Type of publication:
Journal article
Author(s):
Macefield R.; Mandefield L.; Blazeby J.M.; Fairhurst C.; Baird K.; Arundel C.; Chetter I.; Martin B.C.; Hewitt C.; Gkekas A.; Mott A.; Saramago Goncalves D.P.; Swan S.; Torgerson D.; Wilkinson J.; Zahra S.; Dixon S.; Hatfield J.; Oswald A.; Dumville J.; Lee M.M.; Pinkney T.; Stubbs N.; Wilson L.; Clothier A.; Bosanquet D.; Blow M.; Price C.; Todd J.; Munro T.; Pillay W.; Pradhan A.; Garnham A.; Wall M.; Powezka K.; Gerrard D.; Croucher A.; Hadjievangelou N.; Firth A.; Roe T.; Smith G.; Bicknell C.; Carr C.; Negbenose E.; Tarusan L.; Vesey A.; Wilson D.; Bell D.; Fletcher J.; Greenwood C.; Wallace T.; Vallabhaneni S.; Holder S.; Williams J.; Sim S.; Tambyraja A.L.; Kerray F.; Ng A.; Sylvester M.; Slater L.; Rashid S.T.; Palacios A.; Feld K.; Nandhra S.; Stansby G.; Parr N.; Jones L.; Milne J.; Stubbs C.; Hinchliffe R.; Twine C.; Antoniou G.A.; Corbett C.; Munt S.; Warran S.; Fletcher R.; Al-Jundi W.; Burrows M.; Stather P.; Barnes R.; Woodrow T.; Adams B.; Agu O.; Gleeson Y.; D'Souza R.; Erete L.; *Jones S.; *Checketts C.; *Bajic D.; *Matravers R.; Loftus I.; Budge J.; Azhar B.; Juszczak M.; Syed A.; Hancox R.; Pearce C.; Suggett N.; Whitehouse A.; Kuhan G.; Premnath S.; Dattani N.; Hollings V.; Khasawneh F.; AlShakarchi J.; Packer E.
Citation:
Journal of Tissue Viability. 34(3) (no pagination), 2025. Article Number: 100889. Date of Publication: 01 Aug 2025.
Abstract:
Background: Surgical wounds healing by secondary intention are common. Healing is often complicated by surgical site infection (SSI). SSI assessment is important to guide treatment but existing methods generally require in-person assessment, making them resource intensive. A validated patient-reported SSI outcome measure may be useful to overcome this limitation. Aim(s): To modify and validate the Bluebelle Wound Healing Questionnaire (WHQ) for wounds healing by secondary intention. Method(s): The 18-item Bluebelle WHQ developed for wounds healing by primary intention was modified to make it applicable to secondary healing wounds. Testing was performed as part of the SWHSI-2 randomised trial assessing negative pressure wound dressings versus standard care. Participants completed the WHQ at five timepoints; in-person (baseline, post-healing) and by post (3, 6, 12 months). A reference SSI assessment was performed by a research nurse at the time of wound healing. Acceptability and criterion validity (ability of the Bluebelle WHQ to discriminate between SSI/no SSI) were explored by examining questionnaire return rates, levels of missing data and total score sensitivity/specificity values (receiver operating characteristic curve (ROC)). Result(s): Baseline in-person questionnaire return rates were highest (672/686; 98 %), with postal return rates of 428/615 (68.5 %), 274/416 (65.9 %) and 186/296 (62.8 %) at follow up points. Overall, low levels of item-missing data were observed with few problems completing the questionnaire reported. Ability to discriminate between SSI/no SSI was good (Area under ROC = 0.796). Conclusion(s): The modified Bluebelle WHQ is a valuable tool for post-discharge assessment of wounds healing by secondary intention. It is recommended for use in research and clinical practice.
DOI: 10.1016/j.jtv.2025.100889
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