Mexico Hub Community Event Educates on Wound Care

In a bid to empower patients, the GSU Mexico Hub held a community engagement event at the DIF Ruiz Cortines Community Centre, Veracruz on wound care and infection prevention on 22nd February. Dr. Carolina, a dedicated research physician, spearheaded the informative session aimed primarily at the elderly demographic within the community.

The event, attended by 70 people, commenced with an insightful inquiry into the common remedies employed by attendees for wound healing at home. Many disclosed the use of potentially harmful substances like laundry detergent, eggs, and even urine. Such practices, though prevalent, were underscored as detrimental to skin health.

Dr Carolina delved into essential aspects of wound management, highlighting crucial warning signs indicative of infection. Through a meticulous step-by-step demonstration, attendees were equipped with practical skills for effective wound care.

As part of the interactive segment, eight wound care kits were raffled off to attendees. The session culminated in a vibrant Q&A segment, fostering an open dialogue on wound management strategies. Participants also expressed a desire for future sessions covering topics such as diabetes management and pressure ulcer care. Such feedback underscores the pressing need to further educate this demographic on preventive healthcare measures.


EAGLE 2 has launched!

Following on from publication of the EAGLE study last year, we are pleased to announce the launch of EAGLE 2.

Register your hospital

EAGLE 2 will be a snapshot audit of patients undergoing right sided bowel anastomosis, but restricted to units who undertake the EAGLE online training. This training may have already been done (as part of the first EAGLE study), or surgeons in your team may complete it between now and May 2024. A key finding from the EAGLE study was that in centres where most surgeons undertook the training, the anastomotic leak rate fell by almost 50%. We need your help to grow engagement across as many hospitals as possible, so we can validate this finding. EAGLE 2 will be open to hospitals who participated in the original EAGLE study as well as new hospitals.

Units who undertake the EAGLE online training (either as part of ’EAGLE’ or between now and May 2024) prior to data collection can take part. The anticipated audit period will be May/June 2024. Results will be presented at ESCP 2024 in September, and published later this year.

View the training platform

You can find out more about the EAGLE study in the below video:

If you have any questions, please contact the team.


GSU awarded additional funding for Community Engagement activities

The Global Surgery Unit was recently awarded additional Official Development Assistance (ODA) funding from the University of Birmingham and UK Research and Innovation to increase already existing community engagement activities across its Indian and Rwandan research Hubs.

The funding for the India Hub will be used to expand training for local ASHA community health workers (CHWs) on surgical wound management, stoma care and early cancer detection. According to the World Health Organisation, CHWs are healthcare providers who live in the community they serve and receive lower levels of formal education and training than professional healthcare workers such as nurses and doctors. They are key players in addressing the health needs of remote and marginalised low-to-middle-income (LMIC) country settings but traditionally have yet to have a role in post-surgical care. The funding will also be used to disseminate the recently co-developed patient education toolkit co-developed. Since last year, the India Hub has been engaging with ASHA workers and registered medical practitioners in different cities such as Ludhiana, Kolkata and Vellore which garnered the attention of the Punjab Civil Surgeon who tasked the Hub to train an additional 2,000 ASHAs.

On the other hand, the Rwanda Hub will be using its additional funding to expand on PIGEON (ImProving surgIcal care outcomes throuGh the active involvEment of cOmmunity in RwaNda)- a mixed method study that will initially scope CHW’s knowledge of surgical care and co-develop with them an intervention focused on improving surgical care outcomes through the active involvement of CHWs in both rural and urban regions of the country.

ODA is UK government aid that promotes and specifically targets the economic development and welfare of LMICs. Funding is provided through the International Science Partnerships Fund (ISPF) Institutional Support Grant (ODA), funded by Research England, Grant Reference: RE-CL-2023-09.


Community Talks Address SSIs and Smoking Cessation in Kolkata and Vellore

In a bid to promote healthcare awareness and foster essential knowledge among healthcare professionals, a community engagement talk organised by the GSU India Hub, attended by 40 paramedic trainees was held at the School for Skills in Allied Health Sciences, Sonarpur, Kolkata, India on October 31, 2023. 

The talk encompassed an array of crucial topics, including the awareness of surgical site infections (SSIs), wound care at home, recognizing the signs and symptoms of SSI, and the proper management of wound care in a home setting. Furthermore, it highlighted the significance of hand hygiene and the timely change of gloves during wound care procedures.

The interactive session provided a platform for the paramedic trainees to raise queries and concerns regarding the correct use of gloves while handling patients in both hospital and community settings. Questions such as the duration for which gloves can be worn and when to change gloves were addressed, ensuring that these future healthcare professionals are well-prepared to maintain rigorous hygiene standards.

Another event was previously held at the Christian Medical College & Hospital in Vellore on October 27, 2023, catering to 35 patients and their caregivers. The event aimed to create awareness about carcinogens in tobacco products and the importance of smoking cessation.

The talk, delivered in English, Tamil and Hindi, covered various aspects of smoking, including its effects, withdrawals, triggers, risk factors, addictive nature, and the toxic components ingested while smoking. Furthermore, it delved into methods to quit smoking and discussed challenges encountered during cessation, such as withdrawals and triggers.

The outcomes of the session were highly positive, with attendees gaining a deeper understanding of the adverse effects of smoking and the significance of quitting the habit. Many patients were previously unaware of carcinogenic smoking and cessation, highlighting the importance of such community engagement talks.


WOLVERINE Unleashed!

The launch webinar for the latest ESCP audit and cohort study ‘WOLVERINE’ took place on 07th November. The aim of this study is to conduct a prospective cohort study and audit in wound closure and SSI prevention following abdominal surgery.

Presentation

Panel Discussion

Amongst the panellists were GSU hub representatives from Ghana (Prof. Stephen Tabiri, Dr Napoleon Bellua Sam) and India (Dr Parvez David Haque).

WOLVERINE has 2 recruitment periods;

  • Period 1: 01st November 2023 to 15th December 2023 (audit only)
  • Period 2: 02nd January 2024 to 31st March 2024 (audit + elective cohort study)

Patient recruitment for the period 1 audit is now underway and you can register your centre to join here. More than 160 centres have already registered to participate.

If you have any questions please contact wolverine@contacts.bham.ac.uk.


Project Lion Cost Analysis

New Publication: A Prospective, Observational Cost Comparison of Laparoscopic and Open Appendicectomy in Three Tertiary Hospitals in Nigeria

We are pleased to share our latest publication in the World Journal of Surgery from Project LION, which was led by Dr Adewale Adisa at the NIHR Hub in Nigeria.

This study compared the outcome and cost of conventional open and laparoscopic appendectomy for clinically confirmed, uncomplicated, acute appendicitis in a low resource setting. Although the cost effectiveness of laparoscopic surgery has been investigated previously in high human development index (HDI) countries, similar studies are lacking in low and middle HDI countries.

The publication can be found on the following link: https://link.springer.com/article/10.1007/s00268-023-07148-5

Studies- GSU - Lion


Upcoming Webinar On New WOLVERINE Study

The European Society of Coloproctology (ESCP) latest audit and cohort study, Wound Closure and Surgical Site Infection Prevention Strategies in Abdominal Surgery (WOLVERINE) was launched at the Global Reach Symposium at ESCP's 2023 Conference in Vilnius, Lithuania.

The aim of this study is to conduct a prospective cohort study and audit in wound closure and SSI prevention following abdominal surgery. The study will have two data collection periods, one beginning in November 2023, and a second beginning in January 2024. Interested sites can register here. Sites can take part in either the audit alone (November 2023), or the audit and cohort study (January 2024).

Join our upcoming webinar on 07th November to find out more about WOLVERINE. Book your place at https://www.ticketsource.co.uk/escpstudies.


GSU Research Fellows, Staff Deliver Surgical Research Lectures in Nigeria

Research fellows and staff of the NIHR Global Surgery Unit (GSU) visited Obafemi Awolowo University (OAU) in Ile Ife, Nigeria on the 14th-15th of September 2023 to deliver a series of lectures to medical students, surgical residents and other health care professionals.

The GSU contingent was composed of Dr Dmitri Nepogodiev- Public Health registrar and Academic Clinical Lecturer; Drs Maria Picciochi and Virginia Ledda- Clinical PhD Fellows; Dr Omar Omar- Senior Statistician and Epidemiologist, and Mr Michael Bahrami-Hessari- Community Engagement and Involvement (CEI) manager.

The first lectures delivered on the afternoon of the 14th were aimed at 4th and final year medical students and included fundamental topics on the purpose of research and identifying a good research problem. This was followed by practical advice on how a research abstract is written and how an effective academic poster is constructed. Highlights of the GSU cluster randomised trial CHEETAH and DRAGON- an upcoming trial aiming to compare reusable versus disposable surgical drapes and gowns, were also presented. The session ended with the GSU visitors sharing practical tips on how to develop a career in research.

On the morning of the 15th, a research forum was held specifically for surgical residents and tackled topics such as generating research ideas, getting patient input and choosing the appropriate study design, research ethics, the basics of statistics, presenting and publishing research and how research can influence health guidelines and practice.

Finally, in the afternoon of the same day, a symposium on global surgery was held with a variety of health professionals in attendance. Topics included the sharing of the highlights of our randomised controlled trials (FALCON, CHEETAH, PENGUIN, DRAGON), cohort studies (COVIDSurg, HIPPO), health economics analysis (LION) and our CEI initiatives most notably the development of our community and patient education toolkit.  

OAU is a spoke within the Nigeria Hub and has been a top recruiter in GSU trials.


GSU Patient and Community Education Toolkit Launched

The NIHR Global Surgery Unit launched its patient and community education toolkit during its annual meeting in Lagos, Nigeria on the 12th of September 2023. The toolkit is a library of bespoke, localised resources aimed at addressing patient and carer surgical concerns following community consultations across our Hubs in Benin, Ghana, India, Mexico, Nigeria and Rwanda.

From these consultations the most pressing priority identified was caring for surgical wounds at home. To address this, a concise animated video that teaches patients about the signs, symptoms, and self-management of surgical site infections (SSIs) was co-developed with input from stakeholders. The video has been translated into French, Spanish, Twi, Yoruba, Kinyarwanda and Hindi and can be viewed below:

Resources on additional topics identified by the community were also developed. These include early cancer detection, care after laparoscopic surgery, stoma care and what to expect before, during and after surgery. These materials make up the initial version of the dynamic, “living” toolkit which will be continuously refined and expanded as more studies and trials get underway in the unit. 

These developed materials will be utilised in community outreach events and post-discharge briefings for our trial participants, and eventually in patient care. They will also be integrated into upcoming trials to evaluate their impact on patients.