Closed Incision Negative Pressure Therapy Versus Standard of Care Surgical Dressing in Revision Total Knee Arthroplasty

NCT ID: NCT03274466

Last Updated: 2024-10-16

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

294 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-12-05

Study Completion Date

2019-12-19

Brief Summary

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This study evaluates surgical site complications in subjects undergoing revision of a total knee arthroplasty when closed incision negative pressure therapy is used to manage the closed incision, as compared to a standard of care dressing.

Detailed Description

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Conditions

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Surgical Wound Revision Total Knee Arthroplasty Wounds and Injuries Joint Disease Musculoskeletal Disease Prosthesis-Related Infections Infection Postoperative Complications Pathologic Processes

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Closed Incision Negative Pressure Therapy (ciNPT)

Prevena Peel \& Place or Prevena Plus Customizable Dressing and ActiVAC Therapy Unit or Prevena Plus Therapy Unit

Group Type EXPERIMENTAL

Closed Incision Negative Pressure Therapy (ciNPT)

Intervention Type DEVICE

Closed Incision Negative Pressure Therapy applied through a foam bolster with a wicking interface fabric that includes 0.019% ionic silver at 125 mmHg of negative pressure for 5-7 days.

Standard of Care Dressing

Silver impregnated dressing

Group Type ACTIVE_COMPARATOR

Standard of Care Dressing

Intervention Type DEVICE

A standard silver-impregnated dressing applied to a closed surgical incision for 5-7 days post-operatively.

Interventions

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Closed Incision Negative Pressure Therapy (ciNPT)

Closed Incision Negative Pressure Therapy applied through a foam bolster with a wicking interface fabric that includes 0.019% ionic silver at 125 mmHg of negative pressure for 5-7 days.

Intervention Type DEVICE

Standard of Care Dressing

A standard silver-impregnated dressing applied to a closed surgical incision for 5-7 days post-operatively.

Intervention Type DEVICE

Other Intervention Names

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Prevena Peel & Place Prevena Plus Customizable ActiV.A.C. Therapy Unit Prevena Plus 125 Therapy Unit Silver-impregnated dressing, Aquacel Ag Surgical or other equivalent

Eligibility Criteria

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Inclusion Criteria

The subject:

* is at least 22 years of age on the date of informed consent
* is able to provide their own informed consent
* requires a TKA revision defined as one of the following:

1. a one-stage aseptic revision procedure
2. a one-stage septic exchange procedure (requiring removal of all hardware) for acute postoperative infection
3. removal of cement spacer and re-implantation procedure
4. open reduction and internal fixation of peri-prosthetic fractures
* has one or more of the following:

1. a body mass index (BMI) greater than 35 kg/m2
2. a requirement for the use of blood thinners other than acetylsalicylic acid (ASA) after surgery
3. history of or current peripheral vascular disease
4. the presence of lymphedema in the operative limb
5. insulin-dependent diabetes mellitus
6. current tobacco use or previous history of smoking and quitting within the past 30 days
7. a history of prior infection of the operative site
8. current use of immunomodulators or steroids
9. current or history of cancer or hematological malignancy (excluding localized skin cancer)
10. rheumatoid arthritis
11. current renal failure or dialysis
12. malnutrition as determined by the investigator
13. liver disease as determined by the investigator
14. status post solid organ transplant
15. HIV
* is willing and able to return for all scheduled study visits
* if female, has a negative urine or serum pregnancy test at screening and day of revision surgery. Women who have had surgical sterilization by a medically accepted method such as tubal ligation, hysterectomy, or oophorectomy or are post-menopausal, defined as not having menstruation for \>= 12 months will be excluded from requiring this test.


The subject:

* has undergone a TKA revision resulting in a closed surgical incision

Exclusion Criteria

The subject:

* is pregnant or lactating
* will undergo a bilateral TKA within the same operative visit
* will undergo a bilateral TKA in which the first TKA surgery is on the knee selected for study
* will undergo a staged bilateral TKA in which the TKA revision surgery for the knee under study occurs within 30 days of the first TKA procedure
* was previously randomized in this protocol
* has a systemic active infection at the time of revision not including chronic viral infections such as HIV or hepatitis
* has a remote-site skin infection at the time of revision
* was tattooed on the area of the incision within 30 days prior to randomization
* has known sensitivity to the study product components (drape and/or dressing materials in direct contact with the closed incision or skin)
* has known sensitivity to silver
* is currently enrolled in another investigational trial that requires additional interventions
* is planned to be enrolled in another investigational trial that requires additional interventions at any time during the study
* has localized skin cancer around the incision site


The subject:

* has a surgical incision that precludes placement of dressing
* has a TKA revision resulting in a muscle flap
* has a TKA revision resulting in the placement of a spacer
* has an incision drainage and debridement procedure only
* has a surgical incision closed with skin glue
Minimum Eligible Age

22 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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3M

INDUSTRY

Sponsor Role collaborator

KCI USA, Inc

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Carlos Higuera, MD

Role: PRINCIPAL_INVESTIGATOR

The Cleveland Clinic

Locations

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Cleveland Clinic

Weston, Florida, United States

Site Status

Emory University Orthopedics & Spine Hospital

Tucker, Georgia, United States

Site Status

LSU Health Science Center

New Orleans, Louisiana, United States

Site Status

University of Missouri Health Care

Columbia, Missouri, United States

Site Status

Northwell Health - SouthSide Hospital

Bay Shore, New York, United States

Site Status

New York University (NYU)

New York, New York, United States

Site Status

Hospital for Special Surgery

New York, New York, United States

Site Status

Columbia University Medical Center/New York Presbyterian Hospital

New York, New York, United States

Site Status

Northwell Health - Lenox Hill Hospital

New York, New York, United States

Site Status

Duke University Medical Center

Durham, North Carolina, United States

Site Status

Cleveland Clinic

Cleveland, Ohio, United States

Site Status

Joint Implant Surgeons

New Albany, Ohio, United States

Site Status

Oregon Health & Science University

Portland, Oregon, United States

Site Status

University of Pennsylvania

Philadelphia, Pennsylvania, United States

Site Status

Rothman Institute - Thomas Jefferson University Hospital

Philadelphia, Pennsylvania, United States

Site Status

Houston Methodist Research Institute

Houston, Texas, United States

Site Status

Virginia Commonwealth University

Richmond, Virginia, United States

Site Status

Countries

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United States

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Other Identifiers

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KCI.PREVENA.2017.01

Identifier Type: -

Identifier Source: org_study_id

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