Back to resultsStudy of Phasix™ Mesh for VHWG Grade 3 Midline Hernia Repair
Primary Purpose
Hernia, Hernia, Abdominal, Hernia, Incisional
Status
Completed
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
Phasix™ Mesh
Sponsored by
About this trial
This is an interventional treatment trial for Hernia
Eligibility Criteria
Inclusion Criteria:
- Subject must be diagnosed with incisional midline hernia.
- Subject has a VHWG Grade 3 hernia (as defined in the protocol).
- Size of hernia ≥ 10 cm2.
- Subject must be willing to undergo a planned retro-rectus hernia repair (onlay allowed as an exception when retro-rectus placement cannot be achieved; using absorbable suture) with or without Component Separation Technique.
Exclusion Criteria:
- Subject with > 4 previous repairs of the hernia under observation.
- Body Mass Index (BMI) > 35 kg/m2.
- The subject is on, or suspected to be placed on, chemotherapy medications during any part of the study.
- The subject has peritonitis.
- Known human immunodeficiency virus (HIV) infection (if documented in the subject's record).
- The subject has cirrhosis of the liver and/or ascites.
- Subject is American Society of Anesthesiology Class 4 or 5.
- Complete removal of existing mesh from a prior hernia repair (in the same affected area) is not possible.
- The hernia repair requires more than a single piece mesh (with adequate overlap beyond the margins of the defect on all sides).
- Subject has intact permanent mesh adjacent to the current hernia to be repaired.
- Subject's hernia repair requires intraabdominal mesh placement.
- Surgical technique requires surgical bridge repair as the sole repair.
- Subject has any condition that, in the opinion of the Investigator, would preclude the use of the study device, or preclude the subject from completing the follow-up requirements.
- Subject is pregnant or has plans to become pregnant during the study period or is currently breastfeeding.
- Subject has an alcohol/substance abuse problem or has had a relapse within 12 months of the screening visit.
- Subject was involved in another interventional clinical study in the last 30 days prior to Informed Consent Form (ICF) signature.
- Subject is part of the site personnel directly involved with this study.
- Subject has a life expectancy of less than 2 years at the time of enrollment.
- Subject has a known sensitivity to Phasix™ Mesh or component materials (patients with known allergies to tetracycline hydrochloride or kanamycin sulfate should be avoided).
Sites / Locations
- Wilhelminenspital
- Imelda Ziekenhuis
- UZ Gent
- UZ Leuven (Gasthuisberg)
- Bispebjerg Hospital
- Centre Hospitalier Régional Universitaire de Lille
- APHP Hôpital Cochin
- Day Surgery and Hernia Center
- Vivantes Hospital
- Klinikum der Johann Wolfgang Goethe-Universität
- Policlinico Umberto I
- IJsselland Ziekenhuis
- Elkerliek Ziekenhuis
- Isala
- University College London Hospitals NHS Trust
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Phasix™ Mesh
Arm Description
Patients treated with Phasix™ Mesh for hernia repair
Outcomes
Primary Outcome Measures
Number of Participants With One or More Surgical Site Occurrence Within 3 Months of Index Procedure
Proportions of subjects with Surgical Site Occurrences, which are defined as hematoma, seroma, surgical site infection, wound dehiscence, skin necrosis and fistula requiring intervention. Occurrences at the surgical site will be assessed by physical examination at each study visit through 3 months. For analysis purposes, the aggregate Surgical Site Occurrence is defined as follows: "The question <Is there any evidence of surgical site occurrence (SSO) in the same location as the index procedure?> is answered with <yes>
Secondary Outcome Measures
Number of Participants With One or More Surgical Site Occurrence Within 24 Months of Index Procedure
Proportions of subjects with Surgical Site Occurrences, which are defined as hematoma, seroma, surgical site infection, wound dehiscence, skin necrosis and fistula requiring intervention. Occurrences at the surgical site will be assessed by physical examination at each study visit through 3 months. For analysis purposes, the aggregate Surgical Site Occurrence is defined as follows: "The question <Is there any evidence of surgical site occurrence (SSO) in the same location as the index procedure?> is answered with <yes> "
Number of Participants With a Hernia Recurrence
Proportion of subjects with hernia recurrence. Hernia recurrence rates will be assessed by physical examination (or if standard of care via CT/MRI or ultrasonography) at each study visit through 24 months. A recurrent hernia will be defined as any hernia identified or confirmed by the investigator, during any study follow-up visit, in approximately the same position as the hernia repaired in the study procedure.
Number of Participants With One or More Surgical Site Infection
Proportion of subjects with surgical site infections. Infections at the surgical site will be assessed by physical examination at each study visit through 24 months. If an infection is suspected, a routine culture, obtained via each site's standard protocol, should be obtained to determine cell count and type (i.e. yeast, gram positive or gram negative bacteria, or other). If genus and species of the culture are identified as part of the routine practice at the site, that information should be recorded. Classification will follow the US Centers of Disease Control and Prevention (CDC) guidelines for superficial, deep and organ/space surgical site infections.
Mean Change in Pain Between Baseline (Pre-Index Procedure) and 24 Months Post-Index Procedure, as Measured by a 10.0 cm Visual Analogue Scale
Mean change in self-reported pain measured on a Visual Analog Scale between Baseline and 24-month follow up. Scores are measured on a 10.0 cm line, lower values correspond with low pain perception. The outcome measure is presented as the absolute difference between the pain perception at Baseline and the pain perception at 24-month follow up. A negative score means a decrease in pain perception.
Number of Participants With One or More Device-related Adverse Event
Incidence Device-related Adverse Events: number of subjects with one or more possibly or definitely device-related Adverse Event.
Number of Participants Requiring Reoperation Due to Index Hernia Repair
Rate of reoperation due to the index hernia repair: the proportion of subjects with post-procedure reoperation due to the index hernia repair.
Mean Patient Reported Outcomes on Quality of Life Parameters as Measured by the Carolinas Comfort Scale (CCS) at 1, 3, 12 and 24 Months Post-Index Procedure
Each scale score (sensation of mesh, pain or movement limitations) ranges from 0-5 and is the average across the domains. The Total CCS Score ranges from 0-5 and is the average of the 3 scale scores. Low scores represent fewer symptoms or difficulties.
Absolute values of the Total CCS Score at 1-Month follow-up, at 3-Month follow-up, at 12-Month follow-up and at 24-Month follow up are reported.
The absolute value at Baseline, or a change in self-reported quality of life measured by Carolinas Comfort Scale® cannot be reported, as subjects had incorrectly answered the questions on Sensation of Mesh at Baseline where no Phasix Mesh was yet implanted, thereby creating a bias in the results.
Mean Change in Quality of Life Assessments as Measured by the EQ-5D Between Baseline (Pre-Index Procedure) and 24 Months Post-Index Procedure
Change in self-reported quality of life measured by EuroQol-5 Dimensions (EQ-5D™). Each of the 5 dimensions (mobility, self-care, usual activities, pain/discomfort and anxiety/depression) has 3 levels (no problems, some problems and extreme problems). The data is converted into a summary index number between 0 and 1, whereby 1 corresponds with the highest perception of Quality of Life. The outcome measure reports the absolute change from Baseline until 24-months follow up. A positive value corresponds with an increase in Quality of Life.
Mean Surgical Procedure Time of the Index Procedure as Measured From Incision to Closure
Surgical procedure time as measured from incision to closure (skin to skin)
Mean Time Until Participants Were Able to Return to Work
The number of days until subject returned to work, calculated as the date when employed subjects were able to fully get back to work minus the date of surgery.
Mean Length of Hospital Stay Related to Index Procedure
The length of hospital stay for the index procedure is calculated as the date of hospital discharge minus the date of hospital admission. Days in intensive care unit, days in step down unit (medium care) and days in the ward will be summarized as well.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT02720042
Brief Title
Study of Phasix™ Mesh for VHWG Grade 3 Midline Hernia Repair
Official Title
A Post-Market, Prospective, Multi-Center, Single-Arm Clinical Investigation of Phasix™ Mesh for VHWG Grade 3 Midline Hernia Repair
Study Type
Interventional
2. Study Status
Record Verification Date
September 2020
Overall Recruitment Status
Completed
Study Start Date
March 23, 2016 (Actual)
Primary Completion Date
July 31, 2017 (Actual)
Study Completion Date
June 20, 2019 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
C. R. Bard
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The purpose of this study is to collect additional data on safety and performance of Phasix™ Mesh in subjects requiring Ventral Hernia Working Group (VHWG) Grade 3 midline hernia repair.
Detailed Description
Approximately 85 subjects, at approximately 12 sites across Europe will be enrolled and treated to study the use of Phasix™ Mesh. All treated subjects will be followed for 2 years post-implantation.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hernia, Hernia, Abdominal, Hernia, Incisional
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
84 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Phasix™ Mesh
Arm Type
Experimental
Arm Description
Patients treated with Phasix™ Mesh for hernia repair
Intervention Type
Device
Intervention Name(s)
Phasix™ Mesh
Intervention Description
A resorbable mesh prepared from poly-4-hydroxybutyrate (P4HB)
Primary Outcome Measure Information:
Title
Number of Participants With One or More Surgical Site Occurrence Within 3 Months of Index Procedure
Description
Proportions of subjects with Surgical Site Occurrences, which are defined as hematoma, seroma, surgical site infection, wound dehiscence, skin necrosis and fistula requiring intervention. Occurrences at the surgical site will be assessed by physical examination at each study visit through 3 months. For analysis purposes, the aggregate Surgical Site Occurrence is defined as follows: "The question <Is there any evidence of surgical site occurrence (SSO) in the same location as the index procedure?> is answered with <yes>
Time Frame
3 Months
Secondary Outcome Measure Information:
Title
Number of Participants With One or More Surgical Site Occurrence Within 24 Months of Index Procedure
Description
Proportions of subjects with Surgical Site Occurrences, which are defined as hematoma, seroma, surgical site infection, wound dehiscence, skin necrosis and fistula requiring intervention. Occurrences at the surgical site will be assessed by physical examination at each study visit through 3 months. For analysis purposes, the aggregate Surgical Site Occurrence is defined as follows: "The question <Is there any evidence of surgical site occurrence (SSO) in the same location as the index procedure?> is answered with <yes> "
Time Frame
24 Months
Title
Number of Participants With a Hernia Recurrence
Description
Proportion of subjects with hernia recurrence. Hernia recurrence rates will be assessed by physical examination (or if standard of care via CT/MRI or ultrasonography) at each study visit through 24 months. A recurrent hernia will be defined as any hernia identified or confirmed by the investigator, during any study follow-up visit, in approximately the same position as the hernia repaired in the study procedure.
Time Frame
24 Months
Title
Number of Participants With One or More Surgical Site Infection
Description
Proportion of subjects with surgical site infections. Infections at the surgical site will be assessed by physical examination at each study visit through 24 months. If an infection is suspected, a routine culture, obtained via each site's standard protocol, should be obtained to determine cell count and type (i.e. yeast, gram positive or gram negative bacteria, or other). If genus and species of the culture are identified as part of the routine practice at the site, that information should be recorded. Classification will follow the US Centers of Disease Control and Prevention (CDC) guidelines for superficial, deep and organ/space surgical site infections.
Time Frame
24 Months
Title
Mean Change in Pain Between Baseline (Pre-Index Procedure) and 24 Months Post-Index Procedure, as Measured by a 10.0 cm Visual Analogue Scale
Description
Mean change in self-reported pain measured on a Visual Analog Scale between Baseline and 24-month follow up. Scores are measured on a 10.0 cm line, lower values correspond with low pain perception. The outcome measure is presented as the absolute difference between the pain perception at Baseline and the pain perception at 24-month follow up. A negative score means a decrease in pain perception.
Time Frame
24 Months
Title
Number of Participants With One or More Device-related Adverse Event
Description
Incidence Device-related Adverse Events: number of subjects with one or more possibly or definitely device-related Adverse Event.
Time Frame
24 Months
Title
Number of Participants Requiring Reoperation Due to Index Hernia Repair
Description
Rate of reoperation due to the index hernia repair: the proportion of subjects with post-procedure reoperation due to the index hernia repair.
Time Frame
24 Months
Title
Mean Patient Reported Outcomes on Quality of Life Parameters as Measured by the Carolinas Comfort Scale (CCS) at 1, 3, 12 and 24 Months Post-Index Procedure
Description
Each scale score (sensation of mesh, pain or movement limitations) ranges from 0-5 and is the average across the domains. The Total CCS Score ranges from 0-5 and is the average of the 3 scale scores. Low scores represent fewer symptoms or difficulties.
Absolute values of the Total CCS Score at 1-Month follow-up, at 3-Month follow-up, at 12-Month follow-up and at 24-Month follow up are reported.
The absolute value at Baseline, or a change in self-reported quality of life measured by Carolinas Comfort Scale® cannot be reported, as subjects had incorrectly answered the questions on Sensation of Mesh at Baseline where no Phasix Mesh was yet implanted, thereby creating a bias in the results.
Time Frame
24 Months
Title
Mean Change in Quality of Life Assessments as Measured by the EQ-5D Between Baseline (Pre-Index Procedure) and 24 Months Post-Index Procedure
Description
Change in self-reported quality of life measured by EuroQol-5 Dimensions (EQ-5D™). Each of the 5 dimensions (mobility, self-care, usual activities, pain/discomfort and anxiety/depression) has 3 levels (no problems, some problems and extreme problems). The data is converted into a summary index number between 0 and 1, whereby 1 corresponds with the highest perception of Quality of Life. The outcome measure reports the absolute change from Baseline until 24-months follow up. A positive value corresponds with an increase in Quality of Life.
Time Frame
24 Months
Title
Mean Surgical Procedure Time of the Index Procedure as Measured From Incision to Closure
Description
Surgical procedure time as measured from incision to closure (skin to skin)
Time Frame
1 day
Title
Mean Time Until Participants Were Able to Return to Work
Description
The number of days until subject returned to work, calculated as the date when employed subjects were able to fully get back to work minus the date of surgery.
Time Frame
24 Months
Title
Mean Length of Hospital Stay Related to Index Procedure
Description
The length of hospital stay for the index procedure is calculated as the date of hospital discharge minus the date of hospital admission. Days in intensive care unit, days in step down unit (medium care) and days in the ward will be summarized as well.
Time Frame
1 Month
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Subject must be diagnosed with incisional midline hernia.
Subject has a VHWG Grade 3 hernia (as defined in the protocol).
Size of hernia ≥ 10 cm2.
Subject must be willing to undergo a planned retro-rectus hernia repair (onlay allowed as an exception when retro-rectus placement cannot be achieved; using absorbable suture) with or without Component Separation Technique.
Exclusion Criteria:
Subject with > 4 previous repairs of the hernia under observation.
Body Mass Index (BMI) > 35 kg/m2.
The subject is on, or suspected to be placed on, chemotherapy medications during any part of the study.
The subject has peritonitis.
Known human immunodeficiency virus (HIV) infection (if documented in the subject's record).
The subject has cirrhosis of the liver and/or ascites.
Subject is American Society of Anesthesiology Class 4 or 5.
Complete removal of existing mesh from a prior hernia repair (in the same affected area) is not possible.
The hernia repair requires more than a single piece mesh (with adequate overlap beyond the margins of the defect on all sides).
Subject has intact permanent mesh adjacent to the current hernia to be repaired.
Subject's hernia repair requires intraabdominal mesh placement.
Surgical technique requires surgical bridge repair as the sole repair.
Subject has any condition that, in the opinion of the Investigator, would preclude the use of the study device, or preclude the subject from completing the follow-up requirements.
Subject is pregnant or has plans to become pregnant during the study period or is currently breastfeeding.
Subject has an alcohol/substance abuse problem or has had a relapse within 12 months of the screening visit.
Subject was involved in another interventional clinical study in the last 30 days prior to Informed Consent Form (ICF) signature.
Subject is part of the site personnel directly involved with this study.
Subject has a life expectancy of less than 2 years at the time of enrollment.
Subject has a known sensitivity to Phasix™ Mesh or component materials (patients with known allergies to tetracycline hydrochloride or kanamycin sulfate should be avoided).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Hans Jeekel
Organizational Affiliation
Erasmus University Medical Centre Rotterdam
Official's Role
Principal Investigator
Facility Information:
Facility Name
Wilhelminenspital
City
Vienna
Country
Austria
Facility Name
Imelda Ziekenhuis
City
Bonheiden
Country
Belgium
Facility Name
UZ Gent
City
Gent
Country
Belgium
Facility Name
UZ Leuven (Gasthuisberg)
City
Leuven
Country
Belgium
Facility Name
Bispebjerg Hospital
City
Copenhagen
Country
Denmark
Facility Name
Centre Hospitalier Régional Universitaire de Lille
City
Lille
Country
France
Facility Name
APHP Hôpital Cochin
City
Paris
Country
France
Facility Name
Day Surgery and Hernia Center
City
Cottbus
State/Province
Brandenburg
Country
Germany
Facility Name
Vivantes Hospital
City
Berlin
Country
Germany
Facility Name
Klinikum der Johann Wolfgang Goethe-Universität
City
Frankfurt
Country
Germany
Facility Name
Policlinico Umberto I
City
Roma
Country
Italy
Facility Name
IJsselland Ziekenhuis
City
Capelle Aan Den IJssel
Country
Netherlands
Facility Name
Elkerliek Ziekenhuis
City
Helmond
Country
Netherlands
Facility Name
Isala
City
Zwolle
Country
Netherlands
Facility Name
University College London Hospitals NHS Trust
City
London
Country
United Kingdom
12. IPD Sharing Statement
Plan to Share IPD
No
Citations:
PubMed Identifier
34282506
Citation
Van Rooijen MMJ, Tollens T, Jorgensen LN, de Vries Reilingh TS, Piessen G, Kockerling F, Miserez M, Windsor ACJ, Berrevoet F, Fortelny RH, Dousset B, Woeste G, van Westreenen HL, Gossetti F, Lange JF, Tetteroo GWM, Koch A, Jeekel J. Slowly resorbable biosynthetic mesh: 2-year results in VHWG grade 3 hernia repair. Hernia. 2022 Feb;26(1):131-138. doi: 10.1007/s10029-021-02453-1. Epub 2021 Jul 19.
Results Reference
derived
PubMed Identifier
30458747
Citation
van Rooijen MMJ, Jairam AP, Tollens T, Jorgensen LN, de Vries Reilingh TS, Piessen G, Kockerling F, Miserez M, Windsor ACJ, Berrevoet F, Fortelny RH, Dousset B, Woeste G, van Westreenen HL, Gossetti F, Lange JF, Tetteroo GWM, Koch A, Kroese LF, Jeekel J. A post-market, prospective, multi-center, single-arm clinical investigation of Phasix mesh for VHWG grade 3 midline incisional hernia repair: a research protocol. BMC Surg. 2018 Nov 20;18(1):104. doi: 10.1186/s12893-018-0439-7.
Results Reference
derived
Learn more about this trial
Study of Phasix™ Mesh for VHWG Grade 3 Midline Hernia Repair
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