​Johnson & Johnson MedTech has joined leading surgeons from around the world to initiate a standardised classification system for the global evaluation and reporting of surgical site outcomes (SSOs). Experts from across surgical specialties and healthcare disciplines aim to develop a standardised approach for surgeons and wound care teams to more fully capture the scope and incidence of postoperative complications, enabling improved approaches to prevention.
Wound complications including infections, bleeding, wound reopenings, and fluid collections result in a significant burden for patients and global healthcare systems. Despite the prevalence of these complications in perioperative care, post-operative wound outcomes are underreported, and there is currently no comprehensive global standard for defining and monitoring.
“As long-time partners to surgeons and surgical teams around the world, we know firsthand the impact that surgical complications can have on patient outcomes and the overall cost of care globally,” said Nisha Johnson, President, Wound Closure and Healing & Biosurgery, Johnson & Johnson MedTech. “The industry is calling for consistent definitions, standard solutions that improve outcomes, and a comprehensive approach to reporting and data collection that helps advance healing and improve the surgery experience for patients.”
Complications at the surgical wound site occur at higher rates than any other kind of adverse event in hospitalised patients. SSIs are common, can be dangerous and costly. However, SSIs are still underreported, largely due to improper and inconsistent identification methods among health systems. These infections often relate to other post-surgical wound complications including wound breakdown, fluid accumulation, and localised bleeding.
“When most people think about wounds, they think about surgical site infections, but wounds can dehisce, seromas can form, and haematomas can appear. All of these things need to be brought together in a common language so that we can describe the surgical site outcome for every single operation that includes every single type of surgical incision,” said Giles Bond-Smith, MD, MBBS BSc, FRCS, a general surgeon at NHS Oxford Trust. “I am thrilled to come together with other experts in the field, from around the world, to advance our common language in surgery with the aim of reducing the occurrence of surgical complications for patients.”
Expanding surveillance beyond only SSIs by including other complications has the potential to support care teams so that wound complications are more consistently captured and reported, putting the focus on visibility into patient conditions and appropriate intervention and treatment.
“Clear definitions are the first step to attempt to classify all types of wound complications so that we can improve reporting to drive earlier intervention,” said Antonia Chen, MD, MBA, an orthopaedic surgeon specialising in hip and knee replacements. “In orthopaedic surgery, wound complications vary relative to other specialties, with significant focus on closure-related interventions to manage dehiscence. Creating a system that fits across all specialties to address surgical site outcomes throughout the body can drive global consistency in care standards that the industry is missing today.”
Digital solutions can help improve surveillance of surgical wound complications. Johnson & Johnson MedTech’s Polyphonic digital ecosystem will connect data across world-class surgical technologies, robotics, and surgical software while leveraging the global scale of Johnson & Johnson. Leveraging the Polyphonic ecosystem, the company will explore patient monitoring based on new, standard reporting guidelines as determined in SSO classification.
“Digital is a bridge to getting patients more involved in their surgical care,” said Shan Jegatheeswaran, Vice President, Digital, Johnson & Johnson MedTech. “Building on a foundation of standard definitions across the primary contributors to surgical site outcomes, digital solutions connecting surgical teams and patients can be used to encourage more reporting, better wound care management, and increased patient engagement. In the future, these kind of standard classification systems have the potential to enable more personalised models before, during, and after surgery.”
Note: Dr. Bond-Smith and Dr. Chen are both paid consultants for Johnson & Johnson MedTech.
