Sarcoma Surgery Wound Complications Comparing Usual Versus Negative Pressure Dressing

NCT ID: NCT07048184

Last Updated: 2025-07-09

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

NOT_YET_RECRUITING

Clinical Phase

PHASE2

Total Enrollment

94 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-12-01

Study Completion Date

2027-09-30

Brief Summary

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To compare the differences in clinical outcomes and health economics between standard absorbent dressings versus Negative Pressure Wound Therapy dressings following the surgical resection of sarcoma tumours.

Detailed Description

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The investigators propose to undertake a randomised controlled trial comparing standard absorbent dressings with Negative Pressure Wound Therapy (NPWT) dressings in the wound management following resection of sarcoma tumours. By using, NPWT in sarcoma patients the investigators aim to reduce the number of patients experiencing wound complications compared to those who receive standard absorbent dressings. 94 participants will be recruited over 12 months and randomised in a 1:1 ratio to receive either the standard or NPWT dressings. The primary aim will be to determine whether there is a clinically significant difference in wound complications between standard dressings and NPWT dressings over a four-month post-op period. The investigators will assess the patient's wound for signs of infection, dehiscence and other potential complications, and document the incidence and severity of complications. Researchers will also collect the Musculoskeletal Tumour Society Score (MSTS) and Toronto Extremity Salvage Score (TESS) at pre-op and 4 months post-op to understand how the dressings may have impacted function following recovery. In addition, health economic data will also be captured in the form for ED-5D-5L and questionnaires that will focus on the economic impact of surgery and potential wound complications on a patient return to work.

Wound complications following sarcoma tumour surgery can be traumatic for patients during their recovery and postpone subsequent chemotherapy treatments, as well as being an expensive burden to the NHS. NPWT dressings may potentially offer benefits to both patients and the NHS yet there is insufficient data available to support widespread use of this product in sarcoma patients. It is the investigators belief that NPWT is used because anecdotally it is believed to be better than standard absorbent dressings. However, there is a clear lack of robust evidence to support this idea, and the investigator aim to address this by undertaking this study..

Conditions

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Sarcoma Negative Pressure Therapy Wound Complication

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

This study will be fully unblinded due to the nature of the wound dressings used.

Study Groups

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Standard Absorbent Dressing

Standard Absorbent Dressings for wound closure

Group Type ACTIVE_COMPARATOR

Standard Absorbent Dressings

Intervention Type DEVICE

The wound will be closed as per the standard surgical technique and the operating surgeon's preference. Following wound closure of sarcoma tumour resection, standard absorbent dressing will be applied as per local protocols and the pre-op plan

Negative Pressure Wound Therapy Dressing

NPWT Dressings will be used for wound closure

Group Type EXPERIMENTAL

Negative Pressure Wound Therapy (NPWT) Dressings

Intervention Type DEVICE

During wound closure, skin glue is not permitted as this interferes with the NPWT suction mechanism. The NPWT is a mesh-based dressing that will be applied following the transparent occlusive dressing as per the manufacturer's instructions. Patients assigned to NPWT will have their dressing connected to a suction device (ActiV.A.C.®, KCI) providing a constant negative pressure of 125mmHg and left in situ for between 5 and 7 days. The dressings and suction device are all CE-marked medical devices that are being used within their intended usage.

Interventions

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Negative Pressure Wound Therapy (NPWT) Dressings

During wound closure, skin glue is not permitted as this interferes with the NPWT suction mechanism. The NPWT is a mesh-based dressing that will be applied following the transparent occlusive dressing as per the manufacturer's instructions. Patients assigned to NPWT will have their dressing connected to a suction device (ActiV.A.C.®, KCI) providing a constant negative pressure of 125mmHg and left in situ for between 5 and 7 days. The dressings and suction device are all CE-marked medical devices that are being used within their intended usage.

Intervention Type DEVICE

Standard Absorbent Dressings

The wound will be closed as per the standard surgical technique and the operating surgeon's preference. Following wound closure of sarcoma tumour resection, standard absorbent dressing will be applied as per local protocols and the pre-op plan

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Sarcoma of the upper/lower limb or torso requiring wide local excision, planned marginal excision or amputation
* Able to provide informed consent
* Aged 16 years or over
* Able, and willing, to adhere to scheduled trial procedures and visit schedule

Exclusion Criteria

* Previous surgery to planned surgical field
* Contra-indication to surgical excision of the tumour
* Disseminated malignancy on pre-op radiological imaging
* Post-radiation sarcoma
* Allergy to adhesive dressing
* Subjects who, in the opinion of the PI, will be unable to comply with follow-up
Minimum Eligible Age

16 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Glasgow

OTHER

Sponsor Role collaborator

Solventum

INDUSTRY

Sponsor Role collaborator

Sarcoma UK

UNKNOWN

Sponsor Role collaborator

CRUK Trials unit Glasgow

UNKNOWN

Sponsor Role collaborator

NHS Greater Glasgow and Clyde

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Sanjay Gupta, MBBS, MRCS, MSc, MPhil, FRCS

Role: PRINCIPAL_INVESTIGATOR

Department of Trauma and Orthopaedics, Glagow Royal Infirmary, NHS Greater Glasgow and Clyde

Locations

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Glasgow Royal Infirmary

Glasgow, Scotland, United Kingdom

Site Status

Countries

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United Kingdom

Central Contacts

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Eileen Soulis, MA

Role: CONTACT

+4401413017184

James Doonan, PhD

Role: CONTACT

+44 0141 201 6535

Facility Contacts

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James Doonan, PhD

Role: primary

+4401412016535

References

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Semsarzadeh NN, Tadisina KK, Maddox J, Chopra K, Singh DP. Closed Incision Negative-Pressure Therapy Is Associated with Decreased Surgical-Site Infections: A Meta-Analysis. Plast Reconstr Surg. 2015 Sep;136(3):592-602. doi: 10.1097/PRS.0000000000001519.

Reference Type BACKGROUND
PMID: 26313829 (View on PubMed)

Bedi M, King DM, DeVries J, Hackbarth DA, Neilson JC. Does Vacuum-assisted Closure Reduce the Risk of Wound Complications in Patients With Lower Extremity Sarcomas Treated With Preoperative Radiation? Clin Orthop Relat Res. 2019 Apr;477(4):768-774. doi: 10.1097/CORR.0000000000000371.

Reference Type BACKGROUND
PMID: 30811365 (View on PubMed)

Ouyang Z, Trent S, McCarthy C, Cosker T, Stuart R, Pratap S, Whitwell D, White HB, Tao H, Guo X, Maxime Gibbons CL. The incidence, risk factors and outcomes of wound complications after preoperative radiotherapy and surgery for high grade extremity soft tissue sarcomas: A 14-year retrospective study. Eur J Surg Oncol. 2023 Nov;49(11):107086. doi: 10.1016/j.ejso.2023.107086. Epub 2023 Sep 16.

Reference Type BACKGROUND
PMID: 37741042 (View on PubMed)

O'Sullivan B, Davis AM, Turcotte R, Bell R, Catton C, Chabot P, Wunder J, Kandel R, Goddard K, Sadura A, Pater J, Zee B. Preoperative versus postoperative radiotherapy in soft-tissue sarcoma of the limbs: a randomised trial. Lancet. 2002 Jun 29;359(9325):2235-41. doi: 10.1016/S0140-6736(02)09292-9.

Reference Type BACKGROUND
PMID: 12103287 (View on PubMed)

Shields DW, Razii N, Doonan J, Mahendra A, Gupta S. Closed incision negative pressure wound therapy versus conventional dressings following soft-tissue sarcoma excision: a prospective, randomized controlled trial. Bone Jt Open. 2021 Dec;2(12):1049-1056. doi: 10.1302/2633-1462.212.BJO-2021-0103.R1.

Reference Type BACKGROUND
PMID: 34905941 (View on PubMed)

Nandra R, Hwang N, Matharu GS, Reddy K, Grimer R. One-year mortality in patients with bone and soft tissue sarcomas as an indicator of delay in presentation. Ann R Coll Surg Engl. 2015 Sep;97(6):425-33. doi: 10.1308/003588415X14181254790284. Epub 2015 Aug 14.

Reference Type BACKGROUND
PMID: 26274756 (View on PubMed)

Related Links

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Other Identifiers

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GN23ON401

Identifier Type: -

Identifier Source: org_study_id

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