NCT02503904

Brief Summary

The principal aim of the present research is to compare two methods of antibiotic delivery: concomitant tumescent antibiotic delivery (TAD) and intravenous antibiotic delivery (IVAD) versus IVAD alone, (TAD+IVAD vs IVAD), with respect to the prevention of surgical site infections (SSI). The investigators hypothesize that TAD+IVAD will significantly reduce the incidence of SSI compared to IVAD. TAD is the subcutaneous infiltration of a dilute solution of antibiotic(s) in a solution of tumescent local anesthesia (TLA). TLA consists of a dilute solution of lidocaine (1gm/L), epinephrine (1mg/L) and sodium bicarbonate (10mEq/L) in 0.9% physiologic saline. A secondary aim of this study is to compare TAD+IVAD vs IVAD with respect to the prevention of post-operative venous thromboembolism (VTE).

Trial Health

35
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
400

participants targeted

Target at P75+ for phase_2

Timeline
Completed

Started Oct 2015

Typical duration for phase_2

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

December 26, 2014

Completed
7 months until next milestone

First Posted

Study publicly available on registry

July 21, 2015

Completed
2 months until next milestone

Study Start

First participant enrolled

October 1, 2015

Completed
3.7 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

June 1, 2019

Completed
6 months until next milestone

Study Completion

Last participant's last visit for all outcomes

December 1, 2019

Completed
Last Updated

July 21, 2015

Status Verified

July 1, 2015

Enrollment Period

3.7 years

First QC Date

December 26, 2014

Last Update Submit

July 20, 2015

Conditions

Keywords

PharmacologyLidocaineEpinephrineCefazolinMetronidazoleInfectionpreventionprophylaxisSSISurgeryComplications

Outcome Measures

Primary Outcomes (1)

  • Number of surgical site infections

    30 days

Secondary Outcomes (4)

  • Number of post-operative venous thromboembolism

    30 days

  • Amount of postoperative narcotic required

    7 days

  • Hospital length of stay

    30 days

  • Number of participants with adverse events

    24 hours

Study Arms (2)

TAD+IVAD

ACTIVE COMPARATOR
Procedure: Concomitant Tumescent Antibiotic Delivery & IV DeliveryDevice: Subcutaneous Tumescent InfiltrationDrug: cecefazolin and metronidazole (in a dilute solution of tumescent lidocaine, epinephrin and sodium bicarbonate in 0.9% physiologic saline)

IVAD

ACTIVE COMPARATOR
Procedure: Concomitant Tumescent Antibiotic Delivery & IV DeliveryDrug: cecefazolin and metronidazole (in a dilute solution of tumescent lidocaine, epinephrin and sodium bicarbonate in 0.9% physiologic saline)

Interventions

Concomitant subcutaneous infiltration of a dilute antibiotics (cefazolin and metronidazole) in a dilute solution of tumescent lidocaine and epinephrine at the site of a proposed surgical incision.

Also known as: TAD+IVAD
IVADTAD+IVAD

Subcutaneous tumescent infiltration using HK tumescent infiltration cannulas and HK tumescent infiltration pump

TAD+IVAD

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • \. Subjects greater than 18 years of age scheduled for surgical procedure considered to have a high risk for a surgical site infection (SSI) such as 1) secondary repair of a ventral hernia, 2) open bariatric surgery, 3) open abdominal colorectal surgery, 4) trauma surgery, 5) burn surgery or 6) sternotomy.
  • \. Patients must have one of the following risk factors for surgical site infection: emergency surgery, obesity, diabetes mellitus, cancer surgery, be immune-compromised or otherwise be at an increased risk for SSI.
  • \. Only adults will participate as research subjects 4. This study will involve both males and females 5. Patients in ASA (American Society of Anesthesiology) class I or II or III or IV will be included. Treatment assignment will be stratified with respect to ASA classification.
  • \. Abdominal wound classifications: Clean-Contaminated, Contaminated, or Dirty are eligible to participate. Treatment assignment will be stratified with respect wound classification. Similarly, trauma and burn patients will be classified.
  • \. Patient must be able to understand the same written and spoken language as either the surgeon or nurse who provides informed-consent information to the patient.
  • \. Patients must be appropriately screened for the proposed surgery.

You may not qualify if:

  • \. Foreign material in the incision that cannot be removed 13. Recent systemic antimicrobial therapy 14. Clinically significant renal impairment or a creatinine clearance \< 30 mL/min.
  • Vulnerable Subjects are excluded
  • Pregnant women
  • Nursing home residents, or other institutionalized persons are not fully alert, not cognizant or and not able to give informed consent are not eligible to participate as a research subject
  • Children \< 18 years of age

Contact the study team to confirm eligibility.

Sponsors & Collaborators

MeSH Terms

Conditions

Surgical Wound InfectionVenous ThromboembolismInfections

Interventions

ParturitionMetronidazoleEpinephrineSodium Bicarbonate

Condition Hierarchy (Ancestors)

Wound InfectionPostoperative ComplicationsPathologic ProcessesPathological Conditions, Signs and SymptomsThromboembolismEmbolism and ThrombosisVascular DiseasesCardiovascular Diseases

Intervention Hierarchy (Ancestors)

PregnancyReproductionReproductive Physiological PhenomenaReproductive and Urinary Physiological PhenomenaNitroimidazolesNitro CompoundsOrganic ChemicalsImidazolesAzolesHeterocyclic Compounds, 1-RingHeterocyclic CompoundsEthanolaminesAmino AlcoholsAlcoholsAminesBiogenic MonoaminesBiogenic AminesCatecholaminesCatecholsPhenolsBenzene DerivativesHydrocarbons, AromaticHydrocarbons, CyclicHydrocarbonsBicarbonatesCarbonatesCarbonic AcidCarbon Compounds, InorganicInorganic ChemicalsSodium Compounds

Central Study Contacts

Jeffrey A Klein, MD

CONTACT

Study Design

Study Type
interventional
Phase
phase 2
Allocation
RANDOMIZED
Masking
NONE
Purpose
PREVENTION
Intervention Model
PARALLEL
Sponsor Type
INDIV
Responsible Party
SPONSOR

Study Record Dates

First Submitted

December 26, 2014

First Posted

July 21, 2015

Study Start

October 1, 2015

Primary Completion

June 1, 2019

Study Completion

December 1, 2019

Last Updated

July 21, 2015

Record last verified: 2015-07