Plastic & Burns clinical studies taking place at North Bristol NHS Trust

To discover more clinical trials that are taking place, visit the UK Clinical Trials Gateway. You can search by a particular health condition, trial or drug name. 

R&D No	Project Title	Project Description	Department
3837	Ex-vivo Infection Detection - EVIDEnT	Ex-Vivo study to investigate the sensitivity and specificity of a smart dressing to detect clinically relevant wound infection	Plastics and Burns surgery
3860	The OSCAR study - Patient outcomes for scar management therapy	What outcomes matter to adult burns patients that have experienced scar management therapy? (The OSCAR study)	Plastics and Burns surgery

 

General Stationery Templates

 

 

 

 

 

 

 

Policy Documents

 

 

 

 

 

Terms of Reference

 

 

 

 

Dietary Support

Change for Life www.nhs.uk/Change4Life/Pages/change-for-life

The British Dietetic Association – Food Facts www.bda.uk.com/foodfacts/home

Diabetes UK www.diabetes.org.uk/Guide-to-diabetes/Managing-your-diabetes/Healthy-eating

British Heart Foundation www.bhf.org.uk/heart-health/preventing-heart-disease/healthy-eating

Talking Therapies

Bristol Wellbeing https://iapt-bristol.awp.nhs.uk

Gloucestershire Talking Therapies https://iapt-sglos.awp.nhs.uk

Somerset Positive Step http://positivestep.org.uk

Wiltshire Psychological Support https://iapt-wilts.awp.nhs.uk

Specialist Eating Disorder Service www.awp.nhs.uk/services/specialist/steps

 

 

 

Our three Trust Objectives are:

• Deliver Great Care – this includes developing our clinical strategy and working as part of an acute provider collaborative with University Hospitals Bristol and Weston NHS Foundation Trust (UHBW) to tackle our acute provider priorities. It also includes addressing national priorities around the planned care backlog and improved performance in the Emergency Zone.
• Develop Healthcare for the Future – this includes investment in leadership development and training schemes as well as growing our research portfolio.
• Be an Anchor in our Community – this involves mapping and defining our relationships with partner organisations in order to identify opportunities to tackle both health inequalities and unemployment. It also focuses on contributing to public health initiatives and sustainability.

Find out more about our Trust Strategy here.

Following your breast surgery it is important to continue to keep the micropore tape over your scars for up to 6 weeks. The pressure of the micropore tape over your scars helps to reduce tension on the healing wound which helps reduce the risk of developing problematic scarring and improves surgical scars healing.

The tape will need to be removed once a week and new tape reapplied. You can shower with the tape on, use a hairdryer on a low heat settling to dry afterwards.  If the tape comes away from the skin reapply tape. 

Do not remove the tape daily as this will cause you to lose the top layers of skins cells which will hinder the healing process.

After 6 weeks you may start moisturising and massaging your surgical scars with a non-perfumed moisturiser, which helps soften and hydrate your scar tissue.

Your breast and abdominal scars may remain pink and change colour with different temperatures e.g. when you are hot they will appear red and when you are cold they will look purple. This is normal and will gradually fade over time. If your scar starts to become firm, red, raised and itchy, this may be the start of Hypertrophic scarring which may develop in healed skin within the first three months after surgery.

How your scars will heal will be determined by many different factors e.g. poor diet, infection, healing time, your past history of radiotherapy and chemotherapy and your genetic tendency to scar.

Non-surgical treatment can be used to help with the texture and colour these include moisturising and massage, silicone creams, silicone dressing and pressure garments. It is important to remember that scarring can take up to two years to fully settle and some people will need treatment for this length of time.

Scarring should also be protected from sun exposure unit the scar has fully matured (become pale and inactive) this is around 2 years.

If your scarring is giving you concerns please contact the breast reconstruction nurse for advice. You may need and benefit from treatment at our Scar Management Team at Southmead Hospital.

Abdominal Scar

Some patients decide to disguise their abdominal scar by having a tattoo. If you are considering this option you need to ensure that the scar is completely healed. The healing process takes up to 18 months to heal, therefore tattooing must not be undertaken before this time. Tattooing won’t change the texture and it won’t erase the scar.

If you do decide to get a tattoo, make sure that the tattooist is experienced and has done tattoo art for people with similar scars in the past. Ensure that you ask to see photos of their work covering up the scars before booking up your tattoo. It is important to note that the scar may not take the ink, therefore, find out if the price of the tattoo covers all subsequent visits.

Camouflage Clinic

Camouflage creams can be applied to conceal or reduce the noticeability scars. The creams and powders are available in a wide range of shades, which are matched to your skin tone. The products have been clinically tested for skin sensitivity. They are not the same as ordinary cosmetics. They are lightweight but have a far greater covering quality and stay in place for much longer. On the body creams can be safely left in place for 2-3 days. The cream is fully waterproof, so you can swim with it in place.

For an NHS appointment (for example for scarring) you will need to be referred to the camouflage clinic by your GP or hospital consultant or nurse. 

Find out more about the camouflage clinic.

• Position: Lie on your back, knees bent feet on floor, arms by your side.
• Action: Tighten your stomach muscles, press the small of your back against the floor, hold for 5 seconds, let go.
• Breathe out whilst tightening and breathe in as you relax.

 

• Position: Lie on your back, knees bent feet on floor, hands resting on your thighs.
• Action: Flatten your back, your neck, tighten your tummy muscles, curl your head forwards as you slide your hands towards your knees.
• Breathe out whilst tightening and breathe in as you relax.

 

• Position: Lie on your back, knees bent feet on floor, arms across your chest.
• Action: Tighten your stomach muscles, flatten your back, your neck and lift your head and shoulders off the floor.

 

• Lie on your back, fingers just behind your ears, elbows out.
• Tighten your stomach muscles and lift to 30 degrees.
• Breathe out whilst sitting up, breathe in and relax on the way back down.

 

• Sit on a stool or fit-ball with wall behind.
• Cross your arms put your hands on your shoulders.
• Lean your upper body backwards.
• Return to upright after your shoulders touch the wall.

 

• Lie on your back arms by side, knees bent, feet on floor a shoulder width apart.
• Action: Squeeze your bottom muscles and then lift your bottom up off the floor, hold for 3-5 seconds, slowly lower and relax.
• Lie on your front, prop yourself up by your elbows, hold position for 30 seconds.

 

• Check that your posture is returning to normal, from stooped to upright.
• Check that your shoulder movements are returning to pre-op’ range of motion.
• Recover the tone and strength in your tummy muscles.
• Abdominal muscle strength helps to keep your back healthy.
• Tummy muscles can be ‘switched off’ by pain.

Good Posture – Stand Tall
Imagine a piece of string Is attached to the crown of your head and is lifting you up.

Good Posture – Sit tall, avoid slumping or overstretching

Shoulder Movements

• Sideways and up
• Forwards and up  
• Behind your neck
• Behind your back
• Across to your  opposite shoulder

1. Switch on Your Tummy Muscles

• Lie on your back, hands on tummy, knees bent, feet resting on floor, legs hip width apart.
• ‘Long’ neck and back but keep the natural curve in your low back.
• Breathe in slowly and deeply.
• Breathing out, let your tummy button sink towards your spine without flattening or changing the position of your low back.
• Gently tighten your muscles below your tummy button, hold the tension for five seconds and continue breathing.
• Aim for 5-10 of these contractions several times a day.
• Concentrate on contracting the muscles below your belly button during each breath out.

2. Tummy Toning Exercises

• Lie on your back, knees bent, feet on floor, arms by your side.
•  Tighten your tummy muscles as in exercise1.
•  Press the small of your back against the floor.
•  Hold the position for 5 seconds, let go.

3. Heel slide

• Lie on the floor with knees bent, arms by your sides.
• Hold your tummy in, as in exercise 1.
• Keep one leg stationary.
• Slowly slide the opposite leg out until it’s straight with the floor.
• Slide it back in to the starting position.
• Alternate, extending the other leg out and then back. 
• Keep the natural curve of your spine without flattening your back.
• Contracting your abdominal muscles helps to keep your pelvis still whilst your leg moves and your lower tummy muscles work.
• This helps train your tummy muscles to support your spine.

4. Single leg extension

• Lie on the floor with knees bent and arms at your sides.
• Tighten your tummy in as in exercise 1.
• Raise one leg to ‘table top’ position (knees bent in line with hip, shin parallel to the floor).
• Slowly stretch the lifted leg out without arching your back.
• Return your leg to table top position.
• Bring your foot back down to the starting position.
• Switch sides.
• Progress with this until you can extend the leg out and hover it about 2-3 inches above the floor
• Work up to five repetitions on each side without stopping.
• Build to 20 "hovering" repetitions or more on each side without allowing your back or spine to move.

5. Heel Taps

• Lie on the floor, tighten your tummy muscles as in exercise 1. and bring your legs up one at a time to ‘table top’ position 
  (knees bent and over hips, shins parallel to floor).
• Keep one leg stationary, slowly lower other foot down to the floor (keeping knee bent) and back up to table top.
• Keep your low back and spine still throughout.
• Repeat on the opposite side.

6. Knee Rolling

• On your back, knees bent, feet on the floor.
• Roll your knees down to on one side, followed by your pelvis, keep your shoulders on the floor if possible.
• Take a deep breath in and out to stretch, return to the starting point.
• Alternate 8 to 10 times.  

7. Bridging

• Lie flat on the floor, hands resting by your sides. Feet flat on the floor, shoulder width apart, knees bent.
• Contract your abdominals, low back, glutes and slowly lift from tailbone up to form a straight line from your knees, through your hips to your shoulders.
• Hold this position for a few seconds, then slowly lower. The whole cycle of lift, hold and lower  takes at least ten seconds.

8. Stretch

• Lie on the floor face down. Put your hands at your sides at shoulder level.
• Keep your back relaxed hips on the floor, push shoulders up, to rest on your forearms.
• Exhale when you reach the top, let your mid back sag as you exhale.
• Slowly lower yourself to the starting position.
• Push only to the point of tension, maintain your hips on the floor.
• Don’t push into pain, bounce, or force the movement.
• You should have a gentle curve in your back as you push up,
• No severe curvatures in one location.

These exercises have been developed in partnership with Keeping Abreast.