We have shown that a main trial of different dressing strategies, including no dressing, is feasible and would be valuable to the NHS. Patients and practitioners supported the premise of a future trial of dressing types and engaged with the idea that there is equipoise in this area. This engagement was also reflected through the excellent participation in both the qualitative and the quantitative studies, the high consent rate and good adherence to allocation.

We have also developed, validated and tested a new tool, the WHQ, for assessing SSI, which can be used by patients after hospital discharge. This tool has immense potential to improve the efficiency of studies evaluating interventions to reduce SSI.

The NHS now needs to decide whether the research question in a main trial should be specifically about the effect of different dressing strategies, or about the combined effect of different dressing strategies and their effect on wound closure and whether a two-group or three-group trial is needed. There is also the need to consider whether this evaluation should be a standalone study or whether an existing study should be adapted to include glue-as-a-dressing and no dressing groups.