to
the NHS. As well as including people affected by ulcers in agreeing
which treatments are appropriate for whom, we will also work with
the Wounds Research PPI Forum in Manchester during this work. We
have invited a patient to be a co-applicant and will invite others
to join the independent committee overseeing the study.
We will ensure that the findings of this work reach all the
relevant people who can benefit from them in a suitable format.
This includes plain English summaries for the public and relevant
material for other people such as health professionals or NHS
Trusts.
Links to further information
https://bristoltrialscentre.blogs.bristol.ac.uk/details-of-studies/sips/
