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Clinical Trial Details — Status: Enrolling by invitation

Administrative data

NCT number NCT04818190
Other study ID # HS24687
Secondary ID
Status Enrolling by invitation
Phase N/A
First received
Last updated
Start date September 1, 2021
Est. completion date May 1, 2023

Study information

Verified date March 2021
Source University of Manitoba
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The purpose of this study is to compare the sensory return of DIEP flaps with nerve connection to DIEP flaps with no nerve connection to see which is better. This research is being done because the presence of sensation in a reconstructed breast has been shown to improve patient-related quality of life following mastectomy reconstruction and is an important safety factor for prevention of burns and other flap injuries. Unfortunately, women who have breast skin excised during mastectomy are reconstructed with a traditional DIEP flap that does not restore sensation to the skin.


Description:

The Deep Inferior Epigastric Perforator (DIEP) flap is the current standard of care in breast reconstruction. The DIEP flap does not normally have sensation restored. The presence of sensation in a reconstructed breast has been shown to improve patient-rated quality of life following mastectomy and reconstruction and is an important safety factor for prevention of burns and other flap injuries. Unfortunately, women who have breast skin excised during mastectomy are reconstructed with a traditional DIEP flap that does not restore sensation to the skin. As such, the investigators aim to perform a prospective randomized single-blinded trial to evaluate sensory return to DIEP flaps following nerve coaptation. A blinded, prospective study will be performed involving Manitoban women over 18 years undergoing bilateral breast reconstruction with DIEP flaps. The women will have one breast reconstructed in the standard of care (DIEP flap with no nerve coaptation) and one breast reconstructed with both DIEP flap and sensory nerve coaptation; the side of coaptation will be randomized. Objective sensibility to the breast will be tested pre- and post-operatively (3, 6, 12 months) using the Pressure Specified Sensory Device (PSSD). Patients will also complete the Breast Q questionnaire postoperatively.


Recruitment information / eligibility

Status Enrolling by invitation
Enrollment 30
Est. completion date May 1, 2023
Est. primary completion date April 1, 2023
Accepts healthy volunteers No
Gender Female
Age group 18 Years and older
Eligibility Inclusion Criteria: - female subjects older than 18 - scheduled for immediate bilateral breast reconstruction following bilateral non-nipple sparing mastectomy - using DIEP free flap reconstruction - with a large skin paddle Exclusion Criteria: - pre-operative radiation or chemotherapy was performed - post-operative radiation or chemotherapy is planned - reconstruction is performed in a delayed fashion - a nerve conduit is necessary for nerve coaptation

Study Design


Related Conditions & MeSH terms


Intervention

Procedure:
Sensory neurotization
The donor nerve is a cutaneous nerve that is identified with the most inferior lateral perforator vessels. The nerve is then dissected for neurotization and divided at the level of the fascia where it is a pure sensory nerve. The recipient intercostal nerve is usually easily identified in the third intercostal space during the dissection of the internal mammary artery and vein. The anterior branch of the third intercostal nerve can usually be found at the junction of the inferior portion of the third rib and the sternum, approximately 80% of the time. The nerve is dissected and transected medially. It is then mobilized to give it the longest length possible in preparation for neurotization. Neurotization is performed by coapting the donor nerve to the third anterior intercostal nerve directly with a 9-0 nylon suture in standard fashion.

Locations

Country Name City State
Canada Health Science Centre Winnipeg Manitoba

Sponsors (1)

Lead Sponsor Collaborator
University of Manitoba

Country where clinical trial is conducted

Canada, 

Outcome

Type Measure Description Time frame Safety issue
Primary Sensory recovery to neurotized DIEP flap Sensory recovery measured using Pressure Specified Sensory Device 3 months post-operatively
Primary Sensory recovery to neurotized DIEP flap Sensory recovery measured using Pressure Specified Sensory Device 6 months post-operatively
Primary Sensory recovery to neurotized DIEP flap Sensory recovery measured using Pressure Specified Sensory Device 12 months post-operatively
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