Hip fractures affect 70 000 patients per year in the UK, and it is predicted that 100 000 people will suffer a hip fracture in the UK by 2020. Almost all patients undergo surgery to enable them to start walking again. However, between 2% and 7% of patients will get a wound infection. These infections are very serious and lead to a much longer hospital stay, more surgery and for half of the patients - death.
In surgery, the use of negative pressure wound therapy (NPWT) - a type of suction wound dressing - is increasing rapidly. However it has not been tested in hip fracture surgery trials.
This feasibility trial aims to better understand the scale of the infection problem in hip fracture surgery and to explore whether it will be feasible to run a large multicentre trial comparing NPWT with normal wound dressings. This will involve 464 people who have broken their hip being allocated to either a 'standard dressing' or the NPWT dressing.
The study will provide critical information as to how many people develop infection in each group, which will allow us to make a decision on the full scale study.
Primary:
To quantify the rate of ‘deep infection’ after hip fracture surgery in standard dressing and NPWT.
Secondary:
- To determine the number and nature of further surgical interventions related to the injury, in the first 4 months after the index procedure
- To study the practical elements of using ‘deep infection’ at discharge as an outcome measure in this patient group.
- To investigate which outcomes will be required to assess cost effectiveness, of negative pressure wound therapy versus standard dressing for wounds associated with hip fracture surgery in a definitive trial and to determine the rate of recruitment and retention of patients in this study.
- To capture the core outcome dataset for hip fractures
Primary:
Deep Infection; As per CDC definition at 30 days
Secondary:
- Mortality
- Indoor and outdoor walking status
- EQ-5D-5L
- Complications
- Resource Use
- Residential Status
WHISH is now closed to recruitment!!
The study results can be found by clicking to download a pdf of the manuscript here.
