NCT04617353

Brief Summary

In cardiovascular surgery, the most common and serious complication is postoperative wound infection. The most formidable wound complication is mediastinitis, the frequency of which varies from 1 to 3%. Currently, mortality in this group of patients varies from 3.5 to 58.3%. In this regard, the relevance of developing new methods for the prevention and treatment of infectious wound complications is beyond doubt. In this study, it is supposed to examine and evaluate the effectiveness of the combined effects of air-plasma flow and nitric oxide in the treatment of postoperative infectious complications in cardiac surgery.

Trial Health

87
On Track

Trial Health Score

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

Enrollment
80

participants targeted

Target at P50-P75 for not_applicable

Timeline
Completed

Started Mar 2017

Longer than P75 for not_applicable

Geographic Reach
1 country

1 active site

Status
completed

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

March 14, 2017

Completed
3.6 years until next milestone

First Submitted

Initial submission to the registry

October 30, 2020

Completed
6 days until next milestone

First Posted

Study publicly available on registry

November 5, 2020

Completed
1.1 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 20, 2021

Completed
2 years until next milestone

Study Completion

Last participant's last visit for all outcomes

December 20, 2023

Completed
Last Updated

March 1, 2024

Status Verified

February 1, 2024

Enrollment Period

4.8 years

First QC Date

October 30, 2020

Last Update Submit

February 29, 2024

Conditions

Keywords

plasmaendogenous nitric oxideinfectious complicationsmediastinitis

Outcome Measures

Primary Outcomes (4)

  • Death

    In-hospital mortality rate (%)

    30 days

  • Re-infection of the wound

    Rate wound re-infection (%)

    30 days

  • Skin suture incompetence

    Rate of skin suture incompetence (%) due to lack of tissue repair

    30 days

  • Recovery

    Rate of full recovery (%)

    30 days

Study Arms (2)

Plasma

EXPERIMENTAL

(the treatment of sterno-mediastinitis was carried out using a combined method of air-plasma flow and NO therapy)

Procedure: NO-based treatment of sterno-mediastinitis

Standard therapy

OTHER

(patients who were treated for sterno-mediastinitis according to clinical guidelines, the main method of which is a permanent irrigation and aspiration flow drainage method, as well as a Vacuum Assisted Closure (VAC) system of dressings for vacuum drainage)

Procedure: Treatment of sterno-mediastinitis

Interventions

Preparation of a postoperative wound in case of infectious complications. A mandatory sampling material for culture and antibiotic sensitivity is collected before and after the air plasma flow treatment. Direct effect of the air-plasma flow on the entire wound surface in sterilization mode with an exposure of 2-3 minutes for each surgical wound, until the level of bacterial contamination decreases to 10-5 and below. The technique of using air-plasma flow when closing a wound after preventing infectious complications in it. In the postoperative period, daily air-plasma flow treatment in sterilization mode along the suture line for 3 minutes. Penetrating drainage NO supply in the biological stimulation mode daily for 10 days, with an exposure of 1-2 minutes up to 10 days, with a volume of up to 2 liters per minute. Collecting wound culture from the drainage containers on 1-3-7-12 days to detect pathogens and the bacterial number.

Plasma

patients who were treated for sterno-mediastinitis according to clinical guidelines, the main method of which is a permanent irrigation and aspiration flow drainage method, as well as a Vacuum Assisted Closure (VAC) system of dressings for vacuum drainage

Standard therapy

Eligibility Criteria

Age40 Years - 80 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Patients who underwent heart and great vessels surgery with confirmed laboratory, bacteriological, instrumental tests, as well as the presence of clinical signs of sterno-mediastinitis.
  • Signed informed consent to participate in the study

You may not qualify if:

  • Patients who underwent heart and great vessels surgery not through a median sternotomy.
  • Patients who have signs of inconsistency of sutures or any other wound complications, but there are no clinical, laboratory, bacteriological data indicating infection of the postoperative wound.
  • No informed consent to participate in the study.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

TomskNRMC

Tomsk, Tomskay Oblast, 634012, Russia

Location

MeSH Terms

Conditions

Mediastinitis

Condition Hierarchy (Ancestors)

Mediastinal DiseasesThoracic DiseasesRespiratory Tract Diseases

Study Officials

  • Mikhail Kuznetsov, PhD

    Tomsk National Research Medical Center of the Russian Academy of Sciences

    STUDY CHAIR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
NON RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: Patient enrollment according to the inclusion criteria. Carrying out medical manipulations according to the group inclusion criteria. Efficiency control based on the clinical course of the disease, instrumental and laboratory study methods. After the patient is discharged from the hospital, a follow-up examination after 12 months, including an objective examination, a spiral computed tomography of the chest organs. Complete blood count, general urine test, biochemistry blood test. Comparison of the main clinical and laboratory parameters between patients of both groups: the total number of bed-days spent, the time spent in the ICU, the duration of mechanical ventilation, laboratory parameters: red blood cell count, coagulation system, markers of infection and inflammation, state of sepsis, determination of how fast the bone tissue reparation is. CT scan of the chest, sternum, examination of the bacterial flora and bacterial contamination of the postoperative wound
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

October 30, 2020

First Posted

November 5, 2020

Study Start

March 14, 2017

Primary Completion

December 20, 2021

Study Completion

December 20, 2023

Last Updated

March 1, 2024

Record last verified: 2024-02

Data Sharing

IPD Sharing
Will share

Deidentified individual participant data (text, tables, figures, and appendices), underlying the results of the trial, will be shared with researchers to achieve the aims in the approved proposal.

Shared Documents
STUDY PROTOCOL, SAP, ICF, CSR
Time Frame
Proposals may be submitted up to 36 months following publication of the results of the trial. After 36 months, the data will be available in the Center's data ware house but without investigator support other than deposited metadata.
Access Criteria
Information regarding submitting proposals and accessing data may be requested from the principal investigator by e-mail.

Locations