Recognizing and Reporting Surgical Wound Complications After Discharge From Gastrointestinal Surgery in Egypt

Many wound problems after surgery on the digestive system, including wound infection, are first noticed after the patient has already gone home. Delays in noticing a problem and contacting the hospital can delay treatment. Existing studies come mostly from high-income countries and usually look at only one group of people. No study from Egypt or the Arabic-speaking region was found in the sources reviewed. This qualitative study will explore what helps and what gets in the way when patients, family caregivers, and nurses recognize, report, and respond to surgical wound problems after discharge from gastrointestinal surgery. Individual semi-structured interviews will be held in Egyptian Arabic, in person or by telephone, at three hospitals in Egypt. The planned participants are 20 patients discharged 2 to 6 weeks earlier, 12 family caregivers, 15 nurses, and up to 4 key informants, for a planned total of 51. Participants will be chosen purposefully to include a wide range of experiences, and recruitment in each group will stop once further interviews bring no new themes. Interviews will be analysed with reflexive thematic analysis, guided by the Common-Sense Model of Self-Regulation. The main result is a description of the barriers and enablers. Further results are a model of the pathway from noticing a wound change, to reporting it, to the nursing response, and a set of requirements for a nurse-led remote follow-up service.

Inclusion Criteria: * Patients: age 18 years or older * Patients: discharged 2 to 6 weeks before the interview after gastrointestinal surgery (colon, rectum, stomach, small bowel, liver and biliary tract, pancreas, gallbladder) with an abdominal wound (open or laparoscopic) * Patients: Arabic-speaking * Patients: able to give informed consent * Family caregivers: age 18 years or older * Family caregivers: the family member most involved in the patient's wound care or communication with the hospital after discharge * Family caregivers: Arabic-speaking * Nurses: registered nurses working in gastrointestinal or general surgical wards, discharge planning, or infection prevention at a study site * Nurses: at least 1 year of surgical or infection-prevention experience * Key informants: nursing managers, infection-control leads, or surgeons with responsibility for discharge or follow-up policy Exclusion Criteria: * Patients: cognitive impairment or inability to take part in an interview * Patients: still hospitalized or readmitted at the time of interview * Patients: day-case procedures without an abdominal wound requiring home care * Family caregivers: paid or professional caregivers * Nurses: on leave for the whole data collection period * Nurses: in direct line management of the interviewer