- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04597840
Biosynthetic Absorbable Mesh vs Standard of Repair for the Surgical Treatment of Infected Incisional Hernia (COMpACT-BIO)
June 29, 2022 updated by: Hospices Civils de Lyon
Multicenter, Prospective, Longitudinal and Randomized Comparison of Both the Clinical and Economic Impact of Biosynthetic Absorbable Mesh to the Surgical Standard of Care in Contaminated Incisional Hernia Repair
Incisional hernia is one of the most common complications of abdominal surgery and carries a significant burden for both patients and the economic health service.
However, no consensus for the surgical treatment of incisional hernia in contaminated field is currently available.
The purpose of the COMpACT-BIO study is to investigate the clinical and economic benefit of the use of biosynthetic mesh in contaminated incisional hernia repair.
Study Overview
Status
Recruiting
Conditions
Detailed Description
The current standard of incisional hernia repair is reinforcement with permanent synthetic mesh.
However, permanent synthetic mesh is contraindicated in contaminated surgical field due to higher risk of postoperative infection.
In order to resist to infection, absorbable meshes, such as biological and biosynthetic meshes, have been developped.
However, some controversies exist about the clinical benefit of biological meshes in the long term.
Reasons for theses controversies are their overall risk of complication and recurrence and the lack of consensus in which surgical technique to apply.
Moreover, the financial cost of biological meshes is very high.
Recently developed, biosynthetic meshes appear to be a promising option ; Compared to biological meshes, they seem to have several advantages.
However, such data demonstrating the beneficial use of biosynthetic mesh in contaminated incisional hernia repair is not available.
In this regard, the COMpACT-BIO study aims to investigate the clinical and economic benefit of the use of biosynthetic mesh in contaminated incisional hernia repair in comparison to the standard of repair.
This is a multicenter, prospective, longitudinal and randomized study, which also offers a standardized technique of repair.
Study Type
Interventional
Enrollment (Anticipated)
108
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: Guillaume PASSOT, Pr
- Phone Number: +33 4 78 86 23 71
- Email: guillaume.passot@chu-lyon.fr
Study Locations
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-
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Pierre-Bénite, France, 69310
- Recruiting
- Hopital Lyon Sud
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Contact:
- Guillaume PASSOT, Pr
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Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
16 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
All the following inclusion criteria must be fulfilled:
- Age ≥18 years old
- Physical status ASA < 4
- Patient with a mid-line IH
- Patient presenting with an IH without loss of domain
- Surgical indication in elective surgery
- "Potentially contaminated" grade III surgical environment according to the classification of the modified VHWG
- Cure of mid line IH feasible according to the defined standard technical modality (placement of a retromuscular prosthesis)
- No emergency surgical procedure
- Status of social insured or entitled to a social insurance
- Informed and signed consent of the patient after clear and appropriate information
The exclusion criteria are as follows:
- One or multiple incisional hernia out of the midline incision
- Pregnancy, breastfeeding, parturient or childbearing patients without contraception
- Known allergy to tetracyclines;
- Persons protected by law
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: biosynthetic mesh group
Patient will undergo incisional hernia repair with biosynthetic mesh reinforcement.
Based on the discretion of the surgeon, two types of biosynthetic mesh from different brand can be used: the Phasix mesh from BARD or the BioA mesh from GORE.
These two biosynthetic meshes are resorbable, which means they are gradually absorbed by the body.
|
The biosynthetic mesh (Phasix or Bio-A meshes) will be placed as a sublay in the retromuscular position to reinforce midline fascial closure.
All the surgical procedure (including placement and fixation of the mesh) will be performed according to a standardized protocol.
|
Other: standard of repair group
Patient will undergo incisional hernia repair according to the standard of repair, which is simple suture or mesh reinforcement (using synthetic or biological meshes).
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Based on the discretion of the surgeon, the incisional hernia repair will be done by simple suture or by synthetic mesh reinforcement.
All the surgical procedure (including placement and fixation of the mesh if applicable) will be performed according to a standardized protocol.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Rate of incisional hernia recurrence
Time Frame: 3 years after surgery
|
The rate of incisional hernia recurrence will be evaluated by radiologic imaging.
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3 years after surgery
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Days of hospitalization related to incisional hernia repair
Time Frame: For 3 years after surgery
|
Number of days of hospitalization related to hernia repair-related complications will be reported.
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For 3 years after surgery
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Incidence of re-operation related to incisional hernia repair
Time Frame: For 3 years after surgery
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Incidence of incisional hernia repair-related complications leading to re-operation will be reported.
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For 3 years after surgery
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Incidence of wound events
Time Frame: 1 month from surgery date, then 3-, 6- 12-, 24- and 36 months from surgery date
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Incidence of incisional hernia repair-related wound complications, such as wound infection will be reported.
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1 month from surgery date, then 3-, 6- 12-, 24- and 36 months from surgery date
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Incidence of revision surgery or interventional radiologic procedure
Time Frame: 1 month from surgery date, then 3-, 6- 12-, 24- and 36 months from surgery date
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Incidence of revision surgery or interventional radiologic procedure related incisional hernia repair-related wound complications will be reported.
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1 month from surgery date, then 3-, 6- 12-, 24- and 36 months from surgery date
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Rate of early incisional hernia recurrence
Time Frame: 1 month from surgery date, then 3-, 6- 12-, 24- and 36 months from surgery date
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The rate of incisional hernia recurrence evaluated by physical examination and then confirmed by radiologic imaging will be reported.
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1 month from surgery date, then 3-, 6- 12-, 24- and 36 months from surgery date
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Incisional hernia specific quality-of-life assessment
Time Frame: Pre and post-surgery (1 month from surgery date, then 3, 6, 12, 24 and 36 months from surgery date).
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Self reported clinical symptoms before and after incisional hernia repair will be done using a modified version of the Carolina Comfort Scale .
Severity of pain and discomfort pre and post repair will be measured during different daily activities (item).
Each item is scored 0-5 (0= no symptom ; 5= worst symptom).
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Pre and post-surgery (1 month from surgery date, then 3, 6, 12, 24 and 36 months from surgery date).
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Number of healing days
Time Frame: 1 month from surgery date, then 3-, 6- 12-, 24- and 36 months from surgery date
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At each clinical examination, the time between surgery and the end of median scar care will be measured.
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1 month from surgery date, then 3-, 6- 12-, 24- and 36 months from surgery date
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Rate of screening failure
Time Frame: 48 months after the start of the study
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The proportion of patients who did not receive the surgical procedure proposed by the study, and the related reasons of screening failure will be reported.
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48 months after the start of the study
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Assessment of health care consumption related to health care status
Time Frame: pre and post-surgery (1 month from surgery date, then 3, 6, 12, 24 and 36 months from surgery date).
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The cost / quality ratio will be measured using the consumption of health care and the health status.
In one hand, each health care action will be reported (by the patient or the caregiver) and then the total cost relative to the health care will be measured.
In another hand, self-reported health status before and after incisional hernia repair will be done using the EQ-5D-5L questionnaire.
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pre and post-surgery (1 month from surgery date, then 3, 6, 12, 24 and 36 months from surgery date).
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
May 25, 2021
Primary Completion (Anticipated)
October 1, 2024
Study Completion (Anticipated)
October 1, 2024
Study Registration Dates
First Submitted
July 31, 2020
First Submitted That Met QC Criteria
October 16, 2020
First Posted (Actual)
October 22, 2020
Study Record Updates
Last Update Posted (Actual)
July 5, 2022
Last Update Submitted That Met QC Criteria
June 29, 2022
Last Verified
June 1, 2022
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 69HCL20_0215
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
No
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
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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