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Comparison of Surgical Incision Complications in Patients Receiving PICO or Standard Care Following Colorectal Surgery

Primary Purpose

Wounds and Injuries

Status
Withdrawn
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
PICO Softport V1.6
Standard Care
Sponsored by
Smith & Nephew, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Wounds and Injuries focused on measuring Surgical incision, surgical complication, NPWT, negative pressure, colorectal surgery, dehisced

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

INCLUSION CRITERIA

  1. The subject or legal guardian must provide written informed consent (reference section 9.1).
  2. Subjects eighteen (18) years of age or older.
  3. Willing and able to make all required study visits.
  4. Able to follow instructions.
  5. Males or females.
  6. Subject must be classified as a high risk patient in terms of likelihood for SSC's (i.e., heavy smoker (more than 20 cigarettes per day), diabetic, BMI ≥ 30, immunocompromised) or be treated as an emergency patient with obstructed bowel, perforated bowel or peritonitis and be undergoing any of the following procedures:- Left hemicolectomy, right hemicolectomy, extended right hemicolectomy, sigmoidectomy, anterior rectum resection, total colectomy.

EXCLUSION CRITERIA

  1. Contraindications or hypersensitivity to the use of the investigational product or its components (e.g., silicone adhesives and polyurethane films [direct contact with incision], acrylic adhesives [direct contact with skin], polyethylene fabrics and super-absorbent powders [polyacrylates]) within the dressing.
  2. Subjects with extremely fragile skin who require the use of SECURA non-sting barrier skin wipes and have hypersensitivity to the ingredients in the wipes.
  3. Participation in another clinical trial (with use of investigational medicinal product or medical device) within thirty (30) days of Visit 1 or during the study.
  4. Subjects with skin features (e.g., tattoos, pre-existing scarring) which, in the opinion of the Investigator, could interfere with the study assessments.
  5. Subjects who have participated previously in this clinical trial.
  6. Subjects with a reference incision (that is the largest incision that is made during the surgery and the one that is allocated to study treatment) less than 8cm.
  7. Subjects with incisions exceeding 40 cm in length.
  8. Subjects with incisions that are actively bleeding unless homeostasis has been achieved (to be confirmed during surgery).
  9. Patients attending for a re-operation within the last 3 months.
  10. Patients undergoing a procedure as part of palliative care (to be confirmed during surgery).
  11. Patients with a systemic infection (that is not related to perforated bowel or peritonitis) at the time of surgery.
  12. Patients with a known history of poor compliance with medical treatment.
  13. Patients who also have a gynaecological procedure carried out during the colorectal procedure.
  14. Patients other than those with a disease known to affect the immune system that are on steroids or other immune modulators known to impact healing.
  15. Patients with a genetic or acquired healing defect.
  16. Exposure of blood vessels, organs, bone or tendon within the incision (to be confirmed during surgery).
  17. Subjects with a medical or physical condition that, in the opinion of the Investigator, would preclude safe subject participation in the study.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Other

    Arm Label

    PICO

    Standard care

    Arm Description

    Single use NPWT (PICO Softport V1.6)

    Gauze dressing, Film dressing, foam dressing, skin glue, no dressing

    Outcomes

    Primary Outcome Measures

    Number of complications in each group

    Secondary Outcome Measures

    Dehiscence incidence during a 30-day follow-up period
    Haematoma incidence during a 30-day follow-up period
    Seroma incidence during a 30-day follow-up
    Time to surgical incision closure
    Total length of hospital stay, including readmissions during a 30-day follow-up period
    Time to initial discharge during a 30-day follow-up period
    Total number of readmissions during a 30-day follow-up period
    To compare PICO against Standard Care for differences in Health Related Quality of Life (HRQoL) using SF-12 over the 14-day and 30-day follow-up period
    Overall per subject treatment cost for PICO and Standard Care
    Cost per Quality Adjusted Life Year (QALY) within a 30-day follow-up period

    Full Information

    First Posted
    August 25, 2016
    Last Updated
    March 28, 2019
    Sponsor
    Smith & Nephew, Inc.
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    1. Study Identification

    Unique Protocol Identification Number
    NCT02883010
    Brief Title
    Comparison of Surgical Incision Complications in Patients Receiving PICO or Standard Care Following Colorectal Surgery
    Official Title
    A Randomised Controlled Study to Compare Surgical Site Complication Incidence in Subjects Receiving PICO or Standard Care Following Colorectal Surgery
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    March 2019
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    Business decision
    Study Start Date
    January 2017 (Anticipated)
    Primary Completion Date
    January 2017 (Actual)
    Study Completion Date
    January 2017 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Smith & Nephew, Inc.

    4. Oversight

    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    Surgical Site Complications (SSC's) are responsible for increased morbidity in patients undergoing surgery resulting in prolonged length of stay in the hospital while increasing treatment and hospital costs dramatically. Negative Pressure Wound Therapy (NPWT) use on closed incisions has been reported in the literature to reduce SSC's including Surgical Site Infections (SSI's), with many promising studies in general surgery, including some studies using single use NPWT. However, to date, there are very few randomised controlled trials (RCT's) using this intervention. When using PICOTM (NPWT) for this indication, patients may be discharged from hospital earlier, with the negative pressure incision management in place. This has implications in terms of cost savings for the health care system and enables the patient to be able to return to their normal daily routine more quickly. The hypothesis of this study is that PICO NPWT will reduce frequency of SSC's, in a 30 day follow up period, as compared to standard care in patients undergoing colorectal procedures.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Wounds and Injuries
    Keywords
    Surgical incision, surgical complication, NPWT, negative pressure, colorectal surgery, dehisced

    7. Study Design

    Primary Purpose
    Prevention
    Study Phase
    Not Applicable
    Interventional Study Model
    Parallel Assignment
    Masking
    None (Open Label)
    Allocation
    Randomized
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    PICO
    Arm Type
    Experimental
    Arm Description
    Single use NPWT (PICO Softport V1.6)
    Arm Title
    Standard care
    Arm Type
    Other
    Arm Description
    Gauze dressing, Film dressing, foam dressing, skin glue, no dressing
    Intervention Type
    Device
    Intervention Name(s)
    PICO Softport V1.6
    Intervention Description
    PICO is a Single-Use Negative Pressure Wound Therapy (NPWT) System consisting of a small portable pump, 2 lithium batteries, 2 dressings and fixation strips. The system is capable of delivering up to 80 mm Hg negative pressure to a wound or surgical incision site and managing low to moderate levels of exudate or fluid generated by the wound or incision. The therapy may be administered for up to 2 weeks.
    Intervention Type
    Other
    Intervention Name(s)
    Standard Care
    Intervention Description
    Care path normally used by the hospital
    Primary Outcome Measure Information:
    Title
    Number of complications in each group
    Time Frame
    30 days
    Secondary Outcome Measure Information:
    Title
    Dehiscence incidence during a 30-day follow-up period
    Time Frame
    30 days
    Title
    Haematoma incidence during a 30-day follow-up period
    Time Frame
    30 days
    Title
    Seroma incidence during a 30-day follow-up
    Time Frame
    30 days
    Title
    Time to surgical incision closure
    Time Frame
    30 days
    Title
    Total length of hospital stay, including readmissions during a 30-day follow-up period
    Time Frame
    30 days
    Title
    Time to initial discharge during a 30-day follow-up period
    Time Frame
    30 days
    Title
    Total number of readmissions during a 30-day follow-up period
    Time Frame
    30 days
    Title
    To compare PICO against Standard Care for differences in Health Related Quality of Life (HRQoL) using SF-12 over the 14-day and 30-day follow-up period
    Time Frame
    30 days
    Title
    Overall per subject treatment cost for PICO and Standard Care
    Time Frame
    30 days
    Title
    Cost per Quality Adjusted Life Year (QALY) within a 30-day follow-up period
    Time Frame
    30 days

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    INCLUSION CRITERIA The subject or legal guardian must provide written informed consent (reference section 9.1). Subjects eighteen (18) years of age or older. Willing and able to make all required study visits. Able to follow instructions. Males or females. Subject must be classified as a high risk patient in terms of likelihood for SSC's (i.e., heavy smoker (more than 20 cigarettes per day), diabetic, BMI ≥ 30, immunocompromised) or be treated as an emergency patient with obstructed bowel, perforated bowel or peritonitis and be undergoing any of the following procedures:- Left hemicolectomy, right hemicolectomy, extended right hemicolectomy, sigmoidectomy, anterior rectum resection, total colectomy. EXCLUSION CRITERIA Contraindications or hypersensitivity to the use of the investigational product or its components (e.g., silicone adhesives and polyurethane films [direct contact with incision], acrylic adhesives [direct contact with skin], polyethylene fabrics and super-absorbent powders [polyacrylates]) within the dressing. Subjects with extremely fragile skin who require the use of SECURA non-sting barrier skin wipes and have hypersensitivity to the ingredients in the wipes. Participation in another clinical trial (with use of investigational medicinal product or medical device) within thirty (30) days of Visit 1 or during the study. Subjects with skin features (e.g., tattoos, pre-existing scarring) which, in the opinion of the Investigator, could interfere with the study assessments. Subjects who have participated previously in this clinical trial. Subjects with a reference incision (that is the largest incision that is made during the surgery and the one that is allocated to study treatment) less than 8cm. Subjects with incisions exceeding 40 cm in length. Subjects with incisions that are actively bleeding unless homeostasis has been achieved (to be confirmed during surgery). Patients attending for a re-operation within the last 3 months. Patients undergoing a procedure as part of palliative care (to be confirmed during surgery). Patients with a systemic infection (that is not related to perforated bowel or peritonitis) at the time of surgery. Patients with a known history of poor compliance with medical treatment. Patients who also have a gynaecological procedure carried out during the colorectal procedure. Patients other than those with a disease known to affect the immune system that are on steroids or other immune modulators known to impact healing. Patients with a genetic or acquired healing defect. Exposure of blood vessels, organs, bone or tendon within the incision (to be confirmed during surgery). Subjects with a medical or physical condition that, in the opinion of the Investigator, would preclude safe subject participation in the study.
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Beate Hanson, MD, PhD
    Organizational Affiliation
    Vice President, Global Clinical Strategy
    Official's Role
    Study Chair

    12. IPD Sharing Statement

    Plan to Share IPD
    No

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    Comparison of Surgical Incision Complications in Patients Receiving PICO or Standard Care Following Colorectal Surgery

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