Current projects

Post-operative urinary retention (POUR) is a well-recognised complication of inguinal hernia repair (IHR). POUR risks patient distress, catheter-complications and a financial and logistical burden to services.  Separately, in the field of IHR, there has been a lack of research into patients’ perceptions of surgical ‘success’. Our aim is to perform a two-phase, multi-centre prospective study to:

1. Assess the rate, risk factors and impact related to POUR post IH repair.
2. Develop and validate a patient reported outcome measure (PROM) for inguinal hernia repair.

The OAT trial

The OAT study will aim to assess the efficacy of various commonly used thromboprophylaxis regimens in patients undergoing metabolic surgery through the monitoring of anti-Xa levels. The goal is to establish this study among all sites performing metabolic surgery across Ireland. The project will benefit from logistical support from the RCSI in terms of data capture software and trial management.

MetaMet

“MetaMet” is single-centre, randomised controlled feasibility study actively recruiting since January 2023 in University College Hospital Galway. The objective is to compare how two accepted methods of performing a ray amputation, either using a manual bone cutter or an oscillating microsaw to transect the metatarsal shaft, impact short-term wound outcomes. We hypothesise that there will be fewer wound complications, namely re-infection and re-operation, when ray amputation is performed using a microsaw due to reduced trauma to the residual healthy bone. As the prevalence of diabetes and its associated lower limb complications rise amongst the Irish population, research into reducing minor complications, major amputations and healthcare costs is critically important

PINTA

“PINTA” is a multi-centre, randomised controlled feasibility study that aims to start recruiting in Autumn 2023. The objective is to compare rates of wound complications after major lower limb amputations between single-use negative pressure wound therapy devices and standard dressings. Patients in need of a major amputation are high risk for wound complications with little time available to optimise these factors. NPWT has demonstrated positive results in reducing wound complications after other high-risk surgeries and its benefits may be transferable to this vulnerable population. We have six vascular centres across Ireland ready to start recruiting once ethical approval has been granted.

There is a growing appreciation amongst the medical community that obesity is a consequence of complex interactions between genetic, socioeconomic, and cultural influences. Worldwide the prevalence of obesity has increased three-fold over the last three decades.

Many societies and institutions have published their own guidelines and recommendations on the management of patients with obesity, however there is a lack of evidence based surgical specific guidelines on the peri-operative management of patients with obesity.

Using a multi-pronged quality improvement approach the ISRC aims to address the lack of guidance in the peri-operative space by;

1. Disseminating a survey to gather data real world surgical practices amongst non-bariatric surgeons on the management of patients with obesity.
2. Synthesising the data available on the peri-operative practices and outcomes of patients with obesity by conducting a systematic review and meta-analysis.
3. Using data obtained from the survey and systematic review the Irish Surgical Research Collaborative (ISRC) is planning to reach a consensus on peri-operative optimisation of patients with obesity undergoing non-bariatric surgery. The aim is to identify the surgical needs of patients with obesity undergoing non bariatric surgery via an online Delphiconsensus process. The focus of these guidelines will be on peri-operative surgical management and will serve as an adjunct to the existing Association of Anaesthesia of Great Britain and Ireland guidelines published in 2015.

Prophylactic negative pressure wound therapy (NPWT) in laparotomy wounds: a randomised controlled trial comparing negative pressure wound therapy to standard wound management in patients following midline laparotomy

This is a multicentre, prospective randomised controlled trial (RCT) comparing rates of midline wound surgical site infection (SSI) in the 30 days following laparotomy between NPWT and standard dressings.

Recruitment is ongoing across multiple sites

Excision and Negative pressure wound therapy Versus Excision and Leaving Open with standard wound care for management of chronic Pilonidal sinus disease – A randomised controlled trial

This is single-blinded, multicentre, prospective randomised controlled trial (RCT) comparing post-operative and patient-reported outcomes for patients undergoing application of negative-pressure wound therapy (NPWT) after sinus tract excision as compared to excision and standard open wound care in chronic pilonidal sinus disease (PSD). Recruitment is ongoing across multiple sites.

Snapshot audit of frailty prevalence amongst emergency general surgery admissions >60 years

This is a multicentre snapshot audit aiming to evaluate frailty screening of emergency general surgery admissions aged >60 by the on-call surgical teams using the validated Rockwood Clinical Frailty Scale. The secondary aim is to estimate the prevalence of frailty in our population and to investigate the impact of frailty on 30-day outcomes. Study period Sept-October 2024.