- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01913132
PICO Above Incisions After Vascular Surgery
PICO Versus Standard Dressing on Groin Incisions After Vascular Surgery - a Prospective Randomized Trial (INVIPS Trial)
Study Overview
Status
Intervention / Treatment
Detailed Description
As published in the study´s rational and design paper (DOI: 10.4236/ss.2015.612080), we conducted a reanalysis of the material that the original power calculation was based on and included elective cases only which led to a slightly different number of cases needed. Furthermore, it became clear that there were big differences in the infection rates of EVAR (endovascular aortic repair) and open vascular procedures and therefore the need to split the study into two arms, an EVAR arm and an OPEN arm.
To prove a significant effect of the treatment intervention in the EVAR arm with a wound infection rate reduction from previously 4.4% to 1%, 80% power, 5% significance level and Including a margin for loss to follow-up, the EVAR arm requires 497 inguinal incisions. Assuming a surgical site infection rate reduction from 30% to 10% in the OPEN arm of the study, 80% power and 5% significance level, a total of 147 inguinal incisions is required.
We conducted an unannounced interim analysis for a conference presentation that was conducted by the study's principal investigators Stefan Acosta and Julien Hasselmann. Staff in charge of the day-to-day activities of the trial were not involved or actively informed of this. We believe that using an objective wound assessment tool (ASEPSIS score) minimizes any potential bias associated with the interim analysis.
Since the vascular center Malmö has started using closure-devices for almost all EVAR cases and thereby creating virtually no wounds to assess, we have started a multi center extension of the EVAR arm to Örebro University Hospital to be able to include the outstanding cases.
FUNDING
The trial has been funded by public Swedish funds stemming from the Southmost region in Sweden (Region Skåne), the Skåne University Hospital and the Hulda Almroth foundation since 2015 and adds up to a total of 2.81 million SEK (about 311,000 USD). In addition the research group received an unrestricted unconditional research grant of 15,550 USD and a donation of 100 PICO dressing kits from Smith and Nephew in 2013.
ALF (Agreement on medical education and research) funding has been granted for the time period 2019 - 2022 but has not yet been defined monetarily.
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Stefan Acosta, MD PhD
- Phone Number: +4640331000
- Email: stefan.acosta@med.lu.se
Study Locations
-
-
-
Malmö, Sweden
- Recruiting
- Vascular Centre, Malmö, Skåne University Hospital
-
Contact:
- Stefan Acosta, MD PhD
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Patients 18 years of age and above
- Elective vascular surgery
- Inguinal incision (transverse or longitudinal)
- Capable of understanding the study information and giving written informed consent
Exclusion Criteria:
- Emergency surgery
- Ongoing infection in inguinal area
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
No Intervention: Standard wound dressing OPEN
Standard wound dressing
|
|
Experimental: PICO dressing OPEN
Negative pressure wound therapy with PICO (Smith & Nephew)
|
Negative wound pressure therapy
|
No Intervention: Standard dressing EVAR
Standard wound dressing
|
|
Experimental: PICO dressing EVAR
Negative pressure wound therapy with PICO (Smith & Nephew)
|
Negative wound pressure therapy
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Wound infection rate
Time Frame: Wounds will be checked at 3 month follow-up
|
ASEPSIS (Additional treatment, the presence of Serous discharge, Erythema, Purulent exudate, and Separation of the Deep tissues, the isolation of bacteria, and the duration of inpatient stay) score.
Min 0 p, max > 40 p, higher values worse outcome
|
Wounds will be checked at 3 month follow-up
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Overall Costs of treatment
Time Frame: Costs will be checked at 3 months of follow-up
|
Systematic assessment of overall costs
|
Costs will be checked at 3 months of follow-up
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Stefan Acosta, MD PhD, Vascular Centre, Malmö, Skåne University Hospital
- Principal Investigator: Julien Hasselmann, MD, Vascular Centre, Malmö, Skåne University Hospital
Publications and helpful links
General Publications
- Hasselmann J, Bjork J, Svensson-Bjork R, Acosta S. Inguinal Vascular Surgical Wound Protection by Incisional Negative Pressure Wound Therapy: A Randomized Controlled Trial-INVIPS Trial. Ann Surg. 2020 Jan;271(1):48-53. doi: 10.1097/SLA.0000000000003364.
- Svensson-Bjork R, Hasselmann J, Asciutto G, Zarrouk M, Bjork J, Bilos L, Pirouzram A, Acosta S. Negative Pressure Wound Therapy for the Prevention of Surgical Site Infections Using Fascia Closure After EVAR-A Randomized Trial. World J Surg. 2022 Dec;46(12):3111-3120. doi: 10.1007/s00268-022-06740-5. Epub 2022 Oct 14.
- Rezk F, Astrand H, Acosta S. Incisional negative pressure wound therapy for the prevention of surgical site infection after open lower limb revascularization - Rationale and design of a multi-center randomized controlled trial. Contemp Clin Trials Commun. 2019 Oct 14;16:100469. doi: 10.1016/j.conctc.2019.100469. eCollection 2019 Dec.
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimated)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- Dnr 2013/322
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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