search
Back to results

Gentrix™ Versus Biological or Prosthetic Mesh

Primary Purpose

Ventral Incisional Hernia

Status
Terminated
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Gentrix™ Surgical Matrix (Treatment)
Permacol, Parietex, Progrip, Strattice Perforated, or Surgimend (Control)
Sponsored by
University of South Florida
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Ventral Incisional Hernia focused on measuring mesh

Eligibility Criteria

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

Inclusion Criteria:

  • Male and female patients ≥ 18 years old.
  • American Society of Anesthesiologists (ASA) physical status classification of I, II, III or IV.
  • Able to provide informed consent in English or Spanish.
  • Stated willingness to comply with all study procedures and availability for the duration of the study.
  • Body Mass Index (BMI) =< 45.
  • Incisional hernia from a midline incision ≥ 4 cm in greatest diameter, or any recurrent incisional hernia.

Exclusion Criteria:

  • Any other type of ventral hernia, such as umbilical, epigastric or Spigelian hernia.
  • Pregnant, breastfeeding, or unwilling to practice birth control during participation in the study, if applicable.
  • Allergy or hypersensitivity to materials in porcine-based study products, biological or prosthetic meshes, or personal preference.
  • Contraindications to general anesthesia.
  • Patient undergoing any emergency surgery prior to treatment.
  • Severe comorbid conditions likely to limit survival to less than 3 years in the opinion of the Investigator.
  • Have abdominal loss of domain such that the operation would be impractical or would adversely affect respiratory or cardiovascular function to an unacceptable degree in the opinion of the Investigator.
  • Inability to close the fascia primarily with abdominal wall mobilization or component separation; confirmed intra-operatively.
  • History of malignancy within the past 5 years except for non-melanoma skin cancer.
  • Known active malignancy present and/or had chemotherapy 12 weeks prior to screening or planned chemotherapy within 12 weeks of treatment with exception of basal cell carcinoma, squamous cell carcinoma, or prostate cancer in situ.
  • Cirrhosis with or without ascites.
  • Received high dose steroids (>/=100mg of prednisone) within the past 6 weeks of screening.
  • Uncontrolled diabetes (i.e. known HbA1C value > 7% within the prior 6 weeks of the Screening Visit).
  • History of drug addiction (recreational drugs, prescription drugs or alcohol) that in the Investigator's opinion may interfere with protocol assessments and/or the subject's ability to complete the required follow up.
  • Serious or active medical or psychiatric condition which, in the opinion of the Investigator, may interfere with treatment, assessment, or compliance with the protocol.
  • Suspected presence of enterocutaneous fistula.
  • Planned use of external VAC dressing intra-operatively.
  • Suspected bowel obstruction (partial or intermittent), strangulation, peritonitis, or perforation.
  • Active necrotizing fasciitis or any other known active local or systemic infection.
  • Subject report of participation in an investigational drug or device study that would impact the safety or scientific integrity of this study (in the opinion of the Investigator and with the approval of the Sponsor) within the past 6 weeks prior to treatment in this trial.

Sites / Locations

  • Tampa General Hospital
  • University of South Florida - South Tampa Campus
  • University of South Florida Morsani Center for Advanced Health Care

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Active Comparator

Arm Label

Treatment

Control

Arm Description

Gentrix(TM) Surgical Matrix

Standard of care mesh

Outcomes

Primary Outcome Measures

Incidence of incisional hernia recurrence

Secondary Outcome Measures

Time to incisional hernia recurrence
Incidence of wound complications
Complications of interest: surgical site infections, seroma formation, and wound dehiscence or skin separation
Incidence of enterocutaneous fistula formation
Mean Carolinas Comfort Scale score
Patient-centered outcome
Mean Visual Analog Scale score
Patient-centered outcome
Mean mesh deployment time
Defined as the time mesh preparation starts to time mesh placement ends
Mean procedure time
Defined as time of incision to time of closure
Mean total cost of hospitalization for primary admission
Defined as from surgery to hospital discharge
Mean total cost of surgery for primary admission
Defined as from preoperative preparation to anesthesia discharge
Mean total cost of narcotic usage for primary admission
Defined as narcotic use from surgery to hospital discharge
Mean total cost of readmissions
Defined as any hospital readmissions related to ventral hernia complications or recurrence

Full Information

First Posted
January 25, 2017
Last Updated
September 28, 2021
Sponsor
University of South Florida
Collaborators
Integra LifeSciences Corporation
search

1. Study Identification

Unique Protocol Identification Number
NCT03034213
Brief Title
Gentrix™ Versus Biological or Prosthetic Mesh
Official Title
Randomized, Controlled Trial Comparing Separation of Components Repair With Retrorectus Gentrix™ Surgical Matrix Versus Biological or Prosthetic Mesh for Open Ventral Hernia Repair
Study Type
Interventional

2. Study Status

Record Verification Date
September 2021
Overall Recruitment Status
Terminated
Why Stopped
Cease of Funding
Study Start Date
October 6, 2017 (Actual)
Primary Completion Date
June 16, 2021 (Actual)
Study Completion Date
June 16, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of South Florida
Collaborators
Integra LifeSciences Corporation

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The hypothesis for this study is complex incisional hernia repair using the separation of components technique reinforced with retrorectus placement of Gentrix™ Surgical Matrix will lead to fewer incisional hernia recurrences and fewer wound complications compared to the same incisional hernia repair techniques reinforced with other prosthetic or biologically-derived mesh.
Detailed Description
Biological and prosthetic mesh products are extensively used in hernia repairs. However, they also have their limitations. Potential complications associated with prosthetic mesh for hernia repairs include: adverse reactions to the mesh, mesh erosion, stricture formation, adhesions resulting in bowel obstruction, enterocutaneous fistulas, injuries to nearby organs, nerves or blood vessels, infection, chronic pain and hernia recurrence. Potential complications associated with biological mesh include: adverse inflammatory response, laxity, eventration, and recurrent herniation. This study is a two-arm, randomized, controlled trial comparing separation of components repair with retrorectus Gentrix™ Surgical Matrix versus biological or prosthetic mesh for open ventral hernia repair.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Ventral Incisional Hernia
Keywords
mesh

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Treatment
Arm Type
Active Comparator
Arm Description
Gentrix(TM) Surgical Matrix
Arm Title
Control
Arm Type
Active Comparator
Arm Description
Standard of care mesh
Intervention Type
Device
Intervention Name(s)
Gentrix™ Surgical Matrix (Treatment)
Intervention Description
Gentrix™ Surgical Matrix will be placed in the retrorectus space. The anterior midline fascia will be closed with long-acting absorbable suture either with a running or interrupted manner as per the surgeon's discretion.
Intervention Type
Device
Intervention Name(s)
Permacol, Parietex, Progrip, Strattice Perforated, or Surgimend (Control)
Intervention Description
A biological or prosthetic mesh (Permacol, Parietex, Progrip, Strattice Perforated, or Surgimend) will be placed in the retrorectus space. The anterior midline fascia will be closed with long-acting absorbable suture either with a running or interrupted manner as per the surgeon's discretion.
Primary Outcome Measure Information:
Title
Incidence of incisional hernia recurrence
Time Frame
2 years from study incisional hernia repair
Secondary Outcome Measure Information:
Title
Time to incisional hernia recurrence
Time Frame
2 years from study incisional hernia repair
Title
Incidence of wound complications
Description
Complications of interest: surgical site infections, seroma formation, and wound dehiscence or skin separation
Time Frame
90 days from study incisional hernia repair
Title
Incidence of enterocutaneous fistula formation
Time Frame
2 years from study incisional hernia repair
Title
Mean Carolinas Comfort Scale score
Description
Patient-centered outcome
Time Frame
2 years from study incisional hernia repair
Title
Mean Visual Analog Scale score
Description
Patient-centered outcome
Time Frame
2 years from study incisional hernia repair
Title
Mean mesh deployment time
Description
Defined as the time mesh preparation starts to time mesh placement ends
Time Frame
duration of surgery (incisional hernia repair)
Title
Mean procedure time
Description
Defined as time of incision to time of closure
Time Frame
duration of surgery (incisional hernia repair)
Title
Mean total cost of hospitalization for primary admission
Description
Defined as from surgery to hospital discharge
Time Frame
duration of hospitalization for incisional hernia repair
Title
Mean total cost of surgery for primary admission
Description
Defined as from preoperative preparation to anesthesia discharge
Time Frame
duration of surgery (incisional hernia repair)
Title
Mean total cost of narcotic usage for primary admission
Description
Defined as narcotic use from surgery to hospital discharge
Time Frame
duration of hospitalization for incisional hernia repair
Title
Mean total cost of readmissions
Description
Defined as any hospital readmissions related to ventral hernia complications or recurrence
Time Frame
2 years from study incisional hernia repair

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male and female patients ≥ 18 years old. American Society of Anesthesiologists (ASA) physical status classification of I, II, III or IV. Able to provide informed consent in English or Spanish. Stated willingness to comply with all study procedures and availability for the duration of the study. Body Mass Index (BMI) =< 45. Incisional hernia from a midline incision ≥ 4 cm in greatest diameter, or any recurrent incisional hernia. Exclusion Criteria: Any other type of ventral hernia, such as umbilical, epigastric or Spigelian hernia. Pregnant, breastfeeding, or unwilling to practice birth control during participation in the study, if applicable. Allergy or hypersensitivity to materials in porcine-based study products, biological or prosthetic meshes, or personal preference. Contraindications to general anesthesia. Patient undergoing any emergency surgery prior to treatment. Severe comorbid conditions likely to limit survival to less than 3 years in the opinion of the Investigator. Have abdominal loss of domain such that the operation would be impractical or would adversely affect respiratory or cardiovascular function to an unacceptable degree in the opinion of the Investigator. Inability to close the fascia primarily with abdominal wall mobilization or component separation; confirmed intra-operatively. History of malignancy within the past 5 years except for non-melanoma skin cancer. Known active malignancy present and/or had chemotherapy 12 weeks prior to screening or planned chemotherapy within 12 weeks of treatment with exception of basal cell carcinoma, squamous cell carcinoma, or prostate cancer in situ. Cirrhosis with or without ascites. Received high dose steroids (>/=100mg of prednisone) within the past 6 weeks of screening. Uncontrolled diabetes (i.e. known HbA1C value > 7% within the prior 6 weeks of the Screening Visit). History of drug addiction (recreational drugs, prescription drugs or alcohol) that in the Investigator's opinion may interfere with protocol assessments and/or the subject's ability to complete the required follow up. Serious or active medical or psychiatric condition which, in the opinion of the Investigator, may interfere with treatment, assessment, or compliance with the protocol. Suspected presence of enterocutaneous fistula. Planned use of external VAC dressing intra-operatively. Suspected bowel obstruction (partial or intermittent), strangulation, peritonitis, or perforation. Active necrotizing fasciitis or any other known active local or systemic infection. Subject report of participation in an investigational drug or device study that would impact the safety or scientific integrity of this study (in the opinion of the Investigator and with the approval of the Sponsor) within the past 6 weeks prior to treatment in this trial.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Vic Velanovich, MD
Organizational Affiliation
University of South Florida
Official's Role
Principal Investigator
Facility Information:
Facility Name
Tampa General Hospital
City
Tampa
State/Province
Florida
ZIP/Postal Code
33606
Country
United States
Facility Name
University of South Florida - South Tampa Campus
City
Tampa
State/Province
Florida
ZIP/Postal Code
33606
Country
United States
Facility Name
University of South Florida Morsani Center for Advanced Health Care
City
Tampa
State/Province
Florida
ZIP/Postal Code
33612
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
26106284
Citation
FitzGerald JF, Kumar AS. Biologic versus Synthetic Mesh Reinforcement: What are the Pros and Cons? Clin Colon Rectal Surg. 2014 Dec;27(4):140-8. doi: 10.1055/s-0034-1394155.
Results Reference
background
PubMed Identifier
9382393
Citation
Zhou XH, Melfi CA, Hui SL. Methods for comparison of cost data. Ann Intern Med. 1997 Oct 15;127(8 Pt 2):752-6. doi: 10.7326/0003-4819-127-8_part_2-199710151-00063.
Results Reference
background
PubMed Identifier
26206646
Citation
Holihan JL, Alawadi Z, Martindale RG, Roth JS, Wray CJ, Ko TC, Kao LS, Liang MK. Adverse Events after Ventral Hernia Repair: The Vicious Cycle of Complications. J Am Coll Surg. 2015 Aug;221(2):478-85. doi: 10.1016/j.jamcollsurg.2015.04.026. Epub 2015 May 9.
Results Reference
result
PubMed Identifier
25222715
Citation
Fekkes JF, Velanovich V. Amelioration of the effects of obesity on short-term postoperative complications of laparoscopic and open ventral hernia repair. Surg Laparosc Endosc Percutan Tech. 2015 Apr;25(2):151-7. doi: 10.1097/SLE.0000000000000100.
Results Reference
result
PubMed Identifier
21904861
Citation
Poulose BK, Shelton J, Phillips S, Moore D, Nealon W, Penson D, Beck W, Holzman MD. Epidemiology and cost of ventral hernia repair: making the case for hernia research. Hernia. 2012 Apr;16(2):179-83. doi: 10.1007/s10029-011-0879-9. Epub 2011 Sep 9.
Results Reference
result
PubMed Identifier
25472771
Citation
Fischer JP, Wink JD, Tuggle CT, Nelson JA, Kovach SJ. Wound risk assessment in ventral hernia repair: generation and internal validation of a risk stratification system using the ACS-NSQIP. Hernia. 2015 Feb;19(1):103-11. doi: 10.1007/s10029-014-1318-5. Epub 2014 Dec 4.
Results Reference
result
PubMed Identifier
18387468
Citation
Heniford BT, Walters AL, Lincourt AE, Novitsky YW, Hope WW, Kercher KW. Comparison of generic versus specific quality-of-life scales for mesh hernia repairs. J Am Coll Surg. 2008 Apr;206(4):638-44. doi: 10.1016/j.jamcollsurg.2007.11.025. Epub 2008 Feb 1.
Results Reference
result
PubMed Identifier
24166693
Citation
Nielsen K, Poelman MM, den Bakker FM, van der Ploeg T, Bonjer HJ, Schreurs WH. Comparison of the Dutch and English versions of the Carolinas Comfort Scale: a specific quality-of-life questionnaire for abdominal hernia repairs with mesh. Hernia. 2014 Aug;18(4):459-64. doi: 10.1007/s10029-013-1173-9. Epub 2013 Oct 29.
Results Reference
result

Learn more about this trial

Gentrix™ Versus Biological or Prosthetic Mesh

We'll reach out to this number within 24 hrs