Discharge education and patients’ self-management of surgical wounds: a multinational comparative survey

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Abstract Background Surgical site infections are frequent and costly, often occurring after discharge when patients manage their wounds. Despite its importance for self-management, discharge education is delivered inconsistently. Aim To describe patients’ experiences and preferences for surgical wound care discharge education across three countries, and to examine factors associated with their ability to manage their surgical wound following hospital discharge. Methods This study used a cross-sectional design, using the Surgical Wounds And Patient Participation Questionnaire with Australian, Dutch, and Swedish surgical patients approximately two weeks post-discharge. Descriptive and univariate analyses summarised patient characteristics and wound self-management, and binary logistic regression identified independent predictors. Results 520 patients completed the survey. Follow-up instructions (n=439, 84.4%) and contact information for wound concerns (n=443, 85.2%) were the most received discharge information, while 46.9% (n=244) felt excluded from decision-making. Self-reported wound self-management was highest in Australia (90.4%), followed by Sweden (86.5%) and the Netherlands (75.9%). Three significant predictors emerged: care in Australia (OR=4.25, 95% CI [1.82–9.90], p<0.001) and receiving wound closure removal instructions (OR=3.62, 95% CI [1.45–9.05], p=0.006) increased self-management likelihood, while hospital readmission reduced it (OR=0.17, 95% CI [0.04–0.82], p=0.027). Conclusion Patients’ ability to manage surgical wounds at home depends on discharge education and healthcare context. Clear instructions and supportive systems are vital for safe self-care. Implications for Clinical Practice Clear verbal and written instructions are essential for confident self-care, particularly after complex procedures.

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