Negative Pressure Incisional Wound Therapy for High-risk Ventral Hernia Repair

NCT ID: NCT04455724

Last Updated: 2024-06-27

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

110 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-12-14

Study Completion Date

2024-05-01

Brief Summary

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The investigators are testing the ability of vacuum dressings to improve wound healing for patients having large hernias surgically repaired who are at risk of having wound complications. The trial will randomly be giving some patients having this surgery the vacuum dressing and some a standard dressing and observing how their wounds heal in hospital and at follow-up appointments.

Detailed Description

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This study is a multicentre, clinical randomized controlled trial comparing the use of incisional negative pressure wound therapy versus standard sterile dressings in high-risk ventral hernia repairs. The trial will be enrolling patients undergoing elective or emergent ventral hernia repair who have risk factors for surgical wound complications and randomizing them to either receive a PREVENA incisional negative pressure wound therapy system dressing for 7 days post-operatively or a standard sterile dressing.for 2 days post-operatively. The primary outcome will be a composite of a variety of surgical site complications including wound infection, dehiscence, seroma / hematoma formation, non-healing wound, early hernia recurrence, and fistula formation. These will be evaluated by unblinded clinical judgement of treating physicians, and blinded assessment with ultrasonography. Secondary outcomes will include perceived difference in Quality of Life and cost-effectiveness of the intervention.

Conditions

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Ventral Hernia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Investigators Outcome Assessors
Given the physical differences in the negative pressure wound therapy systems compared to standard sterile dressings, patient participants and care providers will not be able to be blinded. Ultrasound evaluators and statisticians, however, will be.

Study Groups

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Negative Pressure Incisional Wound Therapy

A PREVENA™ PEEL \& PLACE™ system kit will be applied to the surgical wound and assembled in the operating room following closure by primary intent. The system will be set for a negative pressure of -125mmHg. The dressing will be left in place for 7 days post-operation, during which the patient may be discharged from hospital. The dressing will only be removed or changed if the treating physician has suspicion of one of the complications included in the primary composite outcome or is planning re-intervention on the surgical site.

Group Type EXPERIMENTAL

Negative pressure incisional wound therapy

Intervention Type DEVICE

A vacuum-style dressing system that is sealed in place over a surgical wound, applying constant negative pressure to the healing tissues.

Standard sterile dressing

A sterile island dressing will be applied to the surgical wound in the operating room following closure by primary intent, which will be removed on post-operative day 2 and left open to air unless there is ongoing discharge.

Group Type ACTIVE_COMPARATOR

Standard sterile dressing

Intervention Type DEVICE

A standard, sterile island dressing

Interventions

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Negative pressure incisional wound therapy

A vacuum-style dressing system that is sealed in place over a surgical wound, applying constant negative pressure to the healing tissues.

Intervention Type DEVICE

Standard sterile dressing

A standard, sterile island dressing

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

1. patients undergoing surgical repair of ventral or incisional hernias greater than 3 cm in largest diameter
2. have one or more of the following risk factors for post-operative surgical site complications:

1. Body Mass Index (BMI) greater than or equal to 30
2. diagnosis of diabetes mellitus (either type I or II)
3. previous history of hernia recurrence
4. active smoker
5. presence of colostomy or ileostomy
6. age greater than 64
7. chronic obstructive pulmonary disease
8. chronic kidney disease
9. clinically immunocompromised.

Exclusion Criteria

1. the abdomen is left open post-operatively, or
2. if the patient has a sensitivity to silver.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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McMaster University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Christopher E Blewett, MD

Role: PRINCIPAL_INVESTIGATOR

McMaster University

Locations

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Niagara Health St. Catharines Site

St. Catharines, Ontario, Canada

Site Status

Countries

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Canada

References

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Lindmark M, Strigard K, Lowenmark T, Dahlstrand U, Gunnarsson U. Risk Factors for Surgical Complications in Ventral Hernia Repair. World J Surg. 2018 Nov;42(11):3528-3536. doi: 10.1007/s00268-018-4642-6.

Reference Type BACKGROUND
PMID: 29700567 (View on PubMed)

Nguyen MT, Berger RL, Hicks SC, Davila JA, Li LT, Kao LS, Liang MK. Comparison of outcomes of synthetic mesh vs suture repair of elective primary ventral herniorrhaphy: a systematic review and meta-analysis. JAMA Surg. 2014 May;149(5):415-21. doi: 10.1001/jamasurg.2013.5014.

Reference Type BACKGROUND
PMID: 24554114 (View on PubMed)

Lee L, Mata J, Landry T, Khwaja KA, Vassiliou MC, Fried GM, Feldman LS. A systematic review of synthetic and biologic materials for abdominal wall reinforcement in contaminated fields. Surg Endosc. 2014 Sep;28(9):2531-46. doi: 10.1007/s00464-014-3499-5. Epub 2014 Mar 12.

Reference Type BACKGROUND
PMID: 24619334 (View on PubMed)

Castro PM, Rabelato JT, Monteiro GG, del Guerra GC, Mazzurana M, Alvarez GA. Laparoscopy versus laparotomy in the repair of ventral hernias: systematic review and meta-analysis. Arq Gastroenterol. 2014 Jul-Sep;51(3):205-11. doi: 10.1590/s0004-2803201400030008.

Reference Type BACKGROUND
PMID: 25296080 (View on PubMed)

Fischer JP, Wink JD, Nelson JA, Kovach SJ 3rd. Among 1,706 cases of abdominal wall reconstruction, what factors influence the occurrence of major operative complications? Surgery. 2014 Feb;155(2):311-9. doi: 10.1016/j.surg.2013.08.014.

Reference Type BACKGROUND
PMID: 24433774 (View on PubMed)

Lovecchio F, Farmer R, Souza J, Khavanin N, Dumanian GA, Kim JY. Risk factors for 30-day readmission in patients undergoing ventral hernia repair. Surgery. 2014 Apr;155(4):702-10. doi: 10.1016/j.surg.2013.12.021. Epub 2013 Dec 25.

Reference Type BACKGROUND
PMID: 24612622 (View on PubMed)

Badia JM, Casey AL, Petrosillo N, Hudson PM, Mitchell SA, Crosby C. Impact of surgical site infection on healthcare costs and patient outcomes: a systematic review in six European countries. J Hosp Infect. 2017 May;96(1):1-15. doi: 10.1016/j.jhin.2017.03.004. Epub 2017 Mar 8.

Reference Type BACKGROUND
PMID: 28410761 (View on PubMed)

Correa NF, de Brito MJ, de Carvalho Resende MM, Duarte MF, Santos FS, Salome GM, Ferreira LM. Impact of surgical wound dehiscence on health-related quality of life and mental health. J Wound Care. 2016 Oct 2;25(10):561-570. doi: 10.12968/jowc.2016.25.10.561.

Reference Type BACKGROUND
PMID: 27681586 (View on PubMed)

Gheorghe A, Moran G, Duffy H, Roberts T, Pinkney T, Calvert M. Health Utility Values Associated with Surgical Site Infection: A Systematic Review. Value Health. 2015 Dec;18(8):1126-37. doi: 10.1016/j.jval.2015.08.004. Epub 2015 Sep 26.

Reference Type BACKGROUND
PMID: 26686800 (View on PubMed)

Guest JF, Fuller GW, Vowden P. Costs and outcomes in evaluating management of unhealed surgical wounds in the community in clinical practice in the UK: a cohort study. BMJ Open. 2018 Dec 14;8(12):e022591. doi: 10.1136/bmjopen-2018-022591.

Reference Type BACKGROUND
PMID: 30552253 (View on PubMed)

Argenta LC, Morykwas MJ. Vacuum-assisted closure: a new method for wound control and treatment: clinical experience. Ann Plast Surg. 1997 Jun;38(6):563-76; discussion 577.

Reference Type BACKGROUND
PMID: 9188971 (View on PubMed)

Capobianco CM, Zgonis T. An overview of negative pressure wound therapy for the lower extremity. Clin Podiatr Med Surg. 2009 Oct;26(4):619-31. doi: 10.1016/j.cpm.2009.08.002.

Reference Type BACKGROUND
PMID: 19778692 (View on PubMed)

Ma Z, Li Z, Shou K, Jian C, Li P, Niu Y, Qi B, Yu A. Negative pressure wound therapy: Regulating blood flow perfusion and microvessel maturation through microvascular pericytes. Int J Mol Med. 2017 Nov;40(5):1415-1425. doi: 10.3892/ijmm.2017.3131. Epub 2017 Sep 13.

Reference Type BACKGROUND
PMID: 28901392 (View on PubMed)

Morykwas MJ, Argenta LC, Shelton-Brown EI, McGuirt W. Vacuum-assisted closure: a new method for wound control and treatment: animal studies and basic foundation. Ann Plast Surg. 1997 Jun;38(6):553-62. doi: 10.1097/00000637-199706000-00001.

Reference Type BACKGROUND
PMID: 9188970 (View on PubMed)

Orgill DP, Manders EK, Sumpio BE, Lee RC, Attinger CE, Gurtner GC, Ehrlich HP. The mechanisms of action of vacuum assisted closure: more to learn. Surgery. 2009 Jul;146(1):40-51. doi: 10.1016/j.surg.2009.02.002. Epub 2009 Apr 19. No abstract available.

Reference Type BACKGROUND
PMID: 19541009 (View on PubMed)

Scherer SS, Pietramaggiori G, Mathews JC, Prsa MJ, Huang S, Orgill DP. The mechanism of action of the vacuum-assisted closure device. Plast Reconstr Surg. 2008 Sep;122(3):786-797. doi: 10.1097/PRS.0b013e31818237ac.

Reference Type BACKGROUND
PMID: 18766042 (View on PubMed)

Moues CM, Vos MC, van den Bemd GJ, Stijnen T, Hovius SE. Bacterial load in relation to vacuum-assisted closure wound therapy: a prospective randomized trial. Wound Repair Regen. 2004 Jan-Feb;12(1):11-7. doi: 10.1111/j.1067-1927.2004.12105.x.

Reference Type BACKGROUND
PMID: 14974959 (View on PubMed)

Dohmen PM, Markou T, Ingemansson R, Rotering H, Hartman JM, van Valen R, Brunott M, Segers P. Use of incisional negative pressure wound therapy on closed median sternal incisions after cardiothoracic surgery: clinical evidence and consensus recommendations. Med Sci Monit. 2014 Oct 4;20:1814-25. doi: 10.12659/MSM.891169.

Reference Type BACKGROUND
PMID: 25280449 (View on PubMed)

Rodriguez-Unda N, Soares KC, Azoury SC, Baltodano PA, Hicks CW, Burce KK, Cornell P, Cooney CM, Eckhauser FE. Negative-Pressure Wound Therapy in the Management of High-Grade Ventral Hernia Repairs. J Gastrointest Surg. 2015 Nov;19(11):2054-61. doi: 10.1007/s11605-015-2894-0. Epub 2015 Aug 4.

Reference Type BACKGROUND
PMID: 26239514 (View on PubMed)

Conde-Green A, Chung TL, Holton LH 3rd, Hui-Chou HG, Zhu Y, Wang H, Zahiri H, Singh DP. Incisional negative-pressure wound therapy versus conventional dressings following abdominal wall reconstruction: a comparative study. Ann Plast Surg. 2013 Oct;71(4):394-7. doi: 10.1097/SAP.0b013e31824c9073.

Reference Type BACKGROUND
PMID: 22868327 (View on PubMed)

Pauli EM, Krpata DM, Novitsky YW, Rosen MJ. Negative pressure therapy for high-risk abdominal wall reconstruction incisions. Surg Infect (Larchmt). 2013 Jun;14(3):270-4. doi: 10.1089/sur.2012.059. Epub 2013 Apr 16.

Reference Type BACKGROUND
PMID: 23590852 (View on PubMed)

Swanson EW, Cheng HT, Susarla SM, Lough DM, Kumar AR. Does negative pressure wound therapy applied to closed incisions following ventral hernia repair prevent wound complications and hernia recurrence? A systematic review and meta-analysis. Plast Surg (Oakv). 2016 Summer;24(2):113-8. Epub 2016 May 27.

Reference Type BACKGROUND
PMID: 27441196 (View on PubMed)

Abesamis GM, Chopra S, Vickery K, Deva AK. A Comparative Trial of Incisional Negative-Pressure Wound Therapy in Abdominoplasty. Plast Reconstr Surg Glob Open. 2019 May 16;7(5):e2141. doi: 10.1097/GOX.0000000000002141. eCollection 2019 May.

Reference Type BACKGROUND
PMID: 31333924 (View on PubMed)

Hussamy DJ, Wortman AC, McIntire DD, Leveno KJ, Casey BM, Roberts SW. Closed Incision Negative Pressure Therapy in Morbidly Obese Women Undergoing Cesarean Delivery: A Randomized Controlled Trial. Obstet Gynecol. 2019 Oct;134(4):781-789. doi: 10.1097/AOG.0000000000003465.

Reference Type BACKGROUND
PMID: 31503147 (View on PubMed)

Ren H, Li Y. Severe complications after negative pressure wound therapy in burned wounds: two case reports. Ther Clin Risk Manag. 2014 Jul 1;10:513-6. doi: 10.2147/TCRM.S66117. eCollection 2014.

Reference Type BACKGROUND
PMID: 25061310 (View on PubMed)

Li Z, Yu A. Complications of negative pressure wound therapy: a mini review. Wound Repair Regen. 2014 Jul-Aug;22(4):457-61. doi: 10.1111/wrr.12190.

Reference Type BACKGROUND
PMID: 24852446 (View on PubMed)

Webster J, Liu Z, Norman G, Dumville JC, Chiverton L, Scuffham P, Stankiewicz M, Chaboyer WP. Negative pressure wound therapy for surgical wounds healing by primary closure. Cochrane Database Syst Rev. 2019 Mar 26;3(3):CD009261. doi: 10.1002/14651858.CD009261.pub4.

Reference Type BACKGROUND
PMID: 30912582 (View on PubMed)

Yu L, Kronen RJ, Simon LE, Stoll CRT, Colditz GA, Tuuli MG. Prophylactic negative-pressure wound therapy after cesarean is associated with reduced risk of surgical site infection: a systematic review and meta-analysis. Am J Obstet Gynecol. 2018 Feb;218(2):200-210.e1. doi: 10.1016/j.ajog.2017.09.017. Epub 2017 Sep 23.

Reference Type BACKGROUND
PMID: 28951263 (View on PubMed)

Stannard JP, Volgas DA, McGwin G 3rd, Stewart RL, Obremskey W, Moore T, Anglen JO. Incisional negative pressure wound therapy after high-risk lower extremity fractures. J Orthop Trauma. 2012 Jan;26(1):37-42. doi: 10.1097/BOT.0b013e318216b1e5.

Reference Type BACKGROUND
PMID: 21804414 (View on PubMed)

Pachowsky M, Gusinde J, Klein A, Lehrl S, Schulz-Drost S, Schlechtweg P, Pauser J, Gelse K, Brem MH. Negative pressure wound therapy to prevent seromas and treat surgical incisions after total hip arthroplasty. Int Orthop. 2012 Apr;36(4):719-22. doi: 10.1007/s00264-011-1321-8. Epub 2011 Jul 15.

Reference Type BACKGROUND
PMID: 21761149 (View on PubMed)

Masden D, Goldstein J, Endara M, Xu K, Steinberg J, Attinger C. Negative pressure wound therapy for at-risk surgical closures in patients with multiple comorbidities: a prospective randomized controlled study. Ann Surg. 2012 Jun;255(6):1043-7. doi: 10.1097/SLA.0b013e3182501bae.

Reference Type BACKGROUND
PMID: 22549748 (View on PubMed)

Grauhan O, Navasardyan A, Hofmann M, Muller P, Stein J, Hetzer R. Prevention of poststernotomy wound infections in obese patients by negative pressure wound therapy. J Thorac Cardiovasc Surg. 2013 May;145(5):1387-92. doi: 10.1016/j.jtcvs.2012.09.040. Epub 2012 Oct 27.

Reference Type BACKGROUND
PMID: 23111014 (View on PubMed)

Grauhan O, Navasardyan A, Tutkun B, Hennig F, Muller P, Hummel M, Hetzer R. Effect of surgical incision management on wound infections in a poststernotomy patient population. Int Wound J. 2014 Jun;11 Suppl 1(Suppl 1):6-9. doi: 10.1111/iwj.12294.

Reference Type BACKGROUND
PMID: 24851729 (View on PubMed)

Other Identifiers

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8183

Identifier Type: -

Identifier Source: org_study_id

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