PICO 7 vs PICO 14 in Revision Hip and Revision Knee Surgery.

NCT ID: NCT05389410

Last Updated: 2024-03-25

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

RECRUITING

Clinical Phase

NA

Total Enrollment

164 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-02-14

Study Completion Date

2027-02-14

Brief Summary

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This is a single-site trial, and it has been designed to compare a revision hip cohort with a revision knee cohort. All consecutive eligible patients, under the care of participating Co-Investigator Orthopaedic Surgeons, are approached for recruitment into the study.

Eligible patients wishing to participate must require either revision hip or revision knee surgery and consent to be randomised to either NPWT PICO dressing for 7-day therapy (PICO 7) or NPWT PICO 14-day therapy (PICO 14).

82 Revision Hips and 82 Revision Knee participants, with 41\* of each cohort randomised to either a 7-day or a 14-day NPWT dressing treatment duration period. The 7-day cohort will be treated with PICO7 dressings and pumps, and the 14-day cohort will be treated with PICO14 dressings.

\*Randomisation will be stratified, so it will continue until there are at least 41 participants in each cohort.

Detailed Description

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Although the efficacy of these dressings is well established in promoting wound healing, the duration of application particularly in revision surgeries, where the surgery has been carried out though old scar tissues is however undetermined at present. The few published studies regarding this do show a benefit, however, they do not address the potential issues surrounding late wound breakdown and the duration of the NPWT on the wound 4,5.

Therefore a proposed randomised study to evaluate whether one-week of negative pressure wound therapy is sufficient or whether a two-week therapy duration is warranted.

This will be done by randomising a minimum of 82 patients who are scheduled for revision hip surgery and 82 patients who are scheduled for revision knee surgery into either a "control group" or a "study group".

The 'control group' cohort will receive a NPWT PICO 7 dressing and pump for a period of week, followed by a hydrocolloid dressing or other standard dressing applied thereafter. The 'study group' cohort will receive a NPWT PICO 14 dressing and pump for a period of 2 weeks, with a dressing change at one week. The pump will be paused during the dressing change, restarting it again once the new dressing has been applied and sealed for another week's NPWT.

Conditions

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Surgical Wound

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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Revision Hip surgery

Participants will be randomised to PICO 7 or PICO 14 intervention.

Group Type EXPERIMENTAL

PICO 7

Intervention Type DEVICE

Participant will receive 7 days of NPWT following revision hip or revision knee surgery.

PICO 14

Intervention Type DEVICE

Participant will receive 14 days of NPWT following revision hip or revision knee surgery.

Revision knee surgery

Participants will be randomised to PICO 7 or PICO 14 intervention.

Group Type ACTIVE_COMPARATOR

PICO 7

Intervention Type DEVICE

Participant will receive 7 days of NPWT following revision hip or revision knee surgery.

PICO 14

Intervention Type DEVICE

Participant will receive 14 days of NPWT following revision hip or revision knee surgery.

Interventions

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PICO 7

Participant will receive 7 days of NPWT following revision hip or revision knee surgery.

Intervention Type DEVICE

PICO 14

Participant will receive 14 days of NPWT following revision hip or revision knee surgery.

Intervention Type DEVICE

Other Intervention Names

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7 day NPWT 14 day NPWT

Eligibility Criteria

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Inclusion Criteria

* Subjects must be over the age of 18 years.
* Participants undergoing aseptic revision hip or aseptic revision knee surgery procedure (a single stage revision procedure).
* Participants must be willing and be able to make all the required study visits to be seen by the research team at the Outpatients department at RJAH.
* Participants must be able to follow instructions.

Exclusion Criteria

* Revisions for infection, where the nature of the infection has a significant influence on the wound healing, discharge, and length of stay.
* Subjects with a history of poor compliance with medical treatment.
* Subjects with contraindications (as per the PICO Instructions for use) or hypersensitivity to the use of the NPWT PICO dressing product or its components e.g.: silicone adhesives, polyurethane films, acrylic adhesives, polyethylene fabrics and super- absorbent powders (polyacrylates) contained within the dressing.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Robert Jones and Agnes Hunt Orthopaedic and District NHS Trust

OTHER_GOV

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Sudheer L Karlakki

Role: PRINCIPAL_INVESTIGATOR

The Robert Jones and Agnes Hunt Orthopaedic Hospital Foundation Trust

Locations

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Robert Jones & Agnes Hunt Orthopaedic Hospital NHS Foundation Trust

Oswestry, Shropshire, United Kingdom

Site Status RECRUITING

Countries

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United Kingdom

Central Contacts

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Julie Steen, BSc. (Hons)

Role: CONTACT

01691404210

Facility Contacts

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Julie Steen

Role: primary

01691404210

References

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Malmsjo M, Huddleston E, Martin R. Biological effects of a disposable, canisterless negative pressure wound therapy system. Eplasty. 2014 Apr 2;14:e15. eCollection 2014.

Reference Type RESULT
PMID: 24741386 (View on PubMed)

Nherera LM, Trueman P, Karlakki SL. Cost-effectiveness analysis of single-use negative pressure wound therapy dressings (sNPWT) to reduce surgical site complications (SSC) in routine primary hip and knee replacements. Wound Repair Regen. 2017 May;25(3):474-482. doi: 10.1111/wrr.12530. Epub 2017 May 3.

Reference Type RESULT
PMID: 28370637 (View on PubMed)

Helito CP, Bueno DK, Giglio PN, Bonadio MB, Pecora JR, Demange MK. NEGATIVE-PRESSURE WOUND THERAPY IN THE TREATMENT OF COMPLEX INJURIES AFTER TOTAL KNEE ARTHROPLASTY. Acta Ortop Bras. 2017 Mar-Apr;25(2):85-88. doi: 10.1590/1413-785220172502169053.

Reference Type RESULT
PMID: 28642657 (View on PubMed)

Miyahara HS, Serzedello FR, Ejnisman L, Lima ALLM, Vicente JRN, Helito CP. INCISIONAL NEGATIVE-PRESSURE WOUND THERAPY IN REVISION TOTAL HIP ARTHROPLASTY DUE TO INFECTION. Acta Ortop Bras. 2018;26(5):300-304. doi: 10.1590/1413-785220182605196038.

Reference Type RESULT
PMID: 30464709 (View on PubMed)

Newman JM, Siqueira MBP, Klika AK, Molloy RM, Barsoum WK, Higuera CA. Use of Closed Incisional Negative Pressure Wound Therapy After Revision Total Hip and Knee Arthroplasty in Patients at High Risk for Infection: A Prospective, Randomized Clinical Trial. J Arthroplasty. 2019 Mar;34(3):554-559.e1. doi: 10.1016/j.arth.2018.11.017. Epub 2018 Nov 17.

Reference Type RESULT
PMID: 30545653 (View on PubMed)

Karlakki SL, Hamad AK, Whittall C, Graham NM, Banerjee RD, Kuiper JH. Incisional negative pressure wound therapy dressings (iNPWTd) in routine primary hip and knee arthroplasties: A randomised controlled trial. Bone Joint Res. 2016 Aug;5(8):328-37. doi: 10.1302/2046-3758.58.BJR-2016-0022.R1.

Reference Type RESULT
PMID: 27496913 (View on PubMed)

Pocock SJ, Simon R. Sequential treatment assignment with balancing for prognostic factors in the controlled clinical trial. Biometrics. 1975 Mar;31(1):103-15.

Reference Type RESULT
PMID: 1100130 (View on PubMed)

Barbachano Y, Coad DS. Inference following designs which adjust for imbalances in prognostic factors. Clin Trials. 2013 Aug;10(4):540-51. doi: 10.1177/1740774513493367. Epub 2013 Jul 5.

Reference Type RESULT
PMID: 23832671 (View on PubMed)

The ASA's Statement on p-values: Context, Process, and Purpose

Reference Type RESULT

Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007 May;39(2):175-91. doi: 10.3758/bf03193146.

Reference Type RESULT
PMID: 17695343 (View on PubMed)

Other Identifiers

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RL1 786

Identifier Type: -

Identifier Source: org_study_id

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