Effect of Prophylactic Prosthesis Placement With Versus Without Omega-3 at the Umbilical Trocar Level on Surgical Site Infection and Herniation After Laparoscopic Cholecystectomy in Patients With Risk Factors.

Surgical Site Infection Clinical Trial

Official title:

Effect of Prophylactic Prosthesis Placement With Versus Without Omega-3 at the Umbilical Trocar Level on Surgical Site Infection and Herniation After Laparoscopic Cholecystectomy in Patients With Risk Factors.

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT04345809
• Other study ID #: AGHO MYL PRELIMI
• Status: Completed
• Start date: January 2016
• Est. completion date: January 2018

Study information

• Verified date: April 2020
• Source: Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

TITLE:

Effect of prophylactic prosthesis placement with versus without omega-3 at the umbilical trocar level on surgical site infection and herniation after laparoscopic cholecystectomy in patients with risk factors.

OBJECTIVE: To evaluate whether the placement of a synthetic prosthesis with omega-3 in its composition at the level of the umbilical trocar after laparoscopic cholecystectomy versus the placement of a synthetic umbilical prosthesis without omega-3 in its composition decreases the rate of surgical site infection (SSI) and trocar site hernia (TSH) in patients with risk factors for infection and herniation.

Description:

METHODS: A prospective study was conducted with 2 consecutive series of patients operated on for cholelithiasis who also had some of the following risk factors that increase the occurrence of SSI or TSH: BMI > 30 kg/m2, diabetes mellitus, age > 65 years and chronic obstructive pulmonary disease. A circular prosthesis with an omega-3 coating was placed in patients in group A, and a prosthesis without omega-3 in its composition was placed in patients in group B. The main variables evaluated were the occurrence of SSI and TSH.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 95
• Est. completion date: January 2018
• Est. primary completion date: January 2017
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years to 90 Years

Eligibility

Inclusion Criteria:

The included patients were between the ages of 18 and 90 years, underwent elective laparoscopic cholecystectomy for symptomatic cholelithiasis and had one of the following risk factors that increase the occurrence of SSI or TSIH:

• Obesity: with a body mass index (BMI) > 30 kg/m2.

• Diabetes Mellitus (insulin dependent or who take oral antidiabetic drugs),

• Age > 65 years and

• COPD treated with inhalers.

Exclusion Criteria:

• Nonfulfillment of the inclusion criteria.

• Conversion to laparotomy during the surgical procedure

• Non-acceptance of participation in the study by the patient

• Loss to follow-up.

Related Conditions & MeSH terms

• Communicable Diseases
• Infection
• Surgical Site Infection
• Surgical Wound Infection

Intervention

Procedure:
• MESH WHIT OMEGA-3
Mesh placement with Omega-3 at the umbilical trocar level after laparoscopic cholecystectomy in patients with risk factors for SSI and eventration.
• MESH WITHOUT OMEGA-3
Mesh placement without Omega-3 at the umbilical trocar level after laparoscopic cholecystectomy in patients with risk factors for SSI and eventration.

Locations

Country	Name	City	State
n/a

Sponsors (1)

Lead Sponsor	Collaborator
Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana

References & Publications (27)

Alam K, Jeffery SLA. Acellular Fish Skin Grafts for Management of Split Thickness Donor Sites and Partial Thickness Burns: A Case Series. Mil Med. 2019 Mar 1;184(Suppl 1):16-20. doi: 10.1093/milmed/usy280. — View Citation

Alfonso-Sanchez JL, Martinez IM, Martín-Moreno JM, González RS, Botía F. Analyzing the risk factors influencing surgical site infections: the site of environmental factors. Can J Surg. 2017 Jun;60(3):155-161. — View Citation

Anthony T, Bergen PC, Kim LT, Henderson M, Fahey T, Rege RV, Turnage RH. Factors affecting recurrence following incisional herniorrhaphy. World J Surg. 2000 Jan;24(1):95-100;discussion 101. — View Citation

Armañanzas L, Ruiz-Tovar J, Arroyo A, García-Peche P, Armañanzas E, Diez M, Galindo I, Calpena R. Prophylactic mesh vs suture in the closure of the umbilical trocar site after laparoscopic cholecystectomy in high-risk patients for incisional hernia. A randomized clinical trial. J Am Coll Surg. 2014 May;218(5):960-8. doi: 10.1016/j.jamcollsurg.2014.01.049. Epub 2014 Feb 18. — View Citation

Arroyo A, García P, Pérez F, Andreu J, Candela F, Calpena R. Randomized clinical trial comparing suture and mesh repair of umbilical hernia in adults. Br J Surg. 2001 Oct;88(10):1321-3. — View Citation

Bowler PG, Jones SA, Walker M, Parsons D. Microbicidal properties of a silver-containing hydrofiber dressing against a variety of burn wound pathogens. J Burn Care Rehabil. 2004 Mar-Apr;25(2):192-6. — View Citation

Brathwaite S, Latchana N, Esemuede I, Harzman A, Husain S. Risk Factors for Surgical Site Infection in Open and Laparoscopic Hartmann Closure: A Multivariate Analysis. Surg Laparosc Endosc Percutan Tech. 2017 Feb;27(1):51-53. doi: 10.1097/SLE.0000000000000365. — View Citation

Chanda W, Joseph TP, Guo XF, Wang WD, Liu M, Vuai MS, Padhiar AA, Zhong MT. Effectiveness of omega-3 polyunsaturated fatty acids against microbial pathogens. J Zhejiang Univ Sci B. 2018 Apr.;19(4):253-262. doi: 10.1631/jzus.B1700063. Review. — View Citation

Cheadle WG. Risk factors for surgical site infection. Surg Infect (Larchmt). 2006;7 Suppl 1:S7-11. Review. — View Citation

Chopra I. The increasing use of silver-based products as antimicrobial agents: a useful development or a cause for concern? J Antimicrob Chemother. 2007 Apr;59(4):587-90. Epub 2007 Feb 16. Review. — View Citation

Comajuncosas J, Vallverdú H, Orbeal R, Parés D. [Trocar site incisional hernia in laparoscopic surgery]. Cir Esp. 2011 Feb;89(2):72-6. doi: 10.1016/j.ciresp.2010.08.007. Epub 2011 Jan 20. Review. Spanish. — View Citation

Fernandez-Gutierrez M, Olivares E, Pascual G, Bellon JM, San Román J. Low-density polypropylene meshes coated with resorbable and biocompatible hydrophilic polymers as controlled release agents of antibiotics. Acta Biomater. 2013 Apr;9(4):6006-18. doi: 10.1016/j.actbio.2012.12.012. Epub 2012 Dec 20. — View Citation

Iannitti DA, Hope WW, Norton HJ, Lincourt AE, Millikan K, Fenoglio ME, Moskowitz M. Technique and outcomes of abdominal incisional hernia repair using a synthetic composite mesh: a report of 455 cases. J Am Coll Surg. 2008 Jan;206(1):83-8. Epub 2007 Oct 18. — View Citation

Justinger C, Slotta JE, Ningel S, Gräber S, Kollmar O, Schilling MK. Surgical-site infection after abdominal wall closure with triclosan-impregnated polydioxanone sutures: results of a randomized clinical pathway facilitated trial (NCT00998907). Surgery. 2013 Sep;154(3):589-95. doi: 10.1016/j.surg.2013.04.011. Epub 2013 Jul 13. — View Citation

Lai NM, Chaiyakunapruk N, Lai NA, O'Riordan E, Pau WS, Saint S. Catheter impregnation, coating or bonding for reducing central venous catheter-related infections in adults. Cochrane Database Syst Rev. 2016 Mar 16;3:CD007878. doi: 10.1002/14651858.CD007878.pub3. Review. — View Citation

Maicas VT, Rochina IJ. [Linoleic acid emulsion on the peri-lesion skin of venal ulcers. Action and cicatrizant effect. Corpus study]. Rev Enferm. 2008 Apr;31(4):26-32. Spanish. — View Citation

Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for Prevention of Surgical Site Infection, 1999. Centers for Disease Control and Prevention (CDC) Hospital Infection Control Practices Advisory Committee. Am J Infect Control. 1999 Apr;27(2):97-132; quiz 133-4; discussion 96. — View Citation

Minar E, Schillinger M. Innovative technologies for SFA occlusions: drug coated balloons in SFA lesions. J Cardiovasc Surg (Torino). 2012 Aug;53(4):481-6. Review. — View Citation

Muysoms FE, Antoniou SA, Bury K, Campanelli G, Conze J, Cuccurullo D, de Beaux AC, Deerenberg EB, East B, Fortelny RH, Gillion JF, Henriksen NA, Israelsson L, Jairam A, Jänes A, Jeekel J, López-Cano M, Miserez M, Morales-Conde S, Sanders DL, Simons MP, Smietanski M, Venclauskas L, Berrevoet F; European Hernia Society. European Hernia Society guidelines on the closure of abdominal wall incisions. Hernia. 2015 Feb;19(1):1-24. doi: 10.1007/s10029-014-1342-5. Epub 2015 Jan 25. — View Citation

Pereira JA, Pera M, Grande L. [Incidence of incisional hernia after open and laparoscopic colorectal cancer resection]. Cir Esp. 2013 Jan;91(1):44-9. doi: 10.1016/j.ciresp.2012.05.004. Epub 2012 Jul 4. Spanish. — View Citation

Sanders D, Lambie J, Bond P, Moate R, Steer JA. An in vitro study assessing the effect of mesh morphology and suture fixation on bacterial adherence. Hernia. 2013 Dec;17(6):779-89. doi: 10.1007/s10029-013-1124-5. Epub 2013 Jun 19. — View Citation

Sauerland S, Korenkov M, Kleinen T, Arndt M, Paul A. Obesity is a risk factor for recurrence after incisional hernia repair. Hernia. 2004 Feb;8(1):42-6. Epub 2003 Sep 6. — View Citation

Sugerman HJ, Kellum JM Jr, Reines HD, DeMaria EJ, Newsome HH, Lowry JW. Greater risk of incisional hernia with morbidly obese than steroid-dependent patients and low recurrence with prefascial polypropylene mesh. Am J Surg. 1996 Jan;171(1):80-4. — View Citation

Tang Y, Zhang MJ, Hellmann J, Kosuri M, Bhatnagar A, Spite M. Proresolution therapy for the treatment of delayed healing of diabetic wounds. Diabetes. 2013 Feb;62(2):618-27. doi: 10.2337/db12-0684. Epub 2012 Oct 5. — View Citation

Tomioka K, Murakami M, Fujimori A, Watanabe M, Koizumi T, Goto S, Otsuka K, Aoki T. Risk Factors for Transumbilical Wound Complications in Laparoscopic Gastric and Colorectal Surgery. In Vivo. 2017 Sep-Oct;31(5):943-948. — View Citation

Wang XC, Zhang D, Yang ZX, Gan JX, Yin LN. Mesh reinforcement for the prevention of incisional hernia formation: a systematic review and meta-analysis of randomized controlled trials. J Surg Res. 2017 Mar;209:17-29. doi: 10.1016/j.jss.2016.09.055. Epub 2016 Oct 4. Review. — View Citation

Woodrow T, Chant T, Chant H. Treatment of diabetic foot wounds with acellular fish skin graft rich in omega-3: a prospective evaluation. J Wound Care. 2019 Feb 2;28(2):76-80. doi: 10.12968/jowc.2019.28.2.76. — View Citation

* Note: There are 27 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	SSI	Surgical Site Infection.	1 year
Primary	TSIH	Trocar site incisional hernia.	1 year