Ventral Hernias Clinical Trial
Official title:
Postoperative Abdominal Binder in Reducing Seroma Formation and Pain After Ventral (Umbi/Epi) Hernia Repair.
Postoperative seroma formation is one of the most common complications after ventral hernia
repair. Although some seromas may not have clinical impact, postoperative seroma formation
often causes pain and discomfort and may even compromise wound healing. The use of
postoperative abdominal binder is often recommended after ventral hernia repair to prevent
seroma and diminish pain, but still with no scientific evidence. The primary aim of the
present study is to investigate the effect of postoperative abdominal binders after
laparoscopic ventral hernia repair on postoperative pain, discomfort and quality of life.
Secondary, we register seroma formation.
Method and material Randomized, controlled, multi-center, investigator-blinded study. A
minimum of 56 patients (2X28 umbi/epi) are included, inclusion number is based on power
calculations. Patients are randomized either to abdominal binder or no abdominal binder. The
abdominal binder is worn from immediately after the operation and continuously for 7 days,
night and day. Outcomes are based on patient self-reported registrations using Visual Analog
Scales (VAS) and Carolina Comfort Scale (CCS), which is a validated, hernia-specific tool to
estimate quality of life, pain and discomfort. Patients are followed-up for 30 days. For
secondary outcome we use ultrasound to measure the volume of seroma formation. We use
Mann-Witney, non-parametric statistics calculating the seroma formation and Friedmanns test
for pain, discomfort and quality of life for the effect of time on inter- and intragroup
differences during the study period. P < 0.05 is considered significant.
Postoperative seroma formation is one of the most common complications after ventral hernia repair. Although some seromas may not have clinical impact postoperative seroma formation often causes pain and discomfort and may even compromise wound healing. Several interventional procedures have been investigated to reduce or avoid postoperative seroma formation such as removal of the hernia sac, VAC (vacuum-assisted closure) therapy, talcum application to the subcutaneous layer, suction etc., but results are conflicting and evidence is of poor quality. The use of postoperative abdominal binder is often recommended after ventral hernia repair to prevent seroma and diminish pain, but still with no scientific evidence. Randomized, controlled, multi-center, investigator-blinded study supplemented with blinded statistical analysis (see below). 56 patients (2 x 28, umbi/epi) Due to power calculations. An intention to treat analysis is done. Patients are randomized either to abdominal binder or no abdominal binder. The abdominal binder is worn from immediately after the operation and continuously for 7 days, night and day. The belts are standard elastic belts (ostomy belts) from "ETO garments©" with standard height of 22 cm. and five different sizes in width (S, M, L, XL, XXL- depending on waist measure). A fitting will be done before the operation by waist measurement according to the recommendation from the company. Patients are followed-up for 30 days with clinical follow-up at day 7 and 30. ;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Investigator), Primary Purpose: Prevention
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