Women's Healthcare - Q3 2023 by Mediaplanet UK&IE

Women’s Healthcare Q3 2023 | A promotional supplement distributed on behalf of Mediaplanet, which takes sole responsibility for its content

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“Community hubs present an opportunity to better meet the needs of women throughout their lives.”

“Women must be given balanced information about all possible treatment options to manage common symptoms of menopause.”

Dr Ranee Thakar, President, Royal College of Obstetricians and Gynaecologists

Dr Paula Briggs, Chair, British Menopause Society

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Lauren Mahon Broadcaster & Charity Founder, GIRLvsCANCER

This October 5,000 women will be diagnosed with Breast Cancer The Aware® Pad is designed to enhance and improve the effectiveness of breast self-examinations. Early detection is your best protection.

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INTERVIEW WITH Professor Mark Little Consultant Interventional Radiologist & Research Lead, University Department of Radiology, Royal Berkshire Hospital, Reading, UK

WRITTEN BY Angelica O’Toole

WRITTEN BY Dr Ranee Thakar President, The Royal College of Obstetricians and Gynaecologists

Uterine fibroid embolisation: how to treat fibroids and why it’s effective

A national women’s health hub model offers a wealth of opportunities, promising to improve the health and wellbeing of women and girls.

Many women are diagnosed with uterine fibroids. While there are many treatment options, uterine fibroid embolisation is minimally invasive and quick.

terine fibroids (also known preservation of the uterus and faster as uterine myomas or recovery time,” says Professor Little. leiomyomas) are common Uterine fibroid embolisation begins and develop in, or around, with a tiny incision in the groin area the uterus. Around two in three or wrist. This incision provides the women develop at least one fibroid interventional radiologist (IR) with at some point in their lives, usually access to arteries that feed the fibroids. between ages 30 and 50. They Embolic material (small spheres) is can be diagnosed during routine then injected to shrink fibroids by gynaecological examination. depriving them of oxygenated blood. Professor Mark Little, Consultant An interventional radiologist, like Interventional Radiologist and Professor Little, uses specialised X-ray Director of Radiology Research, equipment to guide the procedure — explains: “Fibroids which typically lasts are the most common less than one hour. Fibroids are the benign uterine It is performed as an tumours in women outpatient procedure. most common of reproductive age. benign uterine They can have a Helping improve profound impact on tumours in women symptoms women’s quality of UFE treatment can life.” of reproductive age. lead to long-term improvement of Uterine fibroid symptoms of uterine embolisation treatment fibroids. Symptoms include heavy As treatment, women can opt or painful periods; lower back pain; for uterine fibroid embolisation frequent urination; constipation; and (UFE) — also called uterine artery pain during sex. embolisation (UAE). UFE is a If you, or anyone you know, are minimally invasive procedure that diagnosed with uterine fibroids, it’s has been performed for over 20 important to know what the treatment years and is approved by NICE. “The options are. Professor Little urges procedure is performed via a pinhole people affected by uterine fibroids to incision and does not require general look into embolisation, as the uterine anaesthetic. Embolisation offers a preservation and rapid recovery less invasive alternative to surgical benefits can make a real difference to hysterectomy or myomectomy, with someone’s quality of life.

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Health hub model: how to improve access to women’s health services

his year, the Government announced funding for the national rollout of the Women’s Health Hub model in England. These community hubs present an opportunity to better meet the needs of women throughout their lives.

healthcare professionals. Similarly, Jo’s Trust reported that cervical screening uptake is falling year on year among 25 to 29-yearolds. Hubs could increase the uptake of cervical screening, both through education and by offering cervical screenings where appropriate.

Services addressing women’s health Better access to healthcare for needs each woman Women could benefit from more Access to high-quality women’s holistic, joined-up and locally-based health information is lacking. Hubs services. The hubs bring together could allow women to increase their a wide range of care delivered understanding of their own bodies by healthcare professionals with and recognise when something is not expertise in areas of women’s health. normal for them. Gynaecology, sexual and With its combined range of reproductive health services could services, the hub model can deliver be integrated better experiences into this hub and outcomes in The hub model will model, including women’s healthcare improve access to contraception, — reducing the cancer screening many health barriers information about and support face. It can women’s health conditions women with menstrual enable women to and provide timely problems and be seen in the right pelvic pain. By setting, by the right support where needed. doing so, the hubs professional, at the could improve right time. Each hub women’s access, experience and will also be tailored to meet the needs outcomes across their healthcare of locals, aiming to tackle ongoing needs. health inequalities. Prevention and earlier diagnosis of common conditions The hub model will improve access to information about women’s health conditions and provide timely support where needed. Our recent survey about pelvic floor health found that over half of women (53%) who had experienced symptoms of pelvic floor dysfunction did not seek help from a healthcare professional. Of these, 21% said they were too embarrassed. Improving education can help to reduce stigma around symptoms like incontinence and encourage conversations with

Destigmatising women’s health issues The hub model is one of the key commitments within the Women’s Health Strategy for England. Its implementation will be a positive step towards improving healthcare for the 51% of the population that has historically been overlooked. By continuing to raise awareness of common women’s health conditions, we can ensure that support is available to women throughout their lives. We can also help destigmatise conversations about common health issues.

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Why uterine fibroid patients need to be treated with more urgency experts, that the link between UFs and abnormal menstrual bleeding is being missed,” explains Tina Backhouse, General Manager of women’s health pharmaceutical company Theramex. “There is an attitude that, because it is not cancerous, it is seen as not that terrible. However, some patients end up needing a hysterectomy.” She adds: “Women are encouraged to put up with heavy menstrual bleeding as they get older because no one likes to talk about blood loss even if it leads to iron deficiency.” Community discrepancies Dr Sesay also runs a health platform providing visual aids on fibroids. She says: “We need to ensure that the information is available and accessible to all — in a format that is easy to understand, inclusive and culturally sensitive.” Fibroids occur more commonly in Black and South Asian groups compared to their White counterparts. “There is still not much understanding as to why this is the case, as more research is needed. The reality about its prevalence within our communities absolutely needs to be raised both within the communities themselves and to healthcare professionals.”

The need for a better understanding of uterine fibroids in the general population is pressing, with many patients presenting late for specialist support.

terine fibroids (UF), also called leiomyomas or myomas, are growths that appear in the uterus. They are noncancerous and extremely common. When they enter the cavity of the womb, they can influence surface area and affect the functioning of the uterus.

This article has been sponsored by Theramex with contribution by Tina Backhouse. The views and opinions of the healthcare professionals are not necessarily those of Theramex.

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Supporting women presenting symptoms “Not everyone with fibroids has symptoms; and they can be small or large,” explains Dr Natalie Cooper, a consultant obstetrician and gynaecologist at Barts Health NHS Trust. However, many women do have symptoms including heavy or prolonged periods, bleeding between periods, abdominal discomfort, pelvic and lower back pain, plus bladder symptoms. There are many myths and misconceptions surrounding period symptoms as well, according to Dr Aziza Sesay, an NHS GP specialising in women’s health and health inequity. “Many are not aware that having heavy periods is not normal, and this is a common symptom of fibroids. Many

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are unaware of what constitutes a heavy period,” she says. Research calls for individualised care Dr Cooper, who has conducted research on heavy menstrual bleeding, says: “Fibroids restrict women and affect their relationships.” She hopes her research will help to create standardised treatment outcomes. “At the moment, there are several treatments suitable to manage individual symptoms of UF, such as heavy periods,” she adds. “So, we end up with too many options. However, through standardised data, we can better understand which treatments have the best outcomes for various UF symptoms. Women deserve individualised care. At present, they often feel misunderstood or ignored, which is utterly wrong.” Diagnoses being missed Many patients are still waiting well beyond the NHS standard of 18 weeks referral time for treatment. For patients who are in distress and may even need surgery, this can be a life-changing wait, which can impact fertility. “We found, talking to

There is an attitude that, because it is not cancerous, it is seen as not that terrible. However, some patients end up needing a hysterectomy. Drugs not being made available Theramex worry that Government priorities and policymaking could slow down the availability of drugs. “Gynaecology has been one of the worst hit specialisms since Covid; partly because of the consultant vacancies,” Backhouse explains. “However, even when NICE reviews have approved their clinical use, many health trusts fail to offer valuable UF medicines — which can improve symptoms and keep patients out of A&E. This is a travesty, as they should be prescribing them within 90 days of NICE approval.” Postcode prescribing means that those who cannot afford private treatment are more likely to suffer in silence. This adds to the imperative to offer treatments at a nationwide level, insists Backhouse. The need for a better understanding of fibroids in the general population is pressing — starting from what exactly they are to the symptoms associated, their risk factors and all the treatment options available.

INTERVIEW WITH Tina Backhouse General Manager, Theramex UK

INTERVIEW WITH Dr Aziza Sesay NHS GP with a special interest in women’s health and health inequity

INTERVIEW WITH Dr Natalie Cooper Consultant Obstetrician and Gynaecologist, Barts Health NHS Trust and Academic Clinical Lecturer - Obstetrics and Gynaecology at Queen Mary University of London WRITTEN BY James Martin

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Cervical cancer prevention in the UK — what are the tools we need? The UK has the tools to help make cervical cancer a thing of the past; we need government action to get us there as soon as possible.

very day in the UK, nine women are diagnosed with cervical cancer, and two women lose their lives. At Jo’s Cervical Cancer Trust, we know that the impact of cervical cancer can be significant — physically, emotionally and financially — and can last well beyond diagnosis and treatment. However, the UK has the tools to end this disease.

WRITTEN BY Samantha Dixon CEO, Jo’s Cervical Trust

committing to the elimination of cervical cancer. The UK is fortunate to have fantastic and free prevention programmes, but we’re seeing a decline in cervical screening uptake and real inequalities in HPV vaccine coverage. Recent data from NHS England shows that almost one in three women are not attending their cervical screening when invited — and, worryingly, one in two in some areas. Screening levels also have been steadily declining for the last 20 years. Take up of the HPV vaccine was heavily impacted by Covid-19, and children living in high levels of deprivation Almost one in are still less likely to receive it.

Tools for cervical cancer prevention Almost all (99.7%) of cervical cancers are caused by human papillomavirus (HPV), making this cancer largely preventable three women are through a combination of HPV vaccination and cervical screening (also known as cervical cancer together not attending their Ending smear tests). At Jo’s Cervical Cancer Trust, we are Cervical screening prevents more than determined to secure a future that is free cervical screening 70% of cervical cancers and, by testing for from cervical cancer by ensuring that when invited. HPV, it’s possible to stop cancer before it cervical screening and the HPV vaccine are even starts. The HPV vaccine was rolled out made as accessible as possible. However, in schools in 2008. Research has already we need to see government strategies with shown how effective it can be, with cases of cervical cancer clear targets and timelines. There must also be continued falling by 87% among vaccinated women — effectively investment in research and innovations for prevention, eliminating the disease in women born since 1995. diagnosis and treatment. Cervical screening isn’t easy for everyone, and we want to Elimination strategies ensure that everybody has the information and support they Around the world, governments are taking up the call from need. Our Helpline, Forum, information pages and support the World Health Organization to increase vaccination and services are available to anyone that needs them. screening coverage, developing their own strategies and

Breast awareness during and after pregnancy In our years of talking to young people about their breasts and chests, we noticed that pregnancy and breastfeeding were seen by many as a barrier to breast awareness.

t CoppaFeel!, we know how important it is for everyone to get to know their bodies and to talk to their doctor if they notice any unusual changes.

WRITTEN BY Emma Forsyth Health Information Manager, CoppaFeel!

Pregnancy breasts and changes Pregnancy — like puberty, menstruation and menopause — is a natural condition but often comes with breast changes. The difficulty knowing the difference between these natural changes and signs and symptoms of breast cancer is perhaps the reason why pregnant women with breast cancer are doubly likely to be diagnosed at stage 4.1 At CoppaFeel!, we are committed to addressing this health inequity by improving breast awareness during pregnancy and breastfeeding. What breast changes are normal? Hormonal breast changes such as sensitivity, leaking nipples and increased size are all natural in pregnancy. Despite the initial adjustment to these fluctuations, checking is the best way to get used to them and identify any potential problems. Breast conditions, such as mastitis or blocked ducts, should be properly diagnosed by a doctor. If in doubt, it is important that breast cancer is ruled out. An ultrasound scan is a safe and effective way to do this.

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We want to move away from dismissing breast conditions related to pregnancy as ‘just pregnancy boobs’ and improve education about breast health for pregnant and breastfeeding people. Breast awareness guidance Our breast awareness message during pregnancy and breastfeeding remains the same, and our breast awareness tips are as follows: • Look and feel: Some symptoms of breast cancer are visible. • All breast tissue: Breast tissue goes up to the collarbone and under the armpits. • Check roughly once a month. • Get to know your normal: Breast awareness is not about looking for cancer, it’s about getting to know what is normal for you. CoppaFeel! has created an information booklet about breast awareness during pregnancy and breastfeeding. References 1. Public Health England National Cancer Registration and Analysis Service, 2018.

For more information about this and all our other resources, go to coppafeel.org

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Touch, look, check: how to become breast aware and know your normal

We encourage women to get to know their normal and to get any new or unusual changes checked by a GP. Breast screening campaign When it comes to breast cancer, there is no time to waste. The earlier the disease is detected; the more likely treatment is to be successful. This is why we encourage women to attend breast screening appointments when invited. The breast screening programme saves women’s lives from breast cancer and has been key to breast cancer survival rates doubling in the last 40 years.

This Breast Cancer Awareness Month, around 5,000 women in the UK will be diagnosed with breast cancer. Whatever your age, it’s vital you are ‘breast aware.’

O WRITTEN BY Manveet Basra Associate Director of Public Health, Inclusion and Awareness, Breast Cancer Now

ctober marks Breast Cancer Awareness Month — a dedicated time to spotlight breast cancer and spread important breast health awareness messages across society. One woman is diagnosed with breast cancer every 10 minutes in the UK. At Breast Cancer Now, we want to remind people we’re here to provide support to anyone affected by breast cancer, in every way we can, all year round. Why people should be breast aware While most breast changes — including breast lumps — won’t be breast cancer, the sooner it’s diagnosed, the more successful treatment is likely to be. This is why it’s so important that everyone regularly checks their breasts and knows the

signs and symptoms of breast cancer. Yet, our recent breast-checking habits survey revealed there’s still work to be done. It shows that 44% of women in the UK are not checking their breasts regularly for potential signs and symptoms of breast cancer*, and 29% of those who do check, don’t feel confident they would notice a new or unusual change.* Get to know your normal with TLC Checking your breasts only takes a few minutes. It could be while getting dressed, showering or applying moisturiser. It’s important to check your whole breast area, armpits and up to your collarbone (upper chest) for changes. There’s no special technique; at Breast Cancer Now, we say it’s as simple as TLC: touch, look, check.

Improving the lives of breast cancer patients with a single-dose targeted radiotherapy Targeted intraoperative radiation therapy presents a potential paradigm shift in breast cancer treatment delivered during surgery.

R INTERVIEW WITH Ms Siobhan Laws Consultant Surgeon at Hampshire Hospitals NHS Foundation Trust WRITTEN BY Tony Greenway

adiation therapy is an important part of breast cancer treatment. Usually, patients will have surgery to remove their tumour — and only afterwards receive rounds of external beam radiotherapy (EBRT) to reduce the risk of the cancer returning. However, because EBRT is delivered to the entire breast in small doses every day for one to six weeks, patients must travel frequently for treatment. Intraoperative radiation therapy for breast cancer Women with early invasive breast cancer could potentially benefit from a ‘one-shot’ treatment — Targeted intraoperative radiation therapy (TARGIT-IORT). It’s delivered during surgery, and it’s more accurate.

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Trial data1 shows equivalence in breast relapse risk and better patient outcomes. It’s less painful, has better cosmetic effects, and patients can return to work one to two months faster. “While under a general anaesthetic to remove the breast cancer, the space left behind is filled with a probe, and radiotherapy is delivered directly to the area in the breast most at risk of local relapse,” explains Ms Siobhan Laws, Consultant Surgeon at Hampshire Hospitals NHS Foundation Trust. Because TARGIT-IORT treatment is targeted, healthy tissues are protected from unnecessary exposure to potentially harmful radiation. Deemed ‘an absolute no-brainer’ after learning about the trial, research2 patient member Marie Ennis O’Connor says: “As a breast cancer survivor …

There’s no special technique; at Breast Cancer Now, we say it’s as simple as TLC: touch, look, check. However, despite it once being an NHS success story, the programme is now chronically underfunded and overstretched. As part of Breast Cancer Now’s #NoTimeToWaste campaign, we’re calling on the Government to urgently invest in the programme — guaranteeing its accessibility to all eligible women and ensuring it has enough staff and resources to offer the care women deserve now and in decades to come. *2023 Breast Cancer Now YouGov survey

The incredible progress in treatments like TARGIT-IORT fills me with hope that future generations of women won’t have to endure the same gruelling radiotherapy experience I did.” Targeted treatment reduces healthcare pressures TARGIT-IORT can benefit healthcare providers by ultimately freeing up physicists and radiation oncologists. Plus, it can be cost-effective. At least 44,752 patients with breast cancer were treated with TARGIT-IORT in 260 centres across 35 countries. It also saved over 20 million miles of travel and prevented approximately 2,000 non-breast cancer deaths.3 Use of the system is recommended only using machines that are already available and in conjunction with NHS England-specified clinical governance, data collection and submission arrangements.4 With new data, it is hoped that the National Institute for Health and Care Excellence (NICE) will approve TARGIT-IORT for routine NHS use. Nevertheless, Hampshire Hospitals NHS Foundation Trust has been offering the therapy to local NHS patients since 2019. “What is most exciting is the new long-term data1 showing an improvement in overall survival for those treated with TARGIT-IORT,” concludes Ms Laws.

Anyone seeking information or support about breast health can speak to our expert nurses via our free, confidential helpline on 0808 800 6000 or via our online ‘Ask Our Nurse’ service. Find out more at breastcancernow. org/tlc

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References 1. Vaidya J S, Bulsara M, Baum M, Wenz F, Massarut S, Pigorsch S et al. 2020. 2. Bagga, S., Swiderska N., Hooker, C., Royle, J., O’Connor, M.E., Freeney, S., et. al. (2023). (The manuscript is going through the peer-review process at the moment and is not officially published.) 3. Vaidya, J. S., Vaidya, U. J., Baum, M., Bulsara, M. K., Joseph, D., & Tobias, J. S. (2022). 4. National Institute for Health and Care Excellence. (2018).

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What women can do to age healthily and effectively manage their menopause Women should expect to live a third of their lives after menopause, which is a natural life stage. Declining levels of oestrogen following menopause can also be associated with symptoms; and for some women, these symptoms are extreme.

n reproductive life, the ovaries release eggs, capable of developing into a pregnancy, if fertilisation occurs. The ovaries also produce the hormones oestrogen and progesterone. The levels of oestrogen in perimenopause — a time of transition from reproductive to post-reproductive life — are variable, and this can result in problematic symptoms including abnormal bleeding, headache and breast tenderness.

WRITTEN BY Dr Paula Briggs Chair, British Menopause Society

Menopause symptoms and HRT treatment Women must be given balanced information about all possible treatment options to manage common symptoms of menopause, including hot flushes and night sweats. If eligible and willing, hormone replacement therapy (HRT) is the most effective treatment for symptoms. Current NICE guidance recommends this form of treatment for the shortest time in the lowest effective dose. Some women choose to continue treatment for longer, but they should not feel pressured into using HRT. Alternative menopause treatment options The majority of women can use vaginal oestrogen treatments to manage the effect of low levels of oestrogen on tissue quality. This common problem is often referred to as genitourinary syndrome of menopause, and this is an area where long-term treatment is recommended to maintain tissue quality in the vulva, vagina, bladder and urethra. For women in whom HRT is contraindicated (eg. women with a history of hormone receptor-positive breast cancer), other options include some antidepressants — usually in a low dose — for the beneficial effect that these drugs confer on hot flushes, night sweats, sleep pattern and mood. Newer drugs are coming to market very soon, which will reduce hot flushes. Lifestyle changes to aid menopause management For all women, the role of having a healthy lifestyle cannot be underestimated. Important interventions include BP and BMI measurements, as well as blood tests to check a lipid profile. Vitamin D supplements, diet and exercise play an important role in midlife health. A midlife MOT and individualised care are just as important as being able to access HRT. To access reliable information that can help them, women can refer to trusted resources such as Women’s Health Concern (WHC), the patient-facing arm of the British Menopause Society. WHC recently launched a menopause wellness hub with a focus on lifestyle interventions to optimise midlife health.

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How a good diet and collagen supplementation can improve menopause symptoms

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With a nutritious diet and proper supplementation — including collagen intake — women may be able to reduce the intensity of their menopause symptoms.

W INTERVIEW WITH Dr Vidhi Patel Nutritionist, Functional & Integrative Medicine Doctor

INTERVIEW WITH Jennifer Lozano Research & Development Specialist, Minerva Research Labs

e need to ‘normalise’ menopause, insists Dr Vidhi Patel, Nutritionist, Functional & Integrative Medicine Doctor. “It’s just a phase, like pregnancy or puberty. It’s not a monster to worry about.” However, the symptoms of menopause — which often begin between the ages of 45 and 55 — can be hugely debilitating. These may include hot flushes, night sweats, tiredness, hair loss, sagging skin, mood swings, weight gain and muscle and joint pain. Improving nutrition to manage menopause symptoms

A good diet and proper supplementation can reduce the intensity of some symptoms and/or delay their onset. Sharing her personal experience using Gold Collagen Forte Plus, Katia Giordano, Director of Minerva Research Labs, says: “By taking liquid collagen supplements daily, which included ingredients to regulate hormonal imbalance, I was able to reduce my night sweats and hot flushes.” Dr Patel, Katia Giordano and Jennifer Lozano, Research and Development Specialist at Minerva Research Labs, reveal why we need to be open about menopause and how good nutrition can benefit women at this life stage. Minerva Research Labs is a UK-based health and beauty company, which produces collagen-based supplements. What’s your advice to women regarding diet, supplementation and menopause?

INTERVIEW WITH Katia Giordano Director, Minerva Research Labs WRITTEN BY Tony Greenway

Dr Patel: Think of your calcium levels. When oestrogen levels start to drop, calcium levels deposited in the bones drop too, which can lead to osteoporosis. Women in their 40s should therefore eat food rich in calcium. Getting vitamins, including vitamins C, D, E and B6 — either from supplements or food — are also important; as are omega-6 fatty acids, fibre and protein. Have you seen good nutrition impact menopause symptoms?

Dr Patel: I have encountered many real-life testimonies. One woman wanted to avoid the worst menopause symptoms after seeing how it impacted her mother so badly. She pre-emptively started HRT (hormone replacement therapy). However, she had a bad reaction to it, so she stopped HRT, started taking supplements and improved her diet instead. That was three years ago. Now, she’s still pre-menopause.

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What is collagen and why is it important during menopause?

Lozano: Collagen is a natural protein in our body that plays a vital role in maintaining the structure and strength of our skin and preventing hair thinning and breakage. Sufficient protein intake helps protect our bones, joints, ligaments and tendons. Despite our young skin being made up of 80% collagen, it starts to naturally decrease from around the age of 25 — with an annual loss of about 1.5%. Smoking, alcohol consumption, sun exposure and insufficient nutrition can exacerbate this decline. The only way to solve it is with collagen intake, which is why we created a series of liquid-form products that are collagen-based and taken orally. These supplements — which take a holistic approach to menopause — contain essential vitamins, minerals and antioxidants. Gold Collagen Forte Plus combines those nutrients with collagen to support women during menopause in the following ways: • Skin health: collagen replenishment reduces fine lines and wrinkles; addressing skin changes due to menopause. • Joint and muscle support: eases joint pain and stiffness; common in menopause. • Mood enhancement: together with the vitamin B6 help regulate mood swings and irritability. • Vaginal health: improves vaginal elasticity and moisture; reducing discomfort. How would you counter some of the menopause symptoms?

Giordano: I’m post-menopause now; but during menopause, I didn’t take HRT as, due to family history, it would increase my risk of breast cancer. Instead, I focused on my diet and began collagen supplementation. I also supported my collagen intake with probiotics. These regulate the intestine and reduce symptoms of digestive unrest, improve absorption of active nutrients and maximise the effects of collagen. I believe more needs to be done to encourage women to speak openly about their menopause experiences and to share their concerns and anxieties. READ MORE AT HEALTHAWARENESS.CO.UK

Gold Collagen is published in 12 peer-reviewed papers or book chapters and has a total of 13 clinical trials, backed up by scientific credibility. Discover more about Gold Collagen supplements on gold-collagen.com. Also available to buy in Boots.

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Wound care solution benefits at-risk mothers after a C-section Wound care technology is helping reduce the risk of surgical site infections in caesarean section (or C-section) procedures in at-risk patients, leaving mothers able to focus on their newborns.

Immediate skinto-skin contact encourages breastfeeding, providing the newborn with essential nutrients and antibodies. 08

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urgical site infections after mothers give birth by C-section can cause a range of health concerns. It can lead to emotional stress and wound complications requiring further medical intervention. It can also interrupt the natural bonding process between mother and baby. Proactive healing strategies Dr Mendinaro Imcha, consultant obstetrician and gynaecologist at University Hospital Limerick in Ireland, says surgical site infections (SSIs) may interfere with breastfeeding or the patient’s wellbeing. “Infections slow down the healing process, hindering the mother’s ability to care for her newborn and resume daily activities.” Quick healing of the incision requires a multifaceted approach, involving both medical professionals and patients. Dr Imcha says that includes pre-operative screening for high-risk factors and regular checks for infection after the C-section. Proactive strategies for avoiding SSIs have a ripple effect that benefits individual patients, healthcare providers and the wider public health system,” she adds.

Therapy for faster wound healing Single-use negative pressure wound therapy (sNPWT), such as Smith+Nephew’s PICO™ sNPWT solution, can aid recovery,1 particularly in obese women undergoing C-section.2 Dr Imcha explains the proposed mechanism of NPWT. “The negative pressure facilitates cell proliferation and the formation of granulation tissue, which is essential for wound healing and improves blood circulation. The sealed environment, created by the dressing, minimises external contamination risks, effectively shielding the wound from bacteria.”3,4 Benefits of mother-baby bonding Dr Imcha says her experience of NPWT in the clinical setting has been positive.

Patients report comfort and less pain compared to care with standard dressing.5,6 Highlighting mother-baby bonding, she adds: “It is not merely a warm and comforting experience but a critical period that can significantly influence the psychological, emotional and physical trajectory of the child and the mother.” Immediate skin-to-skin contact encourages breastfeeding, providing the newborn with essential nutrients and antibodies. Availability of wound care tech In the UK, around one in four pregnant women every year give birth via C-section7 (around 150,000), with data suggesting 10% are at risk of developing a SSI.8 Kate Backshell, Vice President, Advanced Wound Management, UKINOR division at Smith+Nephew shares her experience of the PICO™ dressing after her children — now aged 4 and 6 — were delivered by C-section. She says women should know that effective wound care technologies are available. “Dressings are just one part of the pathway for reducing the risk of surgical site complications, but choosing an appropriate dressing can make a significant difference.” People at risk of infection The active therapy, rather than a passive absorbent dressing, is NICErecommended for patients who are at risk of developing an SSI9 and is available on the NHS. Backshell says the solution can reduce infection risk by over 50% by creating gentle pressure across the incision line.10 It can be applied immediately after the C-section and has particular benefits for women identified at the pre-op stage as at risk of SSI. This includes people who have had a previous C-section, have diabetes or a body mass index of 30+.8,10 Secure healing Backshell says the first weeks with a new baby are all-consuming, with mothers needing time and space to bond with their baby. “When you have an SSI, you can be in great pain and discomfort, and that can affect your physical ability to pick up the baby.” With the birth of both of her children, she was grateful to have access to the PICO™ system, which enabled her to focus on being a new mum. “With the PICO™ dressing, I had the confidence that the incision would just heal,” she says. “The way the dressing bolsters the incision together makes it feel very secure.” The clinician testimonial in this article represents the individuals’ own opinions, findings and/or experiences. Individual results will vary. ™Trademark of Smith+Nephew. 40793.

INTERVIEW WITH Dr Mendinaro Imcha Clinical Lead for Obstetrics & Gynaecology at UL Hospitals Group

INTERVIEW WITH Kate Backshell Vice President, Advanced Wound Management UK, Ireland and Nordics (UKINOR) Smith+Nephew

WRITTEN BY Mark Nicholls

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References View the online article to see the full reference list at Healthawareness.co.uk 1. Birke-Sorensen H, Malmsjo M, Rome P, et al. 2011;64 Suppl:S1-16. 2. Hyldig N, Vinter CA, Kruse M, et al. 2018;0(0). 3. Brownhill VR, Huddleston E, Bell A, et al. 2020;0(0):1 - 12. 4. Smith+Nephew 2020.Bacterial barrier testing of the PICO dressing. Internal Report. 2001002. 5. Gilchrist B, Robinson M, Jaimes H. 2020; Virtual. 6. Hurd T, Trueman P, Rossington A. 2014;60(3):30-36. 7. NHS Choices. Available at: https://www.nhs.uk/conditions/caesarean-section/ (accessed September, 2023) 8. Wloch C, Wilson J, Lamagni T, Harrington P, Charlett A, Sheridan E. 2012 Oct;119(11):1324- 33. 9. NICE, 2019. [Last accessed: Sept 2023] 10. Hyldig N, Vinter CA, Kruse M, Mogensen O, Bille C, Sorensen JA, et al. 2019 Apr;126(5):628-3

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