NCT02967627

Brief Summary

Surgical Site Infections (SSIs) and wound complications are common occurrences following colorectal resection surgery. Incisional Negative Pressure Wound Therapy (iNPWT) has developing evidence for improving wound complication rates in certain populations. However, there have been no RCTs to date that have looked at iNPWT use after colorectal surgery. We propose a study in which patients are randomized into one of two treatment arms: 1) incisional NPWT, and 2) standard sterile gauze dressings. Patients will be followed for 30 days for diagnosis of infection or wound complication. We will compare primary outcomes in each group using Chi-Squared statistical testing in order to report a Absolute Risk Reduction and Number Needed to Treat

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 not_applicable

Timeline
Completed

Started Nov 2016

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

Study Start

First participant enrolled

November 1, 2016

Completed
15 days until next milestone

First Submitted

Initial submission to the registry

November 16, 2016

Completed
2 days until next milestone

First Posted

Study publicly available on registry

November 18, 2016

Completed
10 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

September 1, 2017

Completed
1 month until next milestone

Study Completion

Last participant's last visit for all outcomes

October 1, 2017

Completed
Last Updated

November 18, 2016

Status Verified

November 1, 2016

Enrollment Period

10 months

First QC Date

November 16, 2016

Last Update Submit

November 17, 2016

Conditions

Outcome Measures

Primary Outcomes (2)

  • Superficial Surgical Site Infection (SSI)

    Infection occurring within the first thirty days after surgery with at least one of the following: 1) purulent drainage from the superficial incision; 2) organisms obtained from an aseptically obtained culture of tissue or fluid from the superficial incision; 3) at least one of the local signs of infection; 4) superficial incision deliberately opened by the surgeon (unless the culture is negative)

    30 days post op

  • Wound Complication

    At least one of the following: 1) seroma; 2) hematoma; 3) SSI; 4) wound dehiscence/disruption

    30 days post op

Secondary Outcomes (5)

  • Length of stay

    approximately 5-10 days on average

  • Wound-related visits post surgery

    30 days post op

  • Need for and duration of home care

    30 days post op

  • Blistering/reaction to wound dressings

    3 days post op

  • Post Op Complications

    30 days post op

Study Arms (2)

Incisional Negative Pressure Wound Therapy (iNPWT)

EXPERIMENTAL

Patients in the iNPWT group will have their incision covered by a single layer of Mepitel wound contact layer followed by application of a KCI V.A.C Simplace ™ Dressing composed of a strip of black foam covering the entire length of the incision followed by coverage of the incision, Mepitel, and foam with an occlusive Tegederm ™ dressing to establish an airtight seal. Negative pressure will then be applied using a SensaT.R.A.C. Pad ™ to a setting of 100 mmHg continuous suction. Dressings shall remain in place and will be removed by the surgical team on the morning of the third post-operative day and left open to air thereafter. Any loss of seal of the dressing shall be reinforced using occlusive dressings.

Device: Incisional Negative Pressure Wound Therapy (iNPWT)

Standard Therapy

ACTIVE COMPARATOR

Patients in the conventional dressings group will receive a standard Mepore ™ dressing applied to cover the entire incision. This will be left in place and and removed by the surgical team on the morning of the second postoperative day and will be left open to air thereafter. Dressings may be either reinforced or changed at the discretion of the surgical team due to drainage or saturation during the first two postoperative days.

Device: Sterile Gauze Dressing

Interventions

Incisional Negative Pressure Wound Therapy devices are lightweight, self contained, portable battery powered (or line powered), suction pumps for medical procedures where secretions and other body fluids and infectious materials must be removed through the application of continuous or intermittent negative pressure. The pumps are operated through computer software, having help and alarm features. The device is indicted for management of chronic, acute, traumatic, subacute and dehisced wounds, partial-thickness burns, ulcers (such as diabetic or pressure), flaps and grafts. The pumps may be used at patient's bedside. These are suitable for use in either hospitals or long term care facilities and nursing homes. These devices will be applied to closed laparotomy incisions with the aim to provide three days of continuous negative pressure of - 100mmHg.

Also known as: Surgical Incision Management System (SIMS), Closed Incisional Negative Pressure Wound Therapy (ciNPWT), V.A.C dressing
Incisional Negative Pressure Wound Therapy (iNPWT)

In most cases, self-adhesive, absorbent dressings will be used for standard wound therapy. However, surgical teams may decide on alternative forms of sterile gauze dressings, as long as the wound site is kept clean and dry. Dressings should be taken down on the second post-operative day.

Also known as: Self-adhesive Absorbent Dressing
Standard Therapy

Eligibility Criteria

Age19 Years+
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • elective colorectal resection for benign or malignant disease
  • surgery involves an anastomosis
  • open or minimally invasive technique
  • midline laparotomy used for specimen extraction

You may not qualify if:

  • under 19
  • allergy/sensitivity to adhesives
  • immunocompromised
  • pregnant
  • emergency surgery
  • elective surgery
  • additional procedures performed at time of surgery

Contact the study team to confirm eligibility.

Sponsors & Collaborators

MeSH Terms

Conditions

Surgical Wound InfectionSeromaHematoma

Condition Hierarchy (Ancestors)

Wound InfectionInfectionsPostoperative ComplicationsPathologic ProcessesPathological Conditions, Signs and SymptomsInflammationHemorrhage

Study Officials

  • Neely O.M. Panton, MD, FRCSC

    UBC Division of General Surgery

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Mitchell A. Webb, MD

CONTACT

Vy Nguyen, MD, FRCSC

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

November 16, 2016

First Posted

November 18, 2016

Study Start

November 1, 2016

Primary Completion

September 1, 2017

Study Completion

October 1, 2017

Last Updated

November 18, 2016

Record last verified: 2016-11