Category: Uncategorized

Julie Tait is the latest member of our work family to reach the amazing milestone of 25 years’ service.

Originally from Rochdale, the warm hearted and mild mannered ‘Northern lass’ has now spanned three family generations of business ownership. Starting in 1997, she worked under original founder, John Prosser (whom she described as a scary headmaster), before son-in-law (and less scary) Bob Cooper took over, and in more recent times, the new sibling owners, Paul, Tom & Hayley (who she says are the best!)

Julie joined Dacey Ltd at the tender age of 22 whilst she was waiting for her degree results from Cardiff University, where she studied History and Theory in Art Design and Architecture. Since joining the business group, Julie has had an interesting career pathway. Her journey started off in Dacey Ltd as a Data Inputter, before becoming a Stock Product Controller. Going forward she became a Customer Services Manager and latterly a Head of Department before she made the jump (or was she pushed?!) across to Orthotix to take up a new role in the rapidly expanding sister business, where she stepped up to become the Operations Manager.

Fast forward several years and Orthotix has grown to become a market leader in the off-the-shelf orthotic sector and Julie has played an integral role in helping build the business from its humble beginning. Her effort and unwavering positivity over the years has recently seen her gain promotion to General Manager, forming part of a new Senior Leadership team tasked with taking the business to the next level.

Thank you for your 25-year service Jules! You truly are one of a kind and everyone at Orthotix is proud of you. Here’s to the next 25 years ‘Botters’ 😊.

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More than a million hernia operations are undertaken in the UK every year and millions more choose to manage their hernias non-operatively and continue with daily life experiencing unease and discomfort. In addition to the Covid lockdowns of 2020 and the restrictions placed on elective surgeries throughout the UK, hernia operations have seen a reduction of 40%, with over six million patients still pending on waiting lists. With extended estimated lead times for non-urgent hernia repairs, it looks like waiting times could be anywhere up to 5 years. With this is mind, there is now an even higher demand for Orthosis to manage hernias in a non-operative capacity.

Hernias occur when part of your internal soft tissues protrude through a weakness in surrounding tissues and muscle walls. These weaknesses can naturally occur from a multitude of different causes. These could include muscle wastage associated with age, general wear and tear, prolonged stress or strain which forms increased intra-cavity pressure and can also occur secondary to a surgical incision.

Inguinal and Femoral Hernias

Inguinal hernias are the most prevalent hernia contributing to over 90% of hernias. They occur in men and appear when the intestine finds a weakness in the upper part of the groin and thigh. The hernia originates after passing through a natural aperture in the groin area called the inguinal canal. This canal is the pathway for the spermatic cord and associated blood vessels and nerves for the testes and lower limb. Due to its natural opening, it acts like a gateway and allows easier passage for the intestine to herniate through it. The prevalence in men is also increased due to straining or excertive exercise which can further exacerbate the issue. Lifting heavier items, heavy weightlifting or excessive toilet straining furthers the risk of developing an inguinal hernia.

Femoral hernias result in a comparable way to that of inguinal hernias. These mostly occur in women rather than men and are less prevalent than inguinal types, usually only contributing to 6-8% of hernias in the groin area. The femoral canal, like the inguinal canal, allows for easy passage for the intestine to pass through the muscle walls and herniate. The femoral canal is slightly lower in nature to the inguinal canal and is located more at hip level. Women have a naturally wider hip, and this results in the femoral canal being stretched. This therefore makes the gateway for the hernia to be larger allowing the intestine to pass much easier in this area in-comparison to than of a man.

Traditionally, groin related hernias were treated with belts and leather padding via an orthosis called a truss. These would work by means of promoting a reducible hernia by hand and then applying the belt and pad over the area to plug and filling the void.

Abdominal Hernias

Abdominal Hernia’s are much less prevalent than inguinal / femoral hernias. These can occur through the umbilicus at birth, via weakness in the abdomen wall, or can result due to pendulous stomachs, pregnancy, surgical incision, or from stoma care. Primary midline hernias are the most common type of abdomen hernia and will include umbilical hernia, para-umbilical, supra-umbilical, and epigastric types.

Birth related hernias usually occur around the umbilicus and result from the separation of the umbilical cord from the baby. The cord runs through the abdominal wall to provide nutrients to the baby during pregnancy. This opening will usually close naturally after birth, however, sometimes can remain open. With a newborn crying and the increased physical exertion in their abdomen, the belly button herniates. These can be massaged and supported with umbilical belts that help support and correct the protrusion, and will usually naturally disappear within the first few years of the babies life. Umbilical hernias are low in prevalence, however, 1 in 5 babies suffering from them. As mentioned earlier these can still occur in adults and are supported with similar belt like navel orthosis that support the waist and the navel area to alleviate pain and reduce any prominence.

Other abdominal hernias commonly arise in the midline where a fibrous tissue called the Linea Alba separates. Its weaker structure compared to than of its surround muscles (rectus abdominus aka the six pack muscles) means its more prone to herniation. The Linea Alba is also known to stretch and thin with larger abdomen types, so it’s also more prevalent to separating if you are overweight or pregnant.

Incisional hernias occur around the abdomen as a result of abdominal surgery. The Linea Alba plays a role in this when there is midline incision. The reason for this is that it has limited blood supply meaning it is a good insertion site for surgeons due to its lack of blood loss in theatre. However, with the incision this creates a further weakness in the abdomen muscles and can force the intestine to re-herniated around the surgical site. Even with gauzing placed subcutaneously to limit post operative displacement, the weakness through the incision can still appear elsewhere and therefore binders can be used to promoting compression and act as a second abdomen, helping to improve healing and aiding in swelling reduction and mobility post operatively.

Products to assist with Common Hernias.

Orthotix are a UK based NHS supplier of class 1 medical devices and the off the shelf range of modern and discrete hernia supports are now available to the NHS and the public and cover a wide array of hernia conditions as mentioned above. Manufactured by both of our partners, Pavis and Orliman, the range encompasses a selection of machine washable hernia supports with innovative materials and cotton-based products to cover a wide array of hernia presentations.

A new innovative way to treat groin related hernias such as inguinal and femoral types is via Hernia Underwear. Used as an alternative to the traditional leather truss type belts, these highly compressive briefs, boxer shorts, and Y front type slips provide uniformed compression around the pelvis and groin and can also provide mild abdominal compression when chosen in the deeper variants. Designed by Healthcare Professionals to effectively reduce pain and discomfort, the low profile, discrete hernia underwear improves cosmetic appearance, offers unparalleled comfort, and are unrestrictive to allow for uninhibited mobility, making them ideal for prolonged daily use.

In addition to this innovative hernia underwear range, Orthotix also offer a selection of other hernia supports including traditional truss’s, elasticated abdominal binders, Stoma care supports, and a selection of genito-hernia supports such as jock straps, bag truss’s and prolapse truss’s.

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How does the NHS routinely test for cervical cancer in women?

Cervical screening started back in the 1960’s via means of the Papanicolaou Test (PAP Smear Test), identifying pre-cancerous cells in the cervix and helped identify women who were at higher risk of cancer development. PAP testing was later stopped when it was realised the method resulted in large quantity of false negatives and misdiagnosis.

In the 1980s it was found that HPV was a key factor in cancer development and the government launched a nationwide campaign introducing a new method looking for specific markers which increased risk. Cytology methods and computerised inputting were introduced, however, despite the government’s best attempts and the strategies becoming much more embedded into routine public health practice, the 1980’s – 1990’s saw numerous failings of the system and almost 100,000 women needing re-examination due to cases being missed.

From 2000 onwards the processes improved and rates have since significantly dropped. Screening was standardised to a 3-year procedure for women between the ages of 25-49, and 5 years for ages above 50+. Cytology screening process replaced its predecessors, via means of a liquid-based cytology (LBC), which subsequently ran alongside the HPV vaccination program which was introduced in 2008. This method continued until 2019 where it was replaced with Hr-HPV DNA testing, where specific high-risk strains of the virus are identified with almost 100% accuracy. Due to this and combined with the already successful vaccine, Hr-HPV screening is now the primary protocol for cervical cancer testing nationwide.

What is the vaccine?

HPV vaccine helps to protect against cancer by stopping viral infection from High-risk HPV strains. The vaccine is given in two doses and has been available to girls aged 12 and above born after 1^st Sept 2006, or to women born after 1991 until the age of 25. Over 10 million vaccinations have been administered since 2008 and has reduced pre-cancerous cell changes by over 87%. Due to its success, public health and the NHS decided from 2019 that the vaccine was to be offered to boys to further limit the risk of HPV transmission between sexes.

Public Health England have suggested the vaccine will now prevent over 64,000 cervical related deaths, and 10,000 anal cancer deaths by 2058. Despite these figures and a well-established national vaccination programme against HPV, the vaccine does not protect against all  types of Hr-HPV and there is no guarantee it will fully stop cancer development. There is always a risk of virus mutation, cell infection and cancer development despite being vaccinated or not.

My passing professional thoughts…

From reading online, comments seem to be based around the age of which screening starts (25) and the gap of which screening intervals occur (3 or 5 years). Not only is the lengthening of the screening duration from 3 to 5 years concerning, but it seems many feel that the age of which screening can start should be dropped from 25 to the age of 18.

With these comments in mind and the science suggesting that the combined protocols are sufficiently managing cervical cancer diagnosis, public health have subsequently suggested screening does not need to occur as often. The fact that HPV is slow acting on cells, taking up to 10 years to development and that under 25s are extremely unlikely to have any developmental changes, they suggest by inviting women to screening early could result in unnecessary investigations and treatment, with higher NHS costs.

The most recent Hr-HPV screening test is reported to be 98% reliable. This then shows that when HPV testing is completed, if the result is negative there is likely no Hr-HPV in the cervix and therefore minimal risk of cancer. If the first screen was completed and clear, even if the day after HPV was transmitted, the virus could then take up to 10 years to become harmful in cells. Therefore, if testing started at 12 alongside the vaccination programme, this would essentially mean you are safe from HPV related cell changes until the age of 22.

Saying that, there is still margin for error in the testing. HPV is usually contracted at a sexually mature age, and the fact the vaccine is offered at an age where teenagers are sexually active, wouldn’t it seem more sensible to screen at a slightly earlier age? With the average UK woman being sexually active by the age of 15, the current method leaves a gap of 10 years from vaccine to screening! This is the same 10 year period that scientists reports cells being able to change in cancerous ways. So, should we screen for Hr-HPV 10 years after the vaccine?