Evidence map›Paper›PMID 37758504›Full record

Trial reportThe British journal of surgery2023

The Hand and Wrist: AntImicrobials and Infection (HAWAII) trial.

Justin Conrad Rosen Wormald, Jeremy Rodrigues, Rinah Bheekharry, Nicholas Riley, Sarah Tucker, Dominic Furniss, Rebecca Dunlop, Robin Jones, Duncan Applebe, Kate Herbert and 3 more

Open access · hybridAbstract readRandomized Controlled Trial
In one paragraph

Trial report in The British journal of surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.0field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Trial
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 4 institutions in 1 country.

Justin Conrad Rosen WormaldOxford Trauma and Emergency Care, Kadoorie Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.ORCID 0000-0001-6197-4093
Jeremy RodriguesWarwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK.ORCID 0000-0002-9347-5026
Rinah BheekharryBuckinghamshire Healthcare NHS Trust, Stoke Mandeville Hospital, Aylesbury, UK.
Nicholas RileyOxford University Healthcare NHS Foundation Trust, Oxford, UK.ORCID 0000-0001-6613-0842
Sarah TuckerOxford University Healthcare NHS Foundation Trust, Oxford, UK.
Dominic FurnissOxford University Healthcare NHS Foundation Trust, Oxford, UK.ORCID 0000-0003-2780-7173
Rebecca DunlopRoyal Cornwall Hospitals NHS Trust, Treliske, Truro, Cornwall, UK.
Robin JonesRoyal Cornwall Hospitals NHS Trust, Treliske, Truro, Cornwall, UK.
Duncan ApplebeOxford Trauma and Emergency Care, Kadoorie Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.ORCID 0000-0003-1493-0391
Kate HerbertOxford Trauma and Emergency Care, Kadoorie Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
Daniel Prieto-AlhambraBotnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK.ORCID 0000-0002-3950-6346
Jonathan CookBotnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK.ORCID 0000-0002-4156-6989
Matthew Lee CostaOxford Trauma and Emergency Care, Kadoorie Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.ORCID 0000-0003-3644-1388
Nuffield Orthopaedic Centre · GBBuckinghamshire Healthcare NHS Trust · GBOxford Health NHS Foundation Trust · GBRoyal Cornwall Hospital Trust · GB

Funding

Blond McIndoe TrustNational Institute for Health and Care ResearchRoyal College of Surgeons
6 · The paper itself

Abstract

backgroundHand trauma, comprising injuries to both the hand and wrist, affects over five million people per year in the NHS, resulting in 250 000 operations each year. Surgical site infection (SSI) following hand trauma surgery leads to significant morbidity. Triclosan-coated sutures may reduce SSI in major abdominal surgery but have never been tested in hand trauma. Feasibility needs to be ascertained before a definitive trial can be delivered in hand trauma.

methodsA multicentre feasibility RCT of antimicrobial sutures versus standard sutures involving adults undergoing surgery for hand trauma to evaluate feasibility for a definitive trial. Secondary objectives were incidence of SSI in both groups, hand function measured with patient-reported outcome measures, health-related quality of life and change in employment. Randomization was performed on a 1:1 basis, stratified by age of the patient and whether the injury was open or closed, using a secure, centralized, online randomization service. Participants were blinded to allocation.

results116 participants were recruited and randomized (60 intervention, 56 control). Of 227 screened, most were eligible (89.5 per cent), and most who were approached agreed to be included in the study (84.7 per cent). Retention was low: 57.5 per cent at 30 days, 52 per cent at 90 days and 45.1 per cent at 6 months. Incidence of SSI was >20 per cent in both groups. Hand function deteriorated after injury but recovered to near pre-injury levels during the study period.

conclusionsRisk of SSI after hand trauma is high. A definitive RCT of antimicrobial sutures in hand trauma surgery is feasible, if retention is improved.

trial registrationISRCTN10771059.

Indexed as

Anti-Infective AgentsAnti-Infective Agents, LocalHand InjuriesAdultHawaiiHumansQuality of LifeSurgical Wound InfectionWristAnti-Infective AgentsAnti-Infective Agents, Local

Identifiers

PMID37758504
PMCPMC10638545
OpenAlexW4387079230

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.