Trauma
KADOORIE CENTRE
FOR CRITICAL CARE
RESEARCH AND
Research & Development
EDUCATION
V O L U M E
OUR RESEARCH
THEMES
treatments
Rehabilitation
Patient / Staff
experience
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F E B R U A R Y
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Keith Willett - National Director
addition he is the Research
Lead for the NHS on the
National Institute of Health
Research (NIHR) Advisory
Board. He combines this
with research at the
Kadoorie Centre and clinical
work on the Trauma Unit.
Professor Keith Willett
Sallie Lamb -Trials Units
INSIDE
THIS
ISSUE:
Sarah Lamb
I S S U E
Keith Willett, Professor of
Orthopaedic Trauma Surgery,
is now also National Director
for Acute Episodes of Care,
NHS Commissioning Board.
This is a challenging post that
covers clinical leadership for
the commissioning of all acute
care in the NHS in England. In
Effectiveness of
Keith Willett
5 ,
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Julie Wright
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Extension Update
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Major Trauma
Outcomes
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AIM
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Update of
Studies
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Forthcoming
Meetings
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Sallie Lamb, Professor of
Rehabilitation and Chair of
the NIHR Health Technology
Assessment Commissioning
Board has been part of two
successful bids to set up
research units in Oxford.
The Oxford Clinical Trials
Research Unit (OCTRU) will
provide leadership and coordinate work across five
existing trials groups. The
aim is to develop clinical trials
methodology and produce high
quality trials.
The Surgical Intervention Trials
Unit (SITU) will provide a
centre for surgical trialists in
the UK. The aim is to draw
upon existing expertise in
Oxford to develop the design
and management of surgical
trials.
Professor Sallie Lamb
Julie Wright - Nurse Consultant
We are delighted to
announce that Julie Wright
has been appointed as a
Nurse Consultant for
Trauma care. This is the first
Trauma Nurse Consultant
post in the UK. This post will
build on existing services to
ensure integration of
evidence into practice and
the maintenance of high
standards of nursing care. In
her presentation for the post
Julie described the core
factors that facilitate
compassionate caring. These
were: the strength of the
evidence, clinical skill,
expertise, the culture of
care, and emotional labour.
Julie’s post will enhance the
work of the Trauma Unit
which is now a Major
Trauma Centre and takes
patients from across the
region.
Debbie Langstaff, Matron and Julie
Wright, Nurse Consultant
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Extension Update
The new extension to the
Kadoorie centre has now been
completed and staff have
moved into the new office
space. The new area has space
for 21 staff, a meeting room
and staff room. There are still
many aspects to sort out but
staff are very pleased with their
new working environment.
We would like to thank the
estates department and the
contractors for all their efforts
and everyone for their tolerance
throughout the building work.
Major Trauma Outcomes
MaTOMS is a Feasibility study into
collecting major trauma outcomes.
Measuring outcomes of care is an
important aspect of monitoring
patient care that may help to
identify where services are most
needed. However practically
obtaining outcome data that is
worthwhile and acceptable to
people who use the service is
often not easy. A review of
outcomes measures for major
trauma and a national workshop of
key stakeholders has identified a
range of outcome measures that
might be suitable for patients who
have major trauma.
This Study aims to gather outcome
data from adults and children, on
discharge, at 6 months and at 1
year. In addition process data will
identify the challenges and degree of
acceptability of gathering outcome
data from this group of patients. It
is anticipated that follow up could
be difficult as patients may come
from anywhere across the country.
A qualitative sub-study will interview
a group of patients at 6 months to
explore their experience of major
trauma and outcomes that are
important to them. The study will
start in February 2013.
Contact: Susanna Symonds
AIM: Update
AIM Trial patient
recruitment ahead of
target!
Across 20 sites collaborating in
the AIM Trial, we are above
target at 378 patients recruited
(target to end January 357)!
Injury Management study for 31
months, with 25 patients to date.
This is a recruitment rate of 0.81
which is right on target!
Fantastic achievement, well
done to all the trauma
teams!
This is the final year of
recruitment for the trial, which
ends on the 31st December 2013;
11 months to go! While our
gratitude goes to all who have
contributed thus far, we ask
that this fantastic effort is
maintained through the
coming months to ensure the
overall target of 525 patients is
achieved. Thank you!
The John Radcliffe Hospital has
been recruiting to the Ankle
Having more surgeons trained in
the delivery of the Close
Contact Casting (the
intervention), allows for more
cover should an appropriate
patient present. If you are a
trauma surgeon who would
like to deliver the study
intervention in theatre, please
contact David Keene in the AIM
Trial office, details below.
The study is holding an event day
‘NIHR Musculoskeletal Trials
Day’ on 8th March 2013 in
Birmingham. This is a joint
meeting with the Warwick trials
group. If you would like to know
more, please contact the trial
office.
AIM Trial Office: Tel: 01865
740328 or
aim.trial@ndorms.ox.ac.uk
Lesley Morgan, AIM Trial Manager
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Update of Studies
Closed Studies
DRAFFT (Distal Radius Acute
Fracture Fixation Trial): This
study closed to recruitment in
June 2012 and has a 1 year follow
up period.
ICUROS (International Costs
and Utilities Related to
Osteoporotic Fractures Study).
This study closed to recruitment
in Oct 2012 and has an 18 month
follow up period.
Open Studies
FRACTT (Functional Recovery
After Pertrochanteric Fracture
Treated with Parathyroid
Hormone (PTH)): The purpose
of the study is to find out if 6
weeks of daily injections of PTH
will improve recovery after a
broken hip, compared to
standard osteoporosis treatment.
OVIVA
A randomized open label study of
intravenous versus oral antibiotic
therapy for serious bone and
joint infections requiring
prolonged antibiotic treatment.
WOLLF:-Wound management of
Open Lower Limb Fractures. A
randomised controlled trial
investigating the value of the
negative-pressure wound therapy in
patients with an open fracture of
the lower limb.
SAFER:-Supports for Ankle
Fractures in Early Rehabilitation
The effects of different ankle
supports after surgery for ankle
fracture in adults.
PRO-Hip Patient reported
outcomes following traumatic hip
fracture. The study aims to
identify important outcomes of
relevance to traumatic hip fracture
and its treatment through patient
interview and focus groups
WaLLTR:-Wales Lower Limb
Trauma Recovery Scale. This
study is part of a larger
observational assessment of
surgical and functional outcomes
in patients who have sustained
major lower limb fractures.
Studies In Set Up
FAB:-Fractures And
Bisphosphonates. A double blind
randomised controlled trial on the
effect of alendronic acid on healing
and clinical outcomes of wrist
fractures
For staff, further information about
these and other studies is on the
intranet: http://orh.oxnet.nhs.uk
(Trauma Unit—Research)
Fracture Free Study
The aim of the study is to
determine the proportion of
participants who have re-fractured
by 24 months.
Forthcoming Meetings
Injuries and Emergencies
Speciality Group (IESG) is
part of the Thames Valley
Comprehensive Local Research
Network (TVCLRN). This a
multidisciplinary meeting for the
discussion of new research
ideas, current research, and
network development.
Chairman: Mr Andrew
MacAndrew.
Next meeting:
Friday 12th April @ 13.30 (lunch
& 12.30) at the Kadoorie
Centre, Oxford.
Following Meeting:
Friday 12th July @ 13.30
Wexham Park Hospital
Trauma Orthopaedic
Research Collaboration
(TORC): This is a national
meeting attended by a mixture of
Trauma, Ortho-geriatric and
Bone & Metabolic Health
specialists and multidisciplinary
staff. It is essential for discussing
potential innovative ideas which
could develop into a research
study.
Chairman: Tim Chesser
Next Meeting:
Friday10th May 2013 @ 11.00 at
the Kadoorie Centre, Oxford
Contact: Louise Spoors
Trauma User Group (TUG):
This is a joint meeting between
clinical and research staff, and
service users such as past patients,
relatives and others who have an
interest in helping to shape
existing and future research
studies. New members are always
welcome. Light refreshments will
be served.
Next Meeting:
Tuesday 8th October 2013 from 6
-8pm at the Kadoorie Centre,
Level 3, John Radcliffe Hospital.
If you are interested in
becoming a member or for
more information please
contact Vivienne Fairclough
or Susanna Symonds
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Kadoorie Centre
for Critical Care Research and Education
Contacts:
Level 3
John Radcliffe Hospital
Chris Bouse
Oxford
Susan Nixey
Phone: 01865 223101/223103
Fax:
01865 223102
OX3 9DU
s.lamb@warwick.ac.uk
louise.spoors@ouh.nhs.uk
sally.lambert@ouh.nhs.uk
susanna.symonds@ouh.nhs.uk
josephalsousou@doctors.org.uk
debbie.langstaff@ouh.nhs.uk
liz.tutton@ouh.nhs.uk
chris.bouse@ouh.nhs.uk
lesley.morgan@ndorms.ox.ac.uk
keith.willett@ndorms.ox.ac.uk
vivienne.fairclough@ouh.nhs.uk
susan.nixey@ouh.nhs.uk
julie.wright@ouh.nhs.uk
lynn.hutchings@ndorms.ox.ac.uk
elizabeth.oastler@ouh.nhs.uk
david.keene@ndorms.ox.ac.uk
emma.roberts@ndorms.ox.ac.uk
Email addresses
linda.andrews@ouh.nhs.uk
www.kadooriecriticalc
are.org.uk
home.oxnet.nhs.uk/
OxfordTraumaUnit
www.crncc.nihr.ac.uk/
about_us/ccrn
Selected recent references
Kearney, R. Acten, J. Lamb,
S. Parsons, N, Costa, M.
(2012) 'The Achilles tendon
total rupture score : a study of
responsiveness, internal
consistency and convergent
validity on patients with acute
Achilles tendon ruptures.' Health
and Quality of Life Outcomes 10
(1) p. 24.
Lall R, Mistry D, Bridle C,
Lamb SE (2012) ‘Telephone
interviews can be used to
collect follow-up data
subsequent to no response to
postal questionnaires in clinical
trials.' Journal Of Clinical
Epidemiology 65 (1), 90 - 99.
Lamb S, Mistry D, Lall R,
Hansen Z, Evans D, Withers EJ,
Underwood, M. (2012) 'Group
cognitive behavioural intervention
for low back pain in primary care.
Extended follow-up of the Back
Skills Training Trial
(ISRCTN54717854).' Pain (Online
Edition) 153 494 - 501.
Adams, J. Bridle, C. Dosanjh,
S. Heine, P. Lamb, S. Lord, J.
McConkey, C, Nichols, V.
Toye, F. Underwood, M,
Williams, M. Williamson, E.
(2012) 'Strengthening and
stretching for rheumatoid arthritis
of the hand (SARAH): design of a
randomised controlled trial of a
hand and upper limb exercise
intervention - ISRCTN89936343
BMC Musculoskeletal Disorders
13 (1), 230.
Roberts, I. Perel, P. PrietoMerino, D. Shakur, H.
Coats, T. Hunt, B. J. Brohi,
K. Willett, K. (2012). Effect of
tranexamic acid on mortality in
patients with traumatic bleeding:
pre-specified analysis of data
from randomised controlled
trial. B Med J, 345. doi:10.1136/
bmj.e5839
Shokoohi, A. Stanworth, S.
Mistry, D. Lamb, S. Staves,
J. Murphy, M. The Risks Of
Red Cell Transfusion For Hip
Fracture Surgery In The Elderly
Vox Sang. 2012 Oct; 3(103): 223
-230. doi: 10.1111/j.14230410.2012.01606.x
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