[x_section parallax=”true” bg_image=”https://reconstructivesurgerytrials.net/wp-content/uploads/2016/02/K-wire-hand-1.png” bg_color=”” style=”margin: 0px 0px 0px 0px; padding: 45px 0px 45px 0px; “][x_row inner_container=”true” marginless_columns=”false” bg_color=”” style=”margin: 0px auto 0px auto; padding: 0px 0px 0px 0px; “][x_column bg_color=”” type=”1/1″ style=”padding: 0px 0px 0px 0px; “][x_gap size=”150px”][/x_column][/x_row][/x_section][x_section style=”margin: 0px 0px 0px 0px; padding: 0px 0px 0px 0px; “][x_row inner_container=”true” marginless_columns=”false” bg_color=”” style=”margin: 0px auto 0px auto; padding: 0px 0px 0px 0px; “][x_column bg_color=”#ffffff” type=”2/3″ class=”left-text ” style=”padding: 0px 0px 0px 0px; “][x_gap size=”20px”][x_custom_headline level=”h2″ looks_like=”h3″ accent=”false”]WIRE[/x_custom_headline][x_gap size=”20px”][x_custom_headline level=”h2″ looks_like=”h3″ accent=”false”]Update[/x_custom_headline][x_feature_list][x_feature_box title=”01-10-2019″ title_color=”” text=”The WIRE Service Evaluation has now closed to new units and finished recruiting patients. A big thank you to all of those who have contributed. The follow phase will continue until the end of 2019.” text_color=”” graphic=”icon” graphic_size=”40px” graphic_shape=”circle” graphic_color=”#ffffff” graphic_bg_color=”#b1005d” align_h=”left” align_v=”top” side_graphic_spacing=”20px” max_width=”none” child=”true” connector_width=”1px” connector_style=”dashed” connector_color=”#272727″ graphic_icon=”line-chart”][/x_feature_list][x_text]

Background

Kirschner wires are commonly used for hand fracture fixation. There is clinical uncertainty as to whether the wires should be buried beneath the skin or left exposed.

Proposed advantages of buried wires include a reduced risk of infection and early wire removal. However, their removal can be associated with the inconvenience and financial implications of further surgery.

Question

The WIRE Trial aims to answer the question:

Should Kirschner wires be buried or left exposed after hand fracture fixation in adults?

Project outline

  1. Systematic review (completed and published in JPRAS)
  2. National clinical practice and patient surveys (published in PRS GO)
  3. National service evaluation of patients undergoing K wire fixation of hand fractures (ongoing)
  4. Application to NIHR RfPB (estimated November 2019)
  5. WIRE RCT (dependent on funding, 2020)

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How can I get involved?

The WIRE Service Evaluation is now closed to new collaborators. Please get in touch at wiretrial@gmail.com if you have any queries.

Responsibilities of a collaborator to be PubMed cited
  • Gain support from your department (e.g. consultant body and hand therapists)
  • Register WIRE-SE (service evaluation) with your NHS Trust
  • Collect data on 10 consecutive patients and follow up data at 3 months
  • Upload anonymised information to REDCap database (5% or lower missing data rate)

Contributing data with a high missing data rate will result in an acknowledgement and certificate rather than PubMed citation.

Benefits

  • Certificate of involvement will be provided on completion of the project.
  • Pubmed citation on any subsequent publication directly related to these data.
  • Cited as a collaborator on any presentation relating to these data and RSTN website.
  • Option to present local data separately (i.e. local or regional meeting).

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Hand surgery units involved

[/x_text][x_map no_container=”false”][/x_map][/x_column][x_column bg_color=”” type=”1/3″ style=”padding: 0px 0px 0px 0px; “][x_gap size=”20px”][x_image type=”none” src=”https://reconstructivesurgerytrials.net/wp-content/uploads/2016/02/WIRE-Logo-slider.png” alt=”” link=”false” href=”#” title=”” target=”” info=”none” info_place=”top” info_trigger=”hover” info_content=””][x_accordion][x_accordion_item title=”Status” open=”true”][icon_list] [icon_list_item type=”check-square-o”]Systematic review published [/icon_list_item][icon_list] [icon_list_item type=”check-square-o”]Clinician survey published [/icon_list_item][icon_list_item type=”square”]National service evaluation [/icon_list_item] [icon_list_item type=”square”]Protocol development[/icon_list_item][icon_list_item type=”square”]PPI for definitive trial [/icon_list_item][icon_list_item type=”square”]NIHR RfPB application [/icon_list_item][icon_list_item type=”square-o”]WIRE RCT[/icon_list_item] [/icon_list] [/x_accordion_item][x_accordion_item title=”Steering group” open=”false”]Sonya Gardiner
Specialty Registrar in Plastic Surgery, London

Hawys Lloyd Hughes
Specialty Registrar in Plastic Surgery, London

Justin Wormald
Specialty Registrar in Plastic Surgery, Oxford
NIHR Academic Clinical Fellow, Oxford

Fadi Issa
Clinical Lecturer in Plastic Surgery, Oxford

Theodore Pezas
Specialty Registrar in Plastic Surgery, West Midlands

Abhilash Jain
Associate Professor in Plastic Surgery, Oxford

Jeremy Rodrigues
Specialty Registrar in Plastic Surgery, Oxford
NIHR Postdoctoral Fellow, Oxford

Matthew D. Gardiner
ATP Hand Fellow, Oxford
Hon Departmental Clinical Lecturer, Oxford[/x_accordion_item][x_accordion_item title=”Collaborators” open=”false”]The WIRE Collaborative (WIRE Surveys) (PubMed cited)
WIRE Local investigators (in alphabetical order) comprises: Frank Acquaah, Neil Brierley, Shixin Bickerton, Whitney Chow, Juliet Clutton, Samuel Coulson, Pat Crowley, Sarah Jayne Edmondson, Andy Fowler, Michael Gallagher, Sophie Howles, Jonathan Jones, Lubna Khan, Dharini Kulendran, Clare Langley, Robert Manton, Mohamed Mohamed, Lisa Ng, Andrej Salibi, Gujral Sameer, Nic Segaren, Kavita Sharma, Andreas Shiatis, Kathryn Steele, Camilla Jay-Stewart, Cindy Suwito, Amy Tam, Arron Thind, Ryckie Wade, Natasha Wielogorska, Katie Young.[/x_accordion_item][x_accordion_item title=”Trials Unit” open=”false”]SITU, Oxford[/x_accordion_item][x_accordion_item title=”Funding” open=”false”]BAPRAS Clinical Trials Pump Priming Award (£20K)[/x_accordion_item][x_accordion_item title=”Downloads” open=”true”]Letter of invitation to WIRE SE Final

WIRE SE collaborator information Final

WIRE SE collaborator presentation Final

WIRE SE Database Final

WIRE SE Patient List
[/x_accordion_item][x_accordion_item title=”Publications” open=”false”]WIRE Collaborative. Buried versus exposed Kirschner wires following fixation of metacarpal and phalangeal fractures: a national clinician and patient survey. Plast Reconstruc Surg Global Open 2018. Accepted in press.

 

Wormald et al. A systematic review of the influence of burying or not burying Kirschner wires on infection rates following fixation of upper extremity fractures. JPRAS 2017; 70(9), 1298–1301.[/x_accordion_item][x_accordion_item title=”Contact” open=”true”]wiretrial@gmail.com[/x_accordion_item][/x_accordion][/x_column][/x_row][/x_section]