Seprafilm in Open Abdomens: a Study of Wound and Adhesion Characteristics in Trauma Damage Control Patients

NCT ID: NCT01594385

Last Updated: 2017-11-20

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-04-30

Study Completion Date

2013-12-31

Brief Summary

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The goal of this study is to test the effects of Seprafilm adhesion barrier on patients who are undergoing open abdomen damage control management for traumatic injuries when compared to no adhesion barrier use. Specifically, the researchers wish to study the effects of Seprafilm adhesion barrier on:

* the number and intensity of adhesions,
* whether there is any difference between treatment groups (Seprafilm vs. no Seprafilm) who go on to successful definitive abdominal closure,
* rate of occurrence of secondary complications (such as abscesses) associated with short- and long-term beneficial effects of reducing adhesion formation,and
* whether there is any difference between treatment groups regarding patient functional recovery.

Detailed Description

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Data to be analyzed includes:

Age, gender, traumatic injuries, trauma alert level, procedure information, length of hospital stay, length of ICU stay, interval between admission and initial operation, interval between operations, whether operation took place during the day or night, duration of operation in minutes, number of surgeons present during the operation, description of the initial operation, justification for using damage control approach, complications noted, injuries missed or delayed in diagnosis, Acute Physiology and Chronic Health Evaluation II (APACHE II) calculations at various time points, Simplified Acute Physiology Score (SAPS II) calculations at various time points, Glasgow Coma Score (GCS) calculations at various time points, changes in GCS at over time, Injury Severity Score (ISS) at various time points, Abbreviated Injury Scale (AIS) at various time points, Penetrating Abdominal Trauma Index score (if applicable) at various time points, complete blood count (CBC) results at various time points, blood chemistry results at various time points, blood gas results at various time points, subject randomization information, number of operations, adhesion scores (Zuhlke and Yaacobi) for each operative procedure, contamination score for each operative procedure, diagnosis and description of sub-procedures for each operative procedure, wound characteristics from the start and end of all operative procedures (e.g. length and width of the fascia and skin), type of abdominal coverage or closure, discharge destination (e.g. home, short term rehabilitation facility, etc.), Functional Outcome Measure score, Glasgow Outcome Score (GOS) at various time points, number and interval of post discharge follow-up visits, wound characteristics since discharge at several time points and complications/complaints noted since discharge at several time points.

Conditions

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Open Abdomen Abdominal Adhesions Trauma Wounds and Injury

Keywords

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Open Abdomen Damage Control Trauma Wound healing Gun shot wounds Stab wounds Automobile accidents Wounds and Injury

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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Seprafilm

The treatment group will receive Seprafilm while the control group will not receive Seprafilm. Allocation of patients will be in 1:1 ratio.

Group Type OTHER

Seprafilm

Intervention Type BIOLOGICAL

Two sheets of the Seprafilm material will be applied at each reoperation. Each sheet will be cut into 1x1 inch squares and applied to the following anatomic areas:

* Two Seprafilm pieces between the liver and the anterior abdominal wall
* Four pieces over the exposed bowel surfaces anteriorly
* Two slightly staggered pieces of Seprafilm in each colic gutter
* Two pieces in the pelvic area.
* If any of the above areas involve an anastomosis or bowel repair, then the Seprafilm should be placed at least 1 inch away from the anastomosis and/or bowel repair.

No Seprafilm

This group will be treated according to the current standard of care. No seprafilm will be applied in this subset of patients.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Seprafilm

Two sheets of the Seprafilm material will be applied at each reoperation. Each sheet will be cut into 1x1 inch squares and applied to the following anatomic areas:

* Two Seprafilm pieces between the liver and the anterior abdominal wall
* Four pieces over the exposed bowel surfaces anteriorly
* Two slightly staggered pieces of Seprafilm in each colic gutter
* Two pieces in the pelvic area.
* If any of the above areas involve an anastomosis or bowel repair, then the Seprafilm should be placed at least 1 inch away from the anastomosis and/or bowel repair.

Intervention Type BIOLOGICAL

Eligibility Criteria

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Inclusion Criteria

* Trauma patients undergoing DC/OA management for traumatic injury
* Age 18+
* Life expectancy longer than 48 hours

Exclusion Criteria

* Prisoners
* Pregnant patients
* Younger than 18 years of age
Minimum Eligible Age

18 Years

Maximum Eligible Age

89 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Stan Stawicki

OTHER

Sponsor Role lead

Responsible Party

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Stan Stawicki

Associate Professor of Surgery

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Stanislaw P Stawicki, MD

Role: PRINCIPAL_INVESTIGATOR

Ohio State University

Locations

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Cooper University Hospital

Camden, New Jersey, United States

Site Status

Carolinas Medical Center

Charlotte, North Carolina, United States

Site Status

The Ohio State University Medical Center

Columbus, Ohio, United States

Site Status

St. Luke's Hospital

Bethlehem, Pennsylvania, United States

Site Status

Thomas Jefferson University

Philadelphia, Pennsylvania, United States

Site Status

Countries

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United States

References

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Stawicki SP, Green JM, Martin ND, Green RH, Cipolla J, Seamon MJ, Eiferman DS, Evans DC, Hazelton JP, Cook CH, Steinberg SM; OPUS 12 Foundation, Inc, Multi-Center Trials Group & OASIT Investigators. Results of a prospective, randomized, controlled study of the use of carboxymethylcellulose sodium hyaluronate adhesion barrier in trauma open abdomens. Surgery. 2014 Aug;156(2):419-30. doi: 10.1016/j.surg.2014.03.007. Epub 2014 Mar 15.

Reference Type RESULT
PMID: 24962185 (View on PubMed)

Other Identifiers

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2009H0311

Identifier Type: -

Identifier Source: org_study_id