Macefield Rhiannon, Mandefield Laura, Blazeby Jane M, Fairhurst Caroline, Baird Kalpita, Arundel Catherine, Chetter Ian, Martin Belen Corbacho, Hewitt Catherine, Gkekas Athanasios, Mott Andrew, Saramago Goncalves Dr Pedro, Swan Samantha, Torgerson David, Wilkinson Jacqueline, Zahra Sabeen, Dixon Stephen, Hatfield Josie, Oswald Angela, Dumville Jo, Lee Mr Matthew, Pinkney Thomas, Stubbs Nikki, Wilson Lyn, Clothier A, Bosanquet D, Blow M, Price C, Todd J, Munro T, Pillay W, Pradhan A, Garnham A, Wall M, Powezka K, Syed A, 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
National Institute for Health and Care Research (NIHR) Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, UK.
York Trials Unit, Department of Health Sciences, University of York, UK.
J Tissue Viability. 2025 Aug;34(3):100889. doi: 10.1016/j.jtv.2025.100889. Epub 2025 Mar 18.
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.
To modify and validate the Bluebelle Wound Healing Questionnaire (WHQ) for wounds healing by secondary intention.
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)).
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).
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.
通过二期愈合的手术伤口很常见。愈合过程常常因手术部位感染（SSI）而变得复杂。SSI评估对于指导治疗很重要，但现有方法通常需要进行现场评估，这使得它们资源消耗大。一种经过验证的患者报告的SSI结局指标可能有助于克服这一局限性。
修改并验证用于二期愈合伤口的蓝铃花伤口愈合问卷（WHQ）。
为一期愈合伤口开发的18项蓝铃花WHQ进行了修改，使其适用于二期愈合伤口。测试作为评估负压伤口敷料与标准护理的SWHSI-2随机试验的一部分进行。参与者在五个时间点完成WHQ；现场（基线、愈合后）和通过邮寄（3、6、12个月）。在伤口愈合时由研究护士进行参考SSI评估。通过检查问卷回收率、缺失数据水平和总分敏感性/特异性值（受试者操作特征曲线（ROC））来探索可接受性和标准效度（蓝铃花WHQ区分SSI/无SSI的能力）。
基线现场问卷回收率最高（672/686；98%），随访点的邮寄回收率分别为428/615（68.5%）、274/416（65.9%）和186/296（62.8%）。总体而言，观察到项目缺失数据水平较低，报告的问卷填写问题较少。区分SSI/无SSI的能力良好（ROC曲线下面积=0.796）。
修改后的蓝铃花WHQ是用于二期愈合伤口出院后评估的有价值工具。建议在研究和临床实践中使用。
