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Background: Surgical wounds healing by secondary intention (SWHSI) represent a significant burden to patients and services. An understanding of quality of life factors affecting this population is essential to recognise the impact of this wound entity on patients. Understanding of the patient experience is necessary to building effective services and designing high-quality research studies to improve care in this population. Methods: Twelve individuals with lived experience of living with a SWHSI or caring for a person with a SWHSI were recruited to one of two focus groups. Participants were identified from those who had previously been recruited into the NIHR-funded SWHSI-2 trial (NIHR17/42/94; a study assessing healing of surgical wound healing by secondary intention). All participants in this cohort had lower limb SWHSIs and a history of peripheral vascular disease. Sessions followed a general topic guide and were guided by the research team. Sessions were audio-recorded, transcribed and analysed using thematic analysis methods. Results: Four main areas of impact on quality of life were identified: mental health, physical symptoms, lifestyle symptoms and service-based impacts. There was a clear heterogeneity of experience seen within the group, with some reporting a more significant impact than others. This was ascribed to the loss of social and professional functioning, and the subsequent impact on mental health. There was a differential impact of this on younger participants (who tended to be employed and hold caring roles for children or family members) compared to older participants who did not have these social roles to fulfil, and were less affected in these areas. The need for improved preoperative counselling was highlighted, as many participants reported feeling unprepared for the postoperative course. Conclusions: This study considered the experiences of patients with a SWHSI and identified the main areas of impact on quality of life. This work will help to underpin future research into treatments and services for the SWHSI population. It may also form the basis for identifying an appropriate patient-reported outcome measure (PROM) related to quality of life in SWHSI for use in the research setting. Limitations of the study included the number and diversity of participants, and the impact of the SARS-CoV-2 (COVID-19) pandemic on the experiences of participants. Further exploration of the area through formal qualitative study is warranted to understand the breadth, generalisability and possible future applications of the work.

Welcome to the latest issue of the Journal of Vascular Societies Great Britain and Ireland (JVSGBI).

Welcome to the fifth issue of the Journal of Vascular Societies Great Britain and Ireland (JVSGBI). We are really delighted with the success of the journal, and this issue marks the first anniversary of the launch at the Vascular Societies GB&I Annual Scientific meeting last year. The increasing interest in the JVSGBI has been demonstrated by the growing number of submitted articles and the impressive website stats (over 3,000 views). This issue includes three editorials. The first by Andrew Garnham (VSGBI President Elect) and Rachael Forsythe (Rouleaux President) provides a thoughtful reflection on the problem of bullying, undermining and harassment in (vascular) surgical training highlighted as a persistent problem by a Rouleaux Club paper in this edition. The second editorial from Dr Una Adderley, National Wound Care Strategy Programme (NWCSP) Director, outlines past achievements and future plans for the programme. Finally, Duygu Yenidogan-Schmidt, Chair of the Executive Committee of AAA UK, a newly formed patient representative group giving national representation to AAA patients and relatives, highlights the origins, purpose and aims of this group. I am sure these editorials will be of great interest to readers. There are four original research articles, the first from the Rouleaux Club, the UK Vascular Surgery Trainees’ Association, reports the findings from their recent bullying, undermining and harassment survey. The second from the Vascular and Endovascular Research Network (VERN) reports the findings from the Tier 3 COVID-19 Vascular Service (COVER) study. The final two original articles present the findings from the James Lind Alliance Priority Setting Partnership from the Vascular Services and Venous Conditions Groups. It is fantastic to see vascular trainees continuing to undertake meaningful and impactful research and choose the JVSGBI to disseminate their work. This edition also contains a research protocol from Ravindhran et al for a systematic review which aims to study changes in functional health status following open abdominal aortic aneurysm repair. Finally, in this issue there is a short educational report entitled ‘Intraoperative management of REBOA’ and a case report entitled ‘Carotid web: an important cause of stroke in young people’. The National Wound Care Strategy Programme Guidelines for lower limb wounds are published as a supplement to this issue and can be located on the journal website. This is our fifth issue, and we would like to take the opportunity to thank all the authors who have submitted articles during the last year, which is building on the success of the journal – your contribution has been really appreciated and I hope you are delighted with your publication. We would also like to thank all the reviewers for their timely and thorough contributions. Finally, please do continue to share your work by submitting articles for publication.

Welcome to the February issue of the Journal of Vascular Societies Great Britain and Ireland (JVSGBI). We are really pleased with the response to the launch issue, which took place at the Vascular Societies GB&I Annual Scientific Meeting held in December 2021. Attendees from all societies and industry were delighted to see the journal, which is open-access and represents the whole vascular community. On behalf of the Editorial Board I would like to extend my thanks to all authors who have submitted articles. This issue includes two important editorials which present the views of both the trainers and the trainees regarding the recent changes to the Vascular Curriculum. This issue also contains further outcomes from individual Special Interest Groups who worked with the James Lind Alliance and perhaps most importantly vascular patients, to identify research priorities across the sub-specialties of vascular surgery. These priorities, I am sure, will guide vascular research and funding for the foreseeable future. It gives me great personal satisfaction to see this crucial work in print. Thank you for all the hard work. We cannot escape the impact of COVID-19 and this issue contains articles highlighting the impact of the pandemic on vascular surgical training in Scotland and the innovative modifications made to the ASPIRE 7 and 8 courses to enable delivery of these important courses despite heavy COVID associated restrictions. Please remember this journal is for members of all societies involved in the management of vascular patients, and we would encourage submissions from all areas of interest to the vascular community. If you would like to share your work and experience with your fellow society members, and the wider vascular community, please submit your articles to JVSGBI, to ensure we can represent everyone with our content. There is also a supplement to this issue of the journal – Provision of Services for People with Vascular Disease 2021. This update sets out the views of the UK Vascular Societies regarding the provision of high quality, evidence based, patient centred vascular services. We hope your organisation can use POVS 2021 to optimise the care delivered to people with vascular disease across your local vascular network. The UK vascular societies are committed to this aim, as is the Vascular Society charity, the Circulation Foundation. Visit the journal website to access the document. Finally, I hope you enjoy reading this issue of JVSGBI, and please do continue to share your work by submitting articles for publication.

Background and objectives: The aim of this systematic review is to explore the current evidence surrounding the changes in functional status following open or endovascular abdominal aortic aneurysm (AAA) repair and the role of postoperative exercise-based rehabilitation programmes. Methods: The proposed study will incorporate two separate systematic reviews within it, one to assess changes in functional status (component 1) and another to consider the role of exercise-based rehabilitation for improving functional status (component 2), both following AAA repair. The Medline, EMBASE and Cochrane CENTRAL databases will be searched using two separate search strategies including the terms “aortic aneurysm”, “functional capacity”, “functional decline” and” exercise therapy”. We plan to include all prospective randomised and non-randomised trials that have considered the impact of AAA repair on functional status and/or the effect of exercise-based rehabilitation following AAA repair. For component 1, the primary outcome will be changes in objective measures of functional capacity or physical function following AAA repair and, for component 2, it will be changes in physical function or functional capacity following exercise-based rehabilitation after AAA repair. The extracted data will include study characteristics – ie, sample size, a description of the intervention and control conditions (where applicable), outcome measures, length of follow-up and main findings related to outcome measures. For both components a narrative synthesis will be produced, supported by a summary table. We intend to conduct quantitative meta-analyses for both components. For each selected outcome we plan to evaluate the certainty of evidence based on the GRADE approach and risk of bias of included studies will be assessed using the Cochrane tool. Conclusions: Based on a lack of current evidence, we present a protocol for a systematic review to investigate the functional changes associated with open and endovascular AAA repair and the potential value of postoperative exercise rehabilitation.

Background: The ankle brachial pressure index (ABPI) is a common diagnostic tool used in the assessment of peripheral arterial disease (PAD). The Doppler ultrasound technique is regarded as the gold-standard method for ABPI measurement; however, time constraints and operator experience limit widespread application in clinical practice, particularly in a primary care setting. Automated ABPI devices are not currently widely used due to a lack of evidence regarding their diagnostic accuracy. The aim of this proposed systematic review and meta-analysis is to explore the current evidence for the accuracy of automated ABPI devices in people with known or suspected PAD. Methods: Systematic searches of electronic databases and grey literature will be performed. We plan to include studies of adult patients with diagnosed or suspected PAD that have compared automated ABPI device readings with manual Doppler ABPI measurements or confirmed the diagnosis of PAD using vascular imaging. Two independent reviewers will screen identified literature for inclusion and perform data extraction. Extracted data will include study and participant characteristics, a description of the index and reference tests, outcome measures and main findings. The methodological quality of selected studies will be assessed using QUADAS-2 and QUADAS-C. Meta-analysis will be performed for studies with paired designs using a bivariate random-effect model to provide pooled estimates of summary accuracy statistics. We intend to conduct subgroup analyses and meta-regression for suspected sources of heterogeneity. Discussion: This review aims to assess the diagnostic accuracy of automated ABPI devices for detecting PAD in patients with known or suspected PAD compared with manual Doppler ABPI measurements or vascular imaging. These results will be used to inform clinical practice and guide future trials.