Efficacy of Negative Pressure Wound Therapy After Total Ankle Arthroplasty

NCT ID: NCT03886818

Last Updated: 2023-09-28

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

48 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-03-25

Study Completion Date

2021-02-17

Brief Summary

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About 500 total ankle prostheses are implanted each year in France. Wound healing issues are the most common complications after Total Ankle Arthroplasty (TAA). In 2010, a French retrospective study observed a wound infection rate of 8% among 592 prostheses implanted. Wound infection rate can vary up to 28% from the data available in the literature. Delayed wound healing is a known risk factor of surgical site infection (SSI). Even if it remains a rare event, its consequences for the patient can be severe and lead to removal and/or replacement of the prosthesis, arthrodesis, or transtibial amputation.

Negative Pressure Wound Therapy (NPWT) is an adjuvant therapy for wound management and healing: it delivers a controlled negative pressure (sub-atmospheric) applied topically onto the wound from a vacuum pump. The wound is filled with wound filler and sealed with an airtight adhesive drape. It allows creating a moist wound environment, removing exudate, and reducing edema and risk of infection.

Incisional NPWT can accelerate wound healing regardless of the surgery performed, including orthopedics. A retrospective study compared the incidence of healing complications after TAA between the administration of the NPWT PICO™ (Smith\&Nephew) and the standard of care of postoperative wounds in 74 patients. A significant reduction of wound healing issues (3% vs. 24%, respectively; p=0.004) and a non-significant reduction of SSI (3% vs. 8%, respectively) were observed.

To the investigator knowledge, no randomized study has been conducted to assess the efficacy of the NPWT PICO™ for postoperative wound healing after TAA: Investigators propose to set up this study to obtain a high level of evidence in this population and investigators assume that the use of the PICO™ system after TAA would reduce delayed wound healing compared to the standard of care with conventional dressings.

Detailed Description

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Conditions

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Ankle Disease

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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PICO strategy

* Use of PICO™ device from the ankle surgery to the post-surgery day 7.
* Use of usual care by simple dressings after post-surgery day 7 up to wound healing

Group Type EXPERIMENTAL

PICO strategy

Intervention Type DEVICE

The PICO system with negatif pression will be used from surgery to day 7. After that, standard dressing will be used untill the wound Healing.

Standard of care

-Usual care by simple dressings after the ankle surgery until the wound healing.

Group Type ACTIVE_COMPARATOR

Standard dressings

Intervention Type DEVICE

Standard dressings will be used from surgery to wound healing

Interventions

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Standard dressings

Standard dressings will be used from surgery to wound healing

Intervention Type DEVICE

PICO strategy

The PICO system with negatif pression will be used from surgery to day 7. After that, standard dressing will be used untill the wound Healing.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Patient aged 18 years or older
* Patient for whom a total ankle arthroplasty has been scheduled
* Patient affiliated to a national health insurance scheme or similar
* Patient who have signed an informed consent form for its participation in the study

Exclusion Criteria

* Patient with contraindication to use of the PICO™ device
* Patient participating in another study including an exclusion period in progress
* Patient participating in another interventional study that may interfere with this research
* Adult patient protected by law, under guardianship or tutorship ;
* Pregnant or breastfeeding women.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hospices Civils de Lyon

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Jean-Luc Dr BESSE

Role: PRINCIPAL_INVESTIGATOR

Hospice Civils de Lyon

Locations

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Service de Chirurgie orthopédique - Groupement Hospitalier Lyon Sud

Lyon, , France

Site Status

Countries

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France

Other Identifiers

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69HCL18_0753

Identifier Type: -

Identifier Source: org_study_id

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