Relation of Skin Closure Method to Groin Wound Infections After Proximal Femoral Artery Exposure.

NCT ID: NCT03468621

Last Updated: 2022-04-05

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

300 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-03-29

Study Completion Date

2022-01-01

Brief Summary

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This study aims to asses whether the rate of surgical wound infections in vascular surgery procedures involving exposure of the proximal femoral artery can be reduced using a different skin closure technique.

Detailed Description

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Summary of the research plan

Background - According to published articles the frequency of groin wound infections after peripheral revascularization varies substantially depending on the source from 5% up to 27%.

Aims of the study - The aim of this randomized clinical trial is to evaluate whether the number of groin wound infections can be reduced with an intradermal skin suture compared to the commonly used metal staples skin closure method.

Methods and study design - This is a randomized clinical trial of patients undergoing a vascular procedure which includes an incision in the groin. The patients will be randomized (1:1) to two different wound closure techniques: subcuticular suture or metal staples. After the procedure the patients will be controlled for four to six weeks and the infection rate in each group is recorded. A clinical diagnosis of infection according to Centre for Disease Control (CDC) guidelines will be recorded, no microbiological samples will be routinely collected.

Statistical analysis - A power analysis has been conducted based on Finnish RCT studies and a retrospective study from our own hospital (submitted to Annals of Vascular Surgery 1/2018) which included all isolated groin wounds from Turku University Hospital Vascular Surgery clinic 2015-2016. According to this analysis between 130-150 patients are needed for each group.

Time and schedule- This is a multicenter trial. Ethical committee approval was acquired in 2015. The randomization will start in the spring of 2018 in the University Hospital of Turku. Later in the year in the other hospitals that are participating in the study once the regional authorities have given their consent.

Ethical aspects - Ethical committee approval was obtained in 2015. The wound closure techniques are all in everyday use already, nothing new and experimental will be used.

Budget - This study is a critical part of quality control and improvement in vascular surgery. The funding will be applied from the Finnish Academy and EVO funding from the ERVA.

Conditions

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Surgical Wound Infection

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Patients are randomised to intradermal and transdermal wound closure techniques. Randomisation is 1:1 and block randomisation is used
Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Investigators

Study Groups

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Intradermal wound closure

Intradermal wound closure of the groin wound

Group Type OTHER

Wound closure

Intervention Type PROCEDURE

Method of wound closure

Transdermal wound closure

Wound closure of the groin wound with metal staples

Group Type OTHER

Wound closure

Intervention Type PROCEDURE

Method of wound closure

Interventions

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Wound closure

Method of wound closure

Intervention Type PROCEDURE

Other Intervention Names

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Intradermal wound closure Transdermal wound closure

Eligibility Criteria

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Inclusion Criteria

* Primary procedure to the groin, isolated groin wound

Exclusion Criteria

* Emergency procedure, secondary procedure, wound is a part of a larger wound in the same limb
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Turku University Hospital

OTHER_GOV

Sponsor Role lead

Responsible Party

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Veikko Nikulainen

Resident in Vascular Surgery

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Harri Hakovirta, adj prof.

Role: STUDY_DIRECTOR

harri [email protected]

Locations

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Keski-Suomen keskussairaala

Jyväskylä, Central Finland, Finland

Site Status

Satakunnan keskussairaala

Pori, Satakunta, Finland

Site Status

University Hospital of Turku

Turku, Southwest Finland, Finland

Site Status

Countries

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Finland

References

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Turtiainen J, Saimanen E, Partio T, Karkkainen J, Kiviniemi V, Makinen K, Hakala T. Surgical wound infections after vascular surgery: prospective multicenter observational study. Scand J Surg. 2010;99(3):167-72. doi: 10.1177/145749691009900312.

Reference Type BACKGROUND
PMID: 21044935 (View on PubMed)

Derksen WJ, Verhoeven BA, van de Mortel RH, Moll FL, de Vries JP. Risk factors for surgical-site infection following common femoral artery endarterectomy. Vasc Endovascular Surg. 2009 Feb-Mar;43(1):69-75. doi: 10.1177/1538574408323502. Epub 2008 Sep 30.

Reference Type BACKGROUND
PMID: 18829586 (View on PubMed)

Daryapeyma A, Ostlund O, Wahlgren CM. Healthcare-associated infections after lower extremity revascularization. Eur J Vasc Endovasc Surg. 2014 Jul;48(1):72-7. doi: 10.1016/j.ejvs.2014.02.003. Epub 2014 Mar 6.

Reference Type BACKGROUND
PMID: 24613135 (View on PubMed)

Stewart AH, Eyers PS, Earnshaw JJ. Prevention of infection in peripheral arterial reconstruction: a systematic review and meta-analysis. J Vasc Surg. 2007 Jul;46(1):148-55. doi: 10.1016/j.jvs.2007.02.065.

Reference Type BACKGROUND
PMID: 17606135 (View on PubMed)

Murphy PG, Tadros E, Cross S, Hehir D, Burke PE, Kent P, Sheehan SJ, Colgan MP, Moore DJ, Shanik GD. Skin closure and the incidence of groin wound infection: a prospective study. Ann Vasc Surg. 1995 Sep;9(5):480-2. doi: 10.1007/BF02143863.

Reference Type BACKGROUND
PMID: 8541198 (View on PubMed)

Gurusamy KS, Toon CD, Allen VB, Davidson BR. Continuous versus interrupted skin sutures for non-obstetric surgery. Cochrane Database Syst Rev. 2014 Feb 14;2014(2):CD010365. doi: 10.1002/14651858.CD010365.pub2.

Reference Type BACKGROUND
PMID: 24526375 (View on PubMed)

Correia RM, Nakano LC, Vasconcelos V, Cristino MA, Flumignan RL. Prevention of infection in peripheral arterial reconstruction of the lower limb. Cochrane Database Syst Rev. 2025 Oct 29;10:CD015022. doi: 10.1002/14651858.CD015022.pub2.

Reference Type DERIVED
PMID: 41159585 (View on PubMed)

Nikulainen V, Helmio P, Salminen P, Hurme S, Kukkonen T, Koskinen T, Hakovirta H. Effect of Skin Closure with Metal Staples vs. Intradermal Suture on Groin Infections after Vascular Surgery: A Randomised Controlled Trial. Eur J Vasc Endovasc Surg. 2025 May;69(5):777-782. doi: 10.1016/j.ejvs.2025.02.004. Epub 2025 Feb 7.

Reference Type DERIVED
PMID: 39923834 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Other Identifiers

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National Wound Infection Study

Identifier Type: -

Identifier Source: org_study_id

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