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  1. Article ; Online: Re-admissions to Hospital for People with Diabetic Related Foot Disease: Admission of Failure or Just the Nature of the Beast?

    Bosanquet, David C / Zayed, Hany

    European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery

    2023  Volume 66, Issue 2, Page(s) 203

    MeSH term(s) Humans ; Hospitalization ; Diabetic Foot/diagnosis ; Diabetic Foot/therapy ; Foot Diseases ; Hospitals ; Retrospective Studies ; Patient Readmission ; Diabetes Mellitus/epidemiology
    Language English
    Publishing date 2023-05-16
    Publishing country England
    Document type Journal Article ; Comment
    ZDB-ID 1225869-6
    ISSN 1532-2165 ; 1078-5884
    ISSN (online) 1532-2165
    ISSN 1078-5884
    DOI 10.1016/j.ejvs.2023.05.011
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  2. Article ; Online: Delays in performing vascular surgery.

    Gwilym, Brenig L / McLain, Alexander D / Bosanquet, David C

    The British journal of surgery

    2022  Volume 109, Issue 11, Page(s) 1176–1177

    MeSH term(s) Humans ; Specialties, Surgical ; Vascular Surgical Procedures
    Language English
    Publishing date 2022-09-02
    Publishing country England
    Document type Journal Article
    ZDB-ID 2985-3
    ISSN 1365-2168 ; 0263-1202 ; 0007-1323 ; 1355-7688
    ISSN (online) 1365-2168
    ISSN 0263-1202 ; 0007-1323 ; 1355-7688
    DOI 10.1093/bjs/znac296
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  3. Article ; Online: Patient perceptions of surveillance of small abdominal aortic aneurysms in the over 85s.

    Jones-Webster, Summer / Davenport, Miles / Weerakkody, Sayuri / Smith, Elisabeth / Reed, Phil / Tree, Jeremy J / Osborne, Lisa A / Bosanquet, David C

    Annals of vascular surgery

    2024  

    Abstract: Objective: Recently instigated local practice for patients with small abdominal aortic aneurysms (AAAs) involves contacting all patients, aged ≥85 years, to discuss with them the advantages and disadvantages of removal from surveillance. However, ... ...

    Abstract Objective: Recently instigated local practice for patients with small abdominal aortic aneurysms (AAAs) involves contacting all patients, aged ≥85 years, to discuss with them the advantages and disadvantages of removal from surveillance. However, reasons why patients opt to remain on, or come off, surveillance, are currently unknown. The current study's objective is to explore patient perception of surveillance decision-making.
    Methods: A mixed-methods exploratory evaluation was undertaken using patient feedback obtained from a telephone survey. All patients aged ≥85 years, who had a consultation regarding ongoing surveillance of small AAAs (30-49mm), and consented, were contacted by researchers, who conducted semi-structured interviews concerning factors influencing decision-making.
    Results: A total of 24 patients (20 male; mean age = 86.9 years) were interviewed; 16/24 (66%) had opted to remain on surveillance, with no age difference between those opting-in or out. Most felt surveillance was important (91%), and that it made them feel safer (73%). The majority (73%) thought they knew what happened when their AAA reached threshold (5.5cm), what happened when a threshold AAA is not fixed (64%), and how major AAA surgery is (59%). However, actual knowledge was poor: most (91%) correctly understood surgery was major; but 56% thought that threshold AAA meant certain death or rupture; and 38% thought immediate surgery was required. Thematic analysis expounded patients' beliefs regarding surveillance, which were summarised in three distinct sub-groups: reliance on professionals' opinions; needing peace of mind; and poor understanding.
    Conclusion: Whilst most patients find surveillance reassuring, patient knowledge of AAA management at threshold is poor, potentially impacting surveillance decision-making. Elderly patients, with small AAAs contemplating ongoing surveillance, need to be better informed about AAA management at threshold to support shared decision-making.
    Language English
    Publishing date 2024-04-06
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 1027366-9
    ISSN 1615-5947 ; 0890-5096
    ISSN (online) 1615-5947
    ISSN 0890-5096
    DOI 10.1016/j.avsg.2024.02.012
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  4. Article ; Online: Small Abdominal Aortic Aneurysms in the Over 85s: Do We Need to Survey Them All?

    Maryosh, Sally / Gwilym, Brenig / Lewis, Peter / McLain, Alexander D / Lewis, David / Bosanquet, David C

    European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery

    2023  Volume 65, Issue 6, Page(s) 911–912

    MeSH term(s) Humans ; Aortic Aneurysm, Abdominal/diagnostic imaging ; Aortic Aneurysm, Abdominal/epidemiology ; Aortic Aneurysm, Abdominal/surgery ; Aortic Rupture/surgery ; Surveys and Questionnaires
    Language English
    Publishing date 2023-03-21
    Publishing country England
    Document type Letter
    ZDB-ID 1225869-6
    ISSN 1532-2165 ; 1078-5884
    ISSN (online) 1532-2165
    ISSN 1078-5884
    DOI 10.1016/j.ejvs.2023.03.019
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  5. Article ; Online: Clinical Effects of Tourniquet Use for Nontraumatic Major Lower Limb Amputation: A Two-Center Retrospective Cohort Study.

    Richards, Owen / Cheema, Yusuf / Gwilym, Brenig / Ambler, Graeme K / Twine, Christopher P / Bosanquet, David C

    Annals of vascular surgery

    2023  Volume 104, Page(s) 53–62

    Abstract: Background: To investigate the effect of tourniquet use on outcomes after major lower limb amputation (MLLA) due to peripheral arterial disease or complications from diabetes mellitus.: Methods: In this 2-center retrospective observational study, ... ...

    Abstract Background: To investigate the effect of tourniquet use on outcomes after major lower limb amputation (MLLA) due to peripheral arterial disease or complications from diabetes mellitus.
    Methods: In this 2-center retrospective observational study, vascular patients who underwent MLLA between January 1, 2016 and December 31, 2020 at 2 UK hospitals were identified using operating theater databases. Hospital databases were used to access medical records, operation notes, and laboratory reports. The use of a tourniquet in each MLLA was noted. The primary outcome was postoperative hemoglobin (Hb) drop (g/L). Secondary outcomes were units of allogeneic blood transfused perioperatively, 90-day revision rates, 90-day wound breakdown rates, surgical site infection (SSI) rates (at 30 days), and 90-day mortality. A follow-up index (a measure of follow-up completeness) was calculated for all 30-day and 90-day outcomes.
    Results: Four hundred seventy two patients underwent MLLA, of which 124 had a tourniquet applied. The median postoperative Hb drop was significantly lower in the tourniquet group compared to the nontourniquet group (13 [interquartile range 5-22] g/L vs. 20 [interquartile range 11-28] g/L; P ≤ 0.001). Thirty three point one percent (41) of tourniquet patients received a blood transfusion perioperatively, compared to 35.6% (124) of nontourniquet patients (P = 0.82). Sixteen percent (76) of patients required surgical revision within 90 days, with no significant difference between the tourniquet and nontourniquet group (20.2% tourniquet vs. 14.7% no tourniquet; P = 0.15). SSI rates (12.0% tourniquet vs. 10.6% no tourniquet, P = 0.66) and 90-day mortality (6.5% tourniquet vs. 10.1% no tourniquet; P = 0.23) were similar. Multivariable regression demonstrated that tourniquet use was independently associated with a reduced hemoglobin drop (β = -4.671, 95% confidence interval -7.51 to -1.83, P ≤ 0.001) but was not associated with wound breakdown, revision surgery, or SSI. Hypertension, SSI, and below-knee amputation using the skew flap technique were all significant predictors of revision surgery. All follow-up indices were ≥ 0.97.
    Conclusions: Tourniquet use in MLLA was associated with a significantly lower fall in postoperative Hb without evidence of harm in terms of SSI, wound breakdown/revision rates, or mortality.
    Language English
    Publishing date 2023-07-14
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 1027366-9
    ISSN 1615-5947 ; 0890-5096
    ISSN (online) 1615-5947
    ISSN 0890-5096
    DOI 10.1016/j.avsg.2023.07.096
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  6. Article ; Online: Groin Wound Infection after Vascular Exposure (GIVE) Risk Prediction Models: Development, Internal Validation, and Comparison with Existing Risk Prediction Models Identified in a Systematic Literature Review.

    Gwilym, Brenig L / Ambler, Graeme K / Saratzis, Athanasios / Bosanquet, David C

    European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery

    2021  Volume 62, Issue 2, Page(s) 258–266

    Abstract: Objective: This study aimed to develop and internally validate risk prediction models for predicting groin wound surgical site infections (SSIs) following arterial intervention and to evaluate the utility of existing risk prediction models for this ... ...

    Abstract Objective: This study aimed to develop and internally validate risk prediction models for predicting groin wound surgical site infections (SSIs) following arterial intervention and to evaluate the utility of existing risk prediction models for this outcome.
    Methods: Data from the Groin wound Infection after Vascular Exposure (GIVE) multicentre cohort study were used. The GIVE study prospectively enrolled 1 039 consecutive patients undergoing an arterial procedure through 1 339 groin incisions. An overall SSI rate of 8.6% per groin incision, and a deep/organ space SSI rate of 3.8%, were reported. Eight independent predictors of all SSIs, and four independent predictors of deep/organ space SSIs were included in the development and internal validation of two risk prediction models. A systematic search of the literature was conducted to identify relevant risk prediction models for their evaluation.
    Results: The "GIVE SSI risk prediction model" ("GIVE SSI model") and the "GIVE deep/organ space SSI risk prediction model" ("deep SSI model") had adequate discrimination (C statistic 0.735 and 0.720, respectively). Three other groin incision SSI risk prediction models were identified; both GIVE risk prediction models significantly outperformed these other risk models in this cohort (C statistic 0.618 - 0.629; p < .050 for inferior discrimination in all cases).
    Conclusion: Two models were created and internally validated that performed acceptably in predicting "all" and "deep" groin SSIs, outperforming current existing risk prediction models in this cohort. Future studies should aim to externally validate the GIVE models.
    MeSH term(s) Aged ; Anti-Infective Agents, Local/therapeutic use ; Area Under Curve ; Blood Vessel Prosthesis ; Chlorhexidine/therapeutic use ; Endovascular Procedures/adverse effects ; Female ; Groin/surgery ; Humans ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Observational Studies as Topic ; Povidone-Iodine/therapeutic use ; Probability ; ROC Curve ; Regression Analysis ; Risk Assessment/methods ; Risk Factors ; Surgical Wound Infection/etiology
    Chemical Substances Anti-Infective Agents, Local ; Povidone-Iodine (85H0HZU99M) ; Chlorhexidine (R4KO0DY52L)
    Language English
    Publishing date 2021-07-08
    Publishing country England
    Document type Comparative Study ; Journal Article ; Systematic Review ; Validation Study
    ZDB-ID 1225869-6
    ISSN 1532-2165 ; 1078-5884
    ISSN (online) 1532-2165
    ISSN 1078-5884
    DOI 10.1016/j.ejvs.2021.05.009
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  7. Article ; Online: COVID-19 and Abdominal Aortic Aneurysm Intervention: When to Defer and When to Operate.

    Gwilym, Brenig L / Kent, Frances / Twine, Christopher P / Bosanquet, David C

    European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery

    2021  Volume 62, Issue 3, Page(s) 485–486

    MeSH term(s) Aortic Aneurysm, Abdominal/diagnostic imaging ; Aortic Aneurysm, Abdominal/surgery ; COVID-19 ; Humans ; SARS-CoV-2
    Language English
    Publishing date 2021-06-04
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 1225869-6
    ISSN 1532-2165 ; 1078-5884
    ISSN (online) 1532-2165
    ISSN 1078-5884
    DOI 10.1016/j.ejvs.2021.05.034
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  8. Article ; Online: Impact of closed-incision negative pressure wound dressings on surgical site infection following groin incisions in vascular surgery; a single-centre experience.

    Barry, Ian Patrick / Turley, Luke P / Gwilym, Brenig L / Bosanquet, David C / Richards, Toby

    Vascular

    2022  Volume 31, Issue 6, Page(s) 1128–1133

    Abstract: Objectives: Surgical site infection (SSI) is a common complication in vascular surgery, and is associated with increased patient morbidity, readmission and reintervention. The aim of this study was to assess the impact of closed-incision negative ... ...

    Abstract Objectives: Surgical site infection (SSI) is a common complication in vascular surgery, and is associated with increased patient morbidity, readmission and reintervention. The aim of this study was to assess the impact of closed-incision negative pressure wound therapy (CiNPWT) upon rate of SSI and length of hospital stay.
    Methods: This study was reported in line with the STROBE guidelines. We assessed the baseline incidence of SSI from a 12-month retrospective cohort and, following a change in practice intervention with CiNPWT, compared to a 6-month prospective cohort. The primary endpoint was incidence of SSI (according to CDC-NHSN guidelines) while secondary endpoints included length of hospital stay, readmission, reintervention and Days Alive and Out of Hospital (DAOH) to 90-days.
    Results: A total of 127 groin incisions were performed: 76 (65 patients) within the retrospective analysis and 51 (42 patients) within the prospective analysis (of whom 69% received CiNPWT). The primary endpoint of SSI was seen in 21.1% of the retrospective cohort and 9.8% of the prospective cohort (
    Conclusion: Introduction of CiNPWT was associated with a reduced length of hospital stay and improved DAOH-90. Further trials on CINPWT should include patient-centred outcomes and healthcare cost analysis.
    MeSH term(s) Humans ; Surgical Wound Infection/diagnosis ; Surgical Wound Infection/epidemiology ; Surgical Wound Infection/therapy ; Groin ; Retrospective Studies ; Vascular Surgical Procedures/adverse effects ; Bandages
    Language English
    Publishing date 2022-06-27
    Publishing country England
    Document type Journal Article
    ZDB-ID 2137151-9
    ISSN 1708-539X ; 1708-5381
    ISSN (online) 1708-539X
    ISSN 1708-5381
    DOI 10.1177/17085381221111007
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  9. Article ; Online: Letter r.e. "Clinical Utility of a New Predicting Score for Radiocephalic Arteriovenous Fistula Survival".

    Bosanquet, David C / Davies, Christopher G

    Annals of vascular surgery

    2017  Volume 43, Page(s) 353–354

    MeSH term(s) Arteriovenous Fistula ; Arteriovenous Shunt, Surgical ; Humans ; Radial Artery/surgery ; Renal Dialysis
    Language English
    Publishing date 2017-05-24
    Publishing country Netherlands
    Document type Letter ; Comment
    ZDB-ID 1027366-9
    ISSN 1615-5947 ; 0890-5096
    ISSN (online) 1615-5947
    ISSN 0890-5096
    DOI 10.1016/j.avsg.2017.05.017
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  10. Article ; Online: The Endovenous Literature: A Perfect Storm of Limited Effectiveness Data, Rapid Technological Evolution and Potential Conflict of Interest.

    Bosanquet, David C / Twine, Christopher P

    European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery

    2017  

    Language English
    Publishing date 2017-10-20
    Publishing country England
    Document type Journal Article
    ZDB-ID 1225869-6
    ISSN 1532-2165 ; 1078-5884
    ISSN (online) 1532-2165
    ISSN 1078-5884
    DOI 10.1016/j.ejvs.2017.09.009
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