Since 2013 GlobalSurg has run two observational studies in abdominal surgery, involving 25,000 patients from over a hundred countries. This has provided vital baseline data to allow us to begin to planning the first GlobalSurg randomised controlled trial (RCT) targeting reduction of surgical site infection (SSI) following abdominal surgery.
At the beginning of this month 60 medical professionals from the GlobalSurg family gathered in Birmingham, UK, for a two day planning conference aiming to design this world first trial.
Amongst the group were 25 surgeons from 17 countries including Benin, Egypt, Ghana, Guatemala, India, Mexico, Nigeria, Pakistan, Peru, Philippines, Rwanda and South Africa.
Planning involved lively discussion and small group work, including focus on the heterogeneity of the network. Philip Alexander, working in a fifty-bed hospital in the foothills of the Indian Himalayas, spoke of the practical difficulties of a trial participant returning for a follow-up appointment in winter when roads could be impassable. In Rwanda, many patients would be unable to pay the transport costs to return to hospital. Innovative methods such as using smartphones to send pictures of wounds or outreach visits to the patient’s home were discussed to maximise follow-up within a trial.
By the end of the meeting there was group consensus that the best interventions to test are 2% alcoholic chlorhexidine skin preparation and a clean set of wound closure instruments.