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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT05977816
Other study ID # RCSI 22-092
Secondary ID
Status Recruiting
Phase N/A
First received
Last updated
Start date July 14, 2023
Est. completion date July 2026

Study information

Verified date August 2023
Source Royal College of Surgeons, Ireland
Contact Claire Donohoe, PhD, FRCSI
Phone 35314103000
Email Cldonohoe@stjames.ie
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

Post-operative wound issues in abdominal surgery have a significant impact on patient outcomes. This study is taking place to investigate if Negative Pressure Wound Therapy (NPWT) dressings reduces Surgical Site Infections, post surgical complications and improves scar appearance compared to standard dressings.


Description:

NPWT dressings are designed to remove and absorb any fluid leaking from the wound. This might reduce surgical site infections, improve wound healing and improve scar appearance compared to using standard dressings. Data is limited in the application of NPWT dressings to laparotomy incisions in the acute and elective care surgery setting. Surgical site infections can complicate a patient's post-operative course significantly, often necessitating a longer length of stay, antibiotic therapy, intervention for wound collections and impair patient mobility and overall recovery. In addition to this, laparotomy wound complications can possibly delay adjuvant therapy and also increases healthcare costs both as an inpatient and in the community. Despite significant measures to reduce such complications in the form of wound care bundles, changing of gloves prior to wound closure etc., surgical site complications continue to represent a huge healthcare burden. The Investigators are conducting this study to determine whether NPWT dressings reduce surgical site infections, improve wound healing and scar appearance. This study will also involve a cost-based analysis and seek information from patients on their quality of life. Results from this study will provide evidence on whether these dressings should be used as standard of care for management of surgical laparotomy wounds.


Recruitment information / eligibility

Status Recruiting
Enrollment 2000
Est. completion date July 2026
Est. primary completion date January 2026
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: - Aged 18 years or older - Patient requires visceral abdominal surgery via a midline laparotomy - Patients who can complete questionnaires Exclusion Criteria: • Patients who are unable to adhere to protocol requirements

Study Design


Intervention

Device:
Negative Pressure Wound Therapy
Application of a negative wound pressure therapy dressing to the wound post laparotomy
Other:
Standard wound dressing
Application of a standard wound dressing to the wound post laparotomy

Locations

Country Name City State
Ireland Portiuncula University Hospital Ballinasloe
Ireland Mayo University Hospital Castlebar
Ireland Our Lady of Lourdes Hospital Drogheda Drogheda
Ireland Beaumont Hospital Dublin
Ireland Mater Misericordiae University Hospital Dublin
Ireland St James's Hospital Dublin
Ireland University Hospital Galway Galway
Ireland Letterkenny University Hospital Letterkenny
Ireland University Hospital Limerick Limerick
Ireland Sligo University Hospital Sligo
Ireland University hospital Kerry Tralee
Ireland University Hospital Waterford Waterford

Sponsors (1)

Lead Sponsor Collaborator
Royal College of Surgeons, Ireland

Country where clinical trial is conducted

Ireland, 

Outcome

Type Measure Description Time frame Safety issue
Primary Rate of Surgical Site Infection (SSI) To compare the rate of surgical site infections within 1 month of the surgical procedure, using Negative Pressure Wound Therapy compared to standard dressings. SSIs will be classified according to Centre for Disease Control (CDC) criteria. 1 month following surgery
Primary Rate of Surgical Site Infection (SSI) To compare the rate of surgical site infections within 3 months of the surgical procedure, using Negative Pressure Wound Therapy compared to standard dressings. SSIs will be classified according to Centre for Disease Control (CDC) criteria. 3 months following surgery
Primary Rate of Surgical Site Infection (SSI) To compare the rate of surgical site infections within 6 months of the surgical procedure, using Negative Pressure Wound Therapy compared to standard dressings. SSIs will be classified according to Centre for Disease Control (CDC) criteria. 6 months following surgery
Secondary Health-related quality of life with the EuroQol-5 dimensions five level index questionnaire (EQ-5D-5L) The questionnaire covers five dimensions of health: mobility, self-care, usual activities, pain or discomfort, and anxiety or depression. Each dimension has 5 levels: no problems (1), slight problems (2), moderate problems (3), severe problems (4) and extreme problems (5). The patient is asked to indicate his/her health state by ticking the box next to the most appropriate statement in each of the five dimensions. The raw scores are also converted to an EQ-5D index value using a scoring algorithm (British tariff) ranging from -0.594 (worst perceived health state) to 1.00 (best perceived health state) Baseline
Secondary Health-related quality of life with the EuroQol-5 dimensions five level index questionnaire (EQ-5D-5L) The questionnaire covers five dimensions of health: mobility, self-care, usual activities, pain or discomfort, and anxiety or depression. Each dimension has 5 levels: no problems (1), slight problems (2), moderate problems (3), severe problems (4) and extreme problems (5). The patient is asked to indicate his/her health state by ticking the box next to the most appropriate statement in each of the five dimensions. The raw scores are also converted to an EQ-5D index value using a scoring algorithm (British tariff) ranging from -0.594 (worst perceived health state) to 1.00 (best perceived health state) 1 month following surgery
Secondary Health-related quality of life with the EuroQol-5 dimensions five level index questionnaire (EQ-5D-5L) The questionnaire covers five dimensions of health: mobility, self-care, usual activities, pain or discomfort, and anxiety or depression. Each dimension has 5 levels: no problems (1), slight problems (2), moderate problems (3), severe problems (4) and extreme problems (5). The patient is asked to indicate his/her health state by ticking the box next to the most appropriate statement in each of the five dimensions. The raw scores are also converted to an EQ-5D index value using a scoring algorithm (British tariff) ranging from -0.594 (worst perceived health state) to 1.00 (best perceived health state) 3 months following surgery
Secondary Health-related quality of life with the EuroQol-5 dimensions five level index questionnaire (EQ-5D-5L) The questionnaire covers five dimensions of health: mobility, self-care, usual activities, pain or discomfort, and anxiety or depression. Each dimension has 5 levels: no problems (1), slight problems (2), moderate problems (3), severe problems (4) and extreme problems (5). The patient is asked to indicate his/her health state by ticking the box next to the most appropriate statement in each of the five dimensions. The raw scores are also converted to an EQ-5D index value using a scoring algorithm (British tariff) ranging from -0.594 (worst perceived health state) to 1.00 (best perceived health state) 6 months following surgery
Secondary Scar assessment - using the Patient and Observer Scar Assessment Scale (POSAS) The POSAS is made up of two scales: the patient scale and the observer scale; each of the six components is scored numerically on a scale of 1 to 10. The component scores are then added together; the worst scar would receive a score of 60, while the best scar would receive a score of 6 1 month following surgery
Secondary Scar assessment - using the Patient and Observer Scar Assessment Scale (POSAS) The POSAS is made up of two scales: the patient scale and the observer scale; each of the six components is scored numerically on a scale of 1 to 10. The component scores are then added together; the worst scar would receive a score of 60, while the best scar would receive a score of 6 3 months following surgery
Secondary Scar assessment - using the Patient and Observer Scar Assessment Scale (POSAS) The POSAS is made up of two scales: the patient scale and the observer scale; each of the six components is scored numerically on a scale of 1 to 10. The component scores are then added together; the worst scar would receive a score of 60, while the best scar would receive a score of 6 6 months following surgery
Secondary Health-related out-of- Pocket Costs assessed using the Costs for Patients Questionnaire (CoPaQ) The CoPaQ measures patient and caregivers out-of-pocket expenses (direct and indirect) associated with a health condition 1 month
Secondary Health-related out-of- Pocket Costs assessed using the Costs for Patients Questionnaire (CoPaQ) The CoPaQ measures patient and caregivers out-of-pocket expenses (direct and indirect) associated with a health condition 3 months
Secondary Health-related out-of- Pocket Costs assessed using the Costs for Patients Questionnaire (CoPaQ) The CoPaQ measures patient and caregivers out-of-pocket expenses (direct and indirect) associated with a health condition 6 months
Secondary Health Economics evaluation of resource use and cost effectiveness using Negative Pressure Wound Therapy dressings Investigating resource use and cost effectiveness of single-use, prophylactic negative pressure wound therapy versus standard dressings for midline laparotomy wounds based on length of hospital stay and costs of dressings 6 months
Secondary Healthcare incremental cost- utility ratio The incremental cost-effectiveness ratio at 6 months for NPWT vesus standard dressings for patients undergoing laparotomy.The effectiveness will be expressed as quality adjusted life years (QALYs) in a cost-utility analysis. QALYs are a composite measure of outcomes where utilities for health states (on 0-1 scale, where 0 corresponds to death and 1 to full health) act as qualitative weights to combine quantity and quality of life. The number of QALYs in each group will be assessed with the EuroQol 5 Dimensions questionnaire (EQ5D). The EQ-5D measures health status in terms of mobility, self-care, usual activities, pain/discomfort and anxiety/depression 6 months
Secondary Healthcare cost-effectiveness ratio at 6 months Assessment of the cost-effectiveness ratio at 6 months between NPWT dressings compared to standard dressings. The criteria of effectiveness used will be; Length of hospital stay, requirement for return to theatre, requirement for critical care and number of dressings used 6 months
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