Prevention of Edema After Coronary Artery Bypass Graft by Customized Pressure-guided Elastic Bandages (PEACCE)
Efficacy of Customized Pressure-Guided Elastic Bandages in Preventing Postoperative Edema and Complications in Coronary Artery Bypass Graft (CABG) Patients: A Comparative Study of Compression Therapy and Standard Post-CABG Care.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Inclusion Criteria :
- All patients scheduled for elective coronary artery bypass grafting (CABG) surgery with saphenous vein harvesting from the leg at Siriraj Hospital.
- Patients aged 18 years and older undergoing CABG surgery with saphenous vein harvesting from the leg at Siriraj Hospital, who willingly consent to participate in the study.
Exclusion Criteria : *
- Patients with an Ankle-brachial pressure index (ABI) < 0.8
- Patients with severe leg swelling (pitting edema of grade 3 or higher) or with pre-existing or post-operative heart failure that remains uncontrolled despite diuretic therapy.
- Patients with occlusive peripheral arterial disease (PAD) or chronic venous insufficiency (CEAP 2s), characterized by significant venous stasis, leg pain, varicose veins, or lymphadenopathy.
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Ratcharnon Srifa, MD
- Phone Number: +66819660944
- Email: gainratcharnon@gmail.com
Study Contact Backup
- Name: Nachasa Khongchu, MSc
- Phone Number: +66877309986
- Email: nachasa.kho@gmail.com
Study Locations
-
-
Bangkok Noi
-
Bangkok, Bangkok Noi, Thailand, 10700
- Recruiting
- Siriraj Hospital
-
Contact:
- Ratcharnon Srifa, Doctor of medicine
- Phone Number: +66819660944
-
Sub-Investigator:
- Ratcharnon Srifa, Doctor of medicine
-
Principal Investigator:
- Prompak Nitayavardhana, Diploma of thoracic surgery
-
Bangkok, Bangkok Noi, Thailand, 10700
- Not yet recruiting
- Faculty of Medicine Siriraj Hospital, Mahidol University
-
Contact:
- Ratcharnon Srifa, MD
- Phone Number: +66819660944
- Email: gainratcharnon@gmail.com
-
Contact:
- Nachasa Khongchu, MSc
- Phone Number: +66877309986
- Email: nachasa.kho@gmail.com
-
Sub-Investigator:
- Ratcharnon Srifa, MD
-
Principal Investigator:
- Prompak Nitayavardhana, MD
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- All patients scheduled for elective coronary artery bypass grafting (CABG) surgery with saphenous vein harvesting from the leg at Siriraj Hospital.
- Patients aged 18 years and older undergoing CABG surgery with saphenous vein harvesting from the leg at Siriraj Hospital, who willingly consent to participate in the study.
Exclusion Criteria:
- Patients with an Ankle-brachial pressure index (ABI) < 0.8
- Patients with severe leg swelling (pitting edema of grade 3 or higher) or with pre-existing or post-operative heart failure that remains uncontrolled despite diuretic therapy.
- Patients with occlusive peripheral arterial disease (PAD) or chronic venous insufficiency (CEAP 2s), characterized by significant venous stasis, leg pain, varicose veins, or lymphadenopathy.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
No Intervention: Standard group
Standard group is the standard of care in post operative CABG surgery patients.
This group used elastic bandage for 24 hours or overnight after surgery.
|
|
|
Active Comparator: CPG-EB group
The intervention group received Customized-pressure guided elastic bandage for 4 weeks post-operatively.
|
Customized-pressure guided elastic bandage group
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
incidence rate of leg swelling
Time Frame: 1, 2 and 6 weeks after CABG surgery
|
Chi-square test
|
1, 2 and 6 weeks after CABG surgery
|
|
Rate of severity level of swelling
Time Frame: 1, 2 and 6 weeks after CABG surgery
|
Chi-square test
|
1, 2 and 6 weeks after CABG surgery
|
|
differences in leg circumference at various locations between preoperative and postoperative measurements between the two groups.
Time Frame: 1, 2 and 6 weeks after CABG surgery
|
Independent sample t-test or Mann-Whitney U test
|
1, 2 and 6 weeks after CABG surgery
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
infection rate
Time Frame: 1, 2 and 6 weeks after CABG surgery
|
Chi-square test
|
1, 2 and 6 weeks after CABG surgery
|
|
rate of delayed wound healing
Time Frame: 1, 2 and 6 weeks after CABG surgery
|
Chi-square test
|
1, 2 and 6 weeks after CABG surgery
|
|
rate of numbness
Time Frame: 1, 2 and 6 weeks after CABG surgery
|
Chi-square test
|
1, 2 and 6 weeks after CABG surgery
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Director: Prompak Nitayavardhana, MD, Siriraj Hospital
Publications and helpful links
General Publications
- Wells FC, Newsom SW, Rowlands C. Wound infection in cardiothoracic surgery. Lancet. 1983 May 28;1(8335):1209-10. doi: 10.1016/s0140-6736(83)92479-0.
- Utley JR, Thomason ME, Wallace DJ, Mutch DW, Staton L, Brown V, Wilde CM, Bell MS. Preoperative correlates of impaired wound healing after saphenous vein excision. J Thorac Cardiovasc Surg. 1989 Jul;98(1):147-9.
- Terada Y, Fukuda S, Tohda E, Kigawa I, Wanibuchi Y, Mitsui T. Venous function and delayed leg swelling following saphenectomy in coronary artery bypass grafting. Jpn J Thorac Cardiovasc Surg. 1999 Nov;47(11):559-62. doi: 10.1007/BF03218062.
- Sermsathanasawadi N, Chatjaturapat C, Pianchareonsin R, Puangpunngam N, Wongwanit C, Chinsakchai K, Ruangsetakit C, Mutirangura P. Use of customised pressure-guided elastic bandages to improve efficacy of compression bandaging for venous ulcers. Int Wound J. 2017 Aug;14(4):636-640. doi: 10.1111/iwj.12656. Epub 2016 Aug 9.
- Reifsnyder T, Bandyk D, Seabrook G, Kinney E, Towne JB. Wound complications of the in situ saphenous vein bypass technique. J Vasc Surg. 1992 May;15(5):843-8; discussion 848-50. doi: 10.1067/mva.1992.36658.
- Rabe E, Partsch H, Morrison N, Meissner MH, Mosti G, Lattimer CR, Carpentier PH, Gaillard S, Junger M, Urbanek T, Hafner J, Patel M, Wu S, Caprini J, Lurie F, Hirsch T. Risks and contraindications of medical compression treatment - A critical reappraisal. An international consensus statement. Phlebology. 2020 Aug;35(7):447-460. doi: 10.1177/0268355520909066. Epub 2020 Mar 2.
- Paletta CE, Huang DB, Fiore AC, Swartz MT, Rilloraza FL, Gardner JE. Major leg wound complications after saphenous vein harvest for coronary revascularization. Ann Thorac Surg. 2000 Aug;70(2):492-7. doi: 10.1016/s0003-4975(00)01414-4.
- O'Hagan B, Kolvekar S. Use of support stockings after cardiac surgery. Prof Nurse. 2000 Jul;15(10):660-2.
- Mountney J, Wilkinson GA. Saphenous neuralgia after coronary artery bypass grafting. Eur J Cardiothorac Surg. 1999 Oct;16(4):440-3. doi: 10.1016/s1010-7940(99)00294-8.
- Mosti G, Iabichella ML, Partsch H. Compression therapy in mixed ulcers increases venous output and arterial perfusion. J Vasc Surg. 2012 Jan;55(1):122-8. doi: 10.1016/j.jvs.2011.07.071. Epub 2011 Sep 23.
- Mosti G, Cavezzi A. Compression therapy in lymphedema: Between past and recent scientific data. Phlebology. 2019 Sep;34(8):515-522. doi: 10.1177/0268355518824524. Epub 2019 Jan 9. No abstract available.
- Lommerud S, Hofoss D. Leg wound infection after coronary artery bypass grafting: A natural experiment comparing use and non-use of a compression stocking. Eur J Cardiovasc Nurs. 2017 Feb;16(2):136-142. doi: 10.1177/1474515116641298. Epub 2016 Jul 8.
- Liehr P, Todd B, Rossi M, Culligan M. Effect of venous support on edema and leg pain in patients after coronary artery bypass graft surgery. Heart Lung. 1992 Jan;21(1):6-11.
- Ho CK, Sun MP, Au TW, Chiu CS. Pneumatic pump reduces leg wound complications in cardiac patients. Asian Cardiovasc Thorac Ann. 2006 Dec;14(6):452-7. doi: 10.1177/021849230601400602.
- Hassoun-Kheir N, Hasid I, Bozhko M, Shaban Z, Glam R, Hussein K, Paul M. Risk factors for limb surgical site infection following coronary artery bypass graft using open great saphenous vein harvesting: a retrospective cohort study. Interact Cardiovasc Thorac Surg. 2018 Oct 1;27(4):530-535. doi: 10.1093/icvts/ivy137.
- Gulack BC, Kirkwood KA, Shi W, Smith PK, Alexander JH, Burks SG, Gelijns AC, Thourani VH, Bell D, Greenberg A, Goldfarb SD, Mayer ML, Bowdish ME; Cardiothoracic Surgical Trials Network (CTSN). Secondary surgical-site infection after coronary artery bypass grafting: A multi-institutional prospective cohort study. J Thorac Cardiovasc Surg. 2018 Apr;155(4):1555-1562.e1. doi: 10.1016/j.jtcvs.2017.10.078. Epub 2017 Dec 6.
- Garland R, Frizelle FA, Dobbs BR, Singh H. A retrospective audit of long-term lower limb complications following leg vein harvesting for coronary artery bypass grafting. Eur J Cardiothorac Surg. 2003 Jun;23(6):950-5. doi: 10.1016/s1010-7940(03)00116-7.
- Dusterhoft V, Bauer M, Buz S, Schaumann B, Hetzer R. Wound-healing disturbances after vein harvesting for CABG: a randomized trial to compare the minimally invasive direct vision and traditional approaches. Ann Thorac Surg. 2001 Dec;72(6):2038-43. doi: 10.1016/s0003-4975(01)03047-8.
- Andrea Nelson E. Understanding compression therapy. J Wound Care. 1998 Jul 2;7(7):323. doi: 10.12968/jowc.1998.7.7.323.
- Alizadeh-Ghavidel A, Ramezannejad P, Mirmesdagh Y, Sadeghpour-Tabaei A. Prevention of edema after coronary artery bypass graft surgery by compression stockings. Res Cardiovasc Med. 2014 May;3(2):e17463. doi: 10.5812/cardiovascmed.17463. Epub 2014 Apr 1.
- Khoshgoftar Z, Ayat Esfahani F, Marzban M, Salehi Omran A, Haji Ghasemi A, Movaghar S, Saadat S. Comparison of compression stocking with elastic bandage in reducing postoperative edema in coronary artery bypass graft patient. J Vasc Nurs. 2009 Dec;27(4):103-6. doi: 10.1016/j.jvn.2009.09.004.
Helpful Links
- This study use the TED stockings after CABG and the protocol. such as the severity of edema and timing of follow up, from this study was used in my study.
- This study compare between stockings and conventional elastic bandages. The protocol, such as difference of circumference between preoperative leg and postoperative leg, was used in my study
- This paper proove that CPG-EB optimal subbandage pressure was not inferior than stockings.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 788/2566(IRB1)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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