{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T08:19:04Z","timestamp":1770970744061,"version":"3.50.1"},"reference-count":25,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T00:00:00Z","timestamp":1770681600000},"content-version":"unspecified","delay-in-days":9,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"NIHR","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"crossref","award":["NIHR207935"],"award-info":[{"award-number":["NIHR207935"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,1,20]]},"published-print":{"date-parts":[[2026,2]]},"abstract":"\n Introduction<\/jats:title>\n Poor access to surgical wound swabbing in the community often results in delayed or inappropriate antibiotic prescribing for surgical site infections. This delay can contribute to prolonged wound healing and poor antimicrobial stewardship. Patient self-swabbing at home could improve access to diagnostic testing, but its feasibility and acceptability remain unexplored.<\/jats:p>\n <\/jats:sec>\n \n Methods and analysis<\/jats:title>\n TREASURE is a multicentre, mixed-methods feasibility study. A total of 40 patient participants and 10 staff stakeholders will be included. 40 adult patients undergoing cardiac surgery via median sternotomy will be recruited from Harefield Hospital (n=25) and the Royal Sussex County Hospital (n=15). Eligible participants will receive a coproduced self-swabbing set of instructions and kit at discharge and perform wound swabbing at home within 1\u201321 days, observed remotely by a researcher via Microsoft Teams. Swabs will be couriered to a central laboratory for bacterial culture with antimicrobial susceptibility testing for pathogens.<\/jats:p>\n The primary feasibility outcome is the proportion of patients successfully completing self-swabbing at home to obtain usable culture swabs with samples received at the laboratory within 24 hours and deemed suitable for processing. Secondary safety and acceptability outcomes include usability of the kit and instructions; patient satisfaction; viability of samples for laboratory analysis; and recruitment and retention rates. A 30-day follow-up will capture wound complications, antibiotic prescribing and healthcare utilisation via patient questionnaires, case note review, general practitioner confirmation and patient interviews. 10 staff stakeholders will be interviewed to inform pathway development.<\/jats:p>\n Quantitative data will be analysed descriptively, with proportions reported alongside 95% CIs. Qualitative data from patients will undergo thematic analysis, and stakeholder interviews will be coded using Normalisation Process Theory. An early health economic model will be developed to explore resource use, costs and proportions of appropriate and timely antibiotic use between current pathways and a proposed pathway, including self-swabbing.<\/jats:p>\n <\/jats:sec>\n \n Ethics and dissemination<\/jats:title>\n West of Scotland Research Ethics Service has reviewed and approved the study (REC reference: 25\/WS\/0079). Findings will be disseminated through the study website, a webinar, peer-reviewed publications, conference presentations, patient and public involvement-led activities and engagement with National Health Service (NHS) stakeholders.<\/jats:p>\n <\/jats:sec>\n \n Trial registration numbers<\/jats:title>\n \n NCT07200401<\/jats:ext-link>\n ,\n ISRCTN28466609<\/jats:ext-link>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-112691","type":"journal-article","created":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T15:28:28Z","timestamp":1770737308000},"page":"e112691","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Is home-based self-swabbing feasible for postoperative wound culture after cardiac surgery? A multicentre mixed-methods feasibility study in the UK"],"prefix":"10.1136","volume":"16","clinical-trial-number":[{"clinical-trial-number":"nct07200401","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"isrctn28466609","registry":"10.18810\/isrctn"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1101-2256","authenticated-orcid":false,"given":"Melissa","family":"Rochon","sequence":"first","affiliation":[{"name":"Directorate of Infection, Guy's and St Thomas\u2019 NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0023-3149","authenticated-orcid":false,"given":"Judith","family":"Tanner","sequence":"additional","affiliation":[{"name":"School of Health Sciences, University of Nottingham, Nottingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5525-2362","authenticated-orcid":false,"given":"Karen","family":"Cariaga","sequence":"additional","affiliation":[{"name":"Directorate of Infection, Guy's and St Thomas\u2019 NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roy","family":"Harris","sequence":"additional","affiliation":[{"name":"Research Support Services (Leicester Hub), University of Nottingham, Nottingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1288-1293","authenticated-orcid":false,"given":"Keith","family":"Wilson","sequence":"additional","affiliation":[{"name":"Research Department (ICECAP), Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chris","family":"Newby","sequence":"additional","affiliation":[{"name":"Research Support Services (Leicester Hub), University of Nottingham, Nottingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kumbi","family":"Kariwo","sequence":"additional","affiliation":[{"name":"Equality Inclusion and Diversity, Birmingham Community Healthcare NHS Foundation Trust, Aston, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1083-4570","authenticated-orcid":false,"given":"Luciana","family":"Sowole","sequence":"additional","affiliation":[{"name":"Directorate of Infection, Guy's and St Thomas\u2019 Hospitals NHS Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6098-6903","authenticated-orcid":false,"given":"Sarah J","family":"Bolton","sequence":"additional","affiliation":[{"name":"CHEATA, Nottingham University Hospitals NHS Trust, Nottingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4568-5483","authenticated-orcid":false,"given":"Janet","family":"Bouttell","sequence":"additional","affiliation":[{"name":"CHEATA, Nottingham University Hospitals NHS Trust, Nottingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3467-0397","authenticated-orcid":false,"given":"Ishtiaq","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department Cardiac Surgery, University Hospitals Sussex NHS Foundation Trust, Worthing, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,2,10]]},"reference":[{"key":"2026021223254430000_16.2.e112691.1","doi-asserted-by":"crossref","unstructured":"Han SM , Greenfield G , Majeed A , et al . Impact of Remote Consultations on Antibiotic Prescribing in Primary Health Care: Systematic Review. J Med Internet Res 2020;22. doi:10.2196\/23482","DOI":"10.2196\/preprints.23482"},{"key":"2026021223254430000_16.2.e112691.2","unstructured":"Sandy-Hodgetts K , Leung E , Andrews E , et al . Surgical wound dehiscence (SWD): International consensus statement on assessment, diagnosis and management. London: Wounds UK, 2023."},{"key":"2026021223254430000_16.2.e112691.3","doi-asserted-by":"crossref","unstructured":"Guest JF , Fuller GW , Griffiths B . Cohort study to characterise surgical site infections after open surgery in the UK\u2019s National Health Service. BMJ Open 2023;13. doi:10.1136\/bmjopen-2023-076735","DOI":"10.1136\/bmjopen-2023-076735"},{"key":"2026021223254430000_16.2.e112691.4","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1089\/sur.2015.241","article-title":"Proportion of Surgical Site Infections Occurring after Hospital Discharge: A Systematic Review","volume":"17","author":"Woelber","year":"2016","journal-title":"Surg Infect (Larchmt)"},{"key":"2026021223254430000_16.2.e112691.5","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.12968\/jowc.2025.34.Sup4b.S1","article-title":"Remote digital surgical wound monitoring and surveillance using smartphones","volume":"34","author":"Rochon","year":"2025","journal-title":"J Wound Care"},{"key":"2026021223254430000_16.2.e112691.6","doi-asserted-by":"crossref","first-page":"959","DOI":"10.12968\/bjon.2003.12.16.11437","article-title":"Infection control: validity and reliability in wound swabbing","volume":"12","author":"Kelly","year":"2003","journal-title":"Br J Nurs"},{"key":"2026021223254430000_16.2.e112691.7","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.14.2.244-269.2001"},{"key":"2026021223254430000_16.2.e112691.8","unstructured":"How long are patients waiting for a GP appointment in England?. Nuffield Trust; 2024."},{"key":"2026021223254430000_16.2.e112691.9","unstructured":"James Lind Alliance Top 10 priorities for research. Available: https:\/\/www.jla.nihr.ac.uk\/priority-setting-partnerships\/healthcare-associated-infections\/top-10-priorities.htm [Accessed 27 Feb 2024]."},{"key":"2026021223254430000_16.2.e112691.10","unstructured":"Rochon M , Cariaga K , Sa F , et al . The unrecognised burden of post-discharge antibiotic consumpton for surgical wounds. The 37th EACTS Annual Meeting 4-7, October; Vienna, Austria, 2023"},{"key":"2026021223254430000_16.2.e112691.11","unstructured":"National Wound Care Strategy Programme . Recommendations for preventing and managing surgical wound complications. 2024."},{"key":"2026021223254430000_16.2.e112691.12","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.jhin.2012.07.025","article-title":"Patient narratives of surgical site infection: implications for practice","volume":"83","author":"Tanner","year":"2013","journal-title":"J Hosp Infect"},{"key":"2026021223254430000_16.2.e112691.13","doi-asserted-by":"crossref","unstructured":"Guest JF , Fuller GW , Vowden P . Cohort study evaluating the burden of wounds to the UK\u2019s National Health Service in 2017\/2018: update from 2012\/2013. BMJ Open 2020;10. doi:10.1136\/bmjopen-2020-045253","DOI":"10.1136\/bmjopen-2020-045253"},{"key":"2026021223254430000_16.2.e112691.14","unstructured":"Briggs T . A national review of adult elective orthopaedic services in England. Getting It Right First Time, 2015."},{"key":"2026021223254430000_16.2.e112691.15","unstructured":"Research reveals levels of inappropriate prescriptions in England. Available: www.gov.uk [Accessed 7 Jul 2024]."},{"key":"2026021223254430000_16.2.e112691.16","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)02724-0\/ATTACHMENT\/4504FC2B-08AE-46D6-BD75-80811DF8B5E6\/MMC1.PDF"},{"key":"2026021223254430000_16.2.e112691.17","unstructured":"World Health Organization . Global antimicrobial resistance forum launched to help tackle common threat to planetary health. 2023. Available: https:\/\/www.who.int\/news-room\/articles-detail\/global-antimicrobial-resistance-forum-launched-to-help-tackle-common-threat-to-planetary-health [Accessed 27 Feb 2024]."},{"key":"2026021223254430000_16.2.e112691.18","unstructured":"NHS England . The NHS long term plan. 2019."},{"key":"2026021223254430000_16.2.e112691.19","unstructured":"NHS England . Delivering a net zero national health service. Greener NHS\u202f\u00bb Delivering a \u2018Net Zero\u2019 National Health Service."},{"key":"2026021223254430000_16.2.e112691.20","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-024-04866-z"},{"key":"2026021223254430000_16.2.e112691.21","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-025-03668-w"},{"key":"2026021223254430000_16.2.e112691.22","unstructured":"National Adult Cardiac Surgery Audit (NACSA) . 2025 annual report. 2023\/24 and 2021\/24 data. 2025. Available: https:\/\/www.nicor.org.uk\/national-cardiac-audit-programme\/cardiac-surgery-audit-nacsa [Accessed 10 Oct 2025]."},{"key":"2026021223254430000_16.2.e112691.23","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"2026021223254430000_16.2.e112691.24","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2296-8-42","article-title":"Process evaluation for complex interventions in primary care: understanding trials using the normalization process model","volume":"8","author":"May","year":"2007","journal-title":"BMC Fam Pract"},{"key":"2026021223254430000_16.2.e112691.25","unstructured":"Rochon M , Jawarchan A , Ingusan SD , et al . Project ID007672: clinical audit of patient-reported antibiotics for wound problems following surgery and review of alternative strategies. Guy\u2019s and St Thomas NHS Foundation Trust; 2023."}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2025-112691","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T07:26:09Z","timestamp":1770967569000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2025-112691"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2]]},"references-count":25,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2,10]]},"published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1136\/bmjopen-2025-112691"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2025-112691","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2]]}}}