Modification and validation of the Bluebelle Wound Healing Questionnaire (WHQ) for assessing surgical site infection in wounds healing by secondary intention
Year: 2025
Type: article
Abstract: 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. • Validation of a modified version of the Bluebelle Wound Healing Questionnaire (WHQ) in wounds healing by secondary intention. • The tool is acceptable to patients with good criterion validity compared to existing methods for SSI assessment. • This is the first validated patient-reported tool for assessing SSI in wounds healing by secondary intention. • It is suitable for use in research and clinical practice.
Source: Journal of Tissue Viability
Authors: Rhiannon Macefield, Laura Mandefield, Jane M. Blazeby, Caroline Fairhurst, Kalpita Baird, Catherine Arundel, Ian Chetter, Belen Corbacho Martin, Catherine Hewitt, Athanasios Gkekas, Andrew Mott, Dr Pedro Saramago Goncalves, Samantha Swan, David Torgerson, Jacqueline Wilkinson, Sabeen Zahra, Stephen Dixon, Josie Hatfield, Angela Oswald, Jo Dumville, Mr Matthew Lee, Thomas Pinkney, Nikki Stubbs, Lyn Wilson, A. Clothier, D. Bosanquet, M. Blow, C. Price, J. Todd, T. Munro, W. Pillay, A. Pradhan, A. Garnham, M. Wall, K. Powezka, A. Syed, D. Gerrard, A. Croucher, N. Hadjievangelou, A. Firth, T. Roe, G. Smith, C. Bicknell, C. Carr, E. Negbenose, L. Tarusan, A. Vesey, D. Wilson, D. Bell, J. Fletcher, C. Greenwood, T. Wallace, S. Vallabhaneni, S. Holder, J. Williams, S. Sim, A.L. Tambyraja, F. Kerray, A. Ng, M. Sylvester, L. Slater, S.T. Rashid, A. Palacios, K. Feld, S. Nandhra, G. Stansby, N. Parr, L. Jones, J. Milne, C. Stubbs, R. Hinchliffe, C. Twine, G.A. Antoniou, C. Corbett, S. Munt, S. Warran, R. Fletcher, W. Al-Jundi, M. Burrows, P. Stather, R. Barnes, T. Woodrow, B. Adams, O. Agu, Y. Gleeson, R. D'Souza, L. Erete, S. Jones, C. Checketts, D. Bajic, R. Matravers, I. Loftus, J. Budge, B. Azhar, M. Juszczak, A. Syed, R. Hancox, C. Pearce, N. Suggett, A. Whitehouse, G. Kuhan, S. Premnath, N. Dattani, V. Hollings, F. Khasawneh, J. AlShakarchi, E. Packer
Institutions: National Institute for Health and Care Research, University of Bristol, NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust, University of York, University of Hull, Hull York Medical School, University of Manchester, Sheffield Teaching Hospitals NHS Foundation Trust, University of Birmingham, Leeds Community Healthcare NHS Trust, Mid Yorkshire Hospitals NHS Trust, Aneurin Bevan University Health Board, Bradford Teaching Hospitals NHS Foundation Trust, Bassetlaw Hospital, Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust, Dudley Group NHS Foundation Trust, University Hospitals Birmingham NHS Foundation Trust, Heartlands Hospital, Frimley Health NHS Foundation Trust, Imperial College Healthcare NHS Trust, NHS Lanarkshire, Leeds Teaching Hospitals NHS Trust, Liverpool University Hospitals NHS Foundation Trust, NHS Lothian, Manchester University NHS Foundation Trust, Newcastle upon Tyne Hospitals NHS Foundation Trust, Northumbria Healthcare NHS Foundation Trust, North Bristol NHS Trust, Pennine Acute Hospitals NHS Trust, Queen Elizabeth Hospital King's Lynn NHS Foundation Trust, Norfolk and Norwich University Hospital, Norfolk and Norwich University Hospitals NHS Foundation Trust, Royal Cornwall Hospital Trust, Royal Free London NHS Foundation Trust, Shrewsbury and Telford Hospital NHS Trust, St George’s University Hospitals NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, University Hospitals of Derby and Burton NHS Foundation Trust, University Hospitals of Leicester NHS Trust, Worcestershire Acute Hospitals NHS Trust
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $2,790
OpenAlex ID: W4408554375