- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04166201
Double Mesh Modification of Incisional Hernia Can be Effective Without Severe Local Complications
Evaluation of Double Mesh Modification of Chevrel's Technique in Management of Midline Incisional Hernia
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
This study is a clinical trial carried out on 22 patients with midline incisional hernia, using the double mesh modification of Chevrel's technique, all the procedures were performed by the same group of surgeons.
The exclusion criteria were American Society of Anesthesiologists (ASA) 3, and 4, inflammatory bowel disease, urgent setting, recurrences and previous abdominal neoplasms with high risk of local recurrence (rectal cancer). All patients were informed and consented before recruitment in the study All patients received an intravenous antibiotic prophylaxis with subcutaneous administration of fractionated heparin before surgery when indicated.
Surgical technique All patients were operated on with the double mesh modification of Chevrel's technique. The previous scar was excised then, dissection of the subcutaneous space was performed deep to the neck of the hernia, not wider than 1cm from the edges of the defect, then the sac was opened and resected, the defect size was measured, the skin and subcutaneous tissue was dissected off the anterior rectus sheath only allowing dissection of an anterior rectus sheath flap just sufficient to close the defect without tension After that a bilateral longitudinal incisions was done on the anterior surface of the anterior rectus sheath and a medial anterior rectus sheath flap was dissected off the rectus abdominis muscle, both recti muscles was dissected off the posterior rectus sheath opening the retrorectus space, each of the medial anterior rectus sheath flaps was sutured to that of the other side with slowly absorbed sutures closing the defect without any tension and reforming the posterior rectus sheath
A sizable prolene mesh was fixed with prolene sutures in the retrorectus space spreading between lateral ends of the space and tunneled up 4 cm in the retrorectus space far from vertical edges of the defect,Then the anterior rectus sheath was closed using a prolene mesh tailored to the size of the space between the lateral flaps of both sides and sutured to the edges of the lateral flaps with interrupted non absorbable sutures.
suction drain is left in site, subcutaneous tissue was closed with Vicryl (3\0) , skin was closed with prolene (3\0), drain was removed when the amount of drainage is below 30 ml \ day .
Data of the patients as demographic data, preoperative investigations, operative findings as defect size, operative time, early postoperative data as viability of skin flaps, wound infection, seroma and early hernia recurrence, late postoperative data as hernia recurrence. All data were collected, properly presented and analyzed using the SPSS package 22.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Sharqya
-
Zagazig, Sharqya, Egypt, 44519
- Zagazig Faculty of Medicine
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
• adult with midline incisional hernia
Exclusion Criteria:
- (ASA) 3, and 4,
- inflammatory bowel disease,
- urgent setting,
- recurrences and previous abdominal neoplasms with high risk of local recurrence (rectal cancer).
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: NA
- Interventional Model: SINGLE_GROUP
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
OTHER: modified chevrel technique
hernioplasty done with double mesh modification of chevrels technique
|
hernioplasty done by modification of the chevrel's technique , no dissection further than 1 cm of the midline laterally, the medial flaps of the anterior rectus sheath is dissected of the anterior surface of the rectus abdominis muscle and sutured together reforming the posterior rectus sheath , one polypropylene mesh was fixed over the posterior rectus sheath and the other was tailored to raw area of the rectis abdominis muscle and sutured to the lateral free edges of the anterior rectus sheath
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
recurrence of the hernia
Time Frame: 2 years
|
the incisional hernia recurs back measured by clinical examination or abdominal CT
|
2 years
|
necrosis of the edges of the wound
Time Frame: 1 week
|
gangrene of the medial edges of the midline incision after dissection of the skin and subcutaneous tissue off the rectus sheath measured by clinical examination
|
1 week
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
seroma
Time Frame: 1 week
|
presence of serous fluid collection in the subcutaneous space measured by superficial probe ultrasound examination
|
1 week
|
hematoma
Time Frame: 1 week
|
blood collection around the mesh prosthesis measured by superficial probe ultrasound examination
|
1 week
|
abdominal wall pain
Time Frame: 1 year
|
pain related to the surgical wound or the mesh prosthesis fixation sutures , measured by visual analogue scale
|
1 year
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start (ACTUAL)
Primary Completion (ACTUAL)
Study Completion (ACTUAL)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ACTUAL)
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
- modified chevrel technique
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
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.
Clinical Trials on Incisional Hernia of Midline of Abdomen
-
Medtronic - MITGRecruitingIncisional Hernia | Incisional Hernia of Midline of Abdomen | Midline LaparotomySpain, United Kingdom, Netherlands, Croatia, Germany
-
City Clinical Hospital No.1 named after N.I. PirogovPirogov Russian National Research Medical UniversityNot yet recruitingIncisional Hernia of Midline of AbdomenRussian Federation
-
Erasmus Medical CenterMedtronic; Alrijne HospitalNot yet recruitingIncisional Hernia of Midline of AbdomenNetherlands
-
City Clinical Hospital No.1 named after N.I. PirogovPirogov Russian National Research Medical UniversityRecruiting
-
Karolinska InstitutetRecruitingIncisional Hernia of Midline of AbdomenSweden
-
Hospital del MarRecruitingIncisional Hernia of Midline of AbdomenSpain
-
Fundación para el Fomento de la Investigación Sanitaria...CompletedIncisional Hernia of Midline of AbdomenSpain
-
Azienda Sanitaria Locale Napoli 2 NordRecruitingIncisional Hernia After Midline LaparotomyItaly
-
Lawson Health Research InstituteEthicon, Inc.Not yet recruitingIncisional Hernia of Anterior Abdominal Wall
-
Erasmus Medical CenterElisabeth-TweeSteden Ziekenhuis; Rijnstate Hospital; Groene Hart Ziekenhuis; Red... and other collaboratorsCompletedQuality of Life | Pain | Hernia | Wound Infection | Burst AbdomenNetherlands
Clinical Trials on double mesh hernioplasty with modified chevrel's technique
-
Zagazig UniversityCompletedHernia Incisional VentralEgypt
-
Hospital General Universitario ElcheCompletedInguinal Hernia | Inguinal Hernia Repair | Open Inguinal Hernia
-
All India Institute of Medical Sciences, BhubaneswarUnknownLocal Anaesthesia | Hernias Inguinal ReducibleIndia
-
Air Force Military Medical University, ChinaUnknownEndoscopic Retrograde Cholangiopancreatography | Biliary CannulationChina
-
Varazdin General HospitalCompletedIncisional Ventral Hernia | Recurrent Ventral HerniaCroatia
-
Renmin Hospital of Wuhan UniversityRecruitingChronic Constipation | Rectal Prolapse | Obstructive Defecation SyndromeChina
-
Ospedale di Circolo - Fondazione MacchiUnknown
-
Peking Union Medical College HospitalUnknown
-
Hospital Universitario 12 de OctubreCompletedReconstructive Surgical Procedure
-
Hvidovre University HospitalUniversity of CopenhagenCompleted