- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT06068517
Closed Incision Negative Pressure Wound Therapy for the Prevention of Surgical Site Infections in Abdominal Surgery (CISSI)
Closed Incision Negative Pressure Wound Therapy for the Prevention of Surgical Site Infections in Abdominal Surgery - A Multicenter Randomized Controlled Trial
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Background:
Surgical site infections (SSI) are a frequent complication after abdominal surgery and are associated with increased morbidity and mortality, longer hospital stay, and significantly increased healthcare costs. Closed incision negative pressure wound therapy (ciNPWT) is a non-invasive, vacuum-assisted system that applies negative pressure to closed surgical incisions. Recent meta-analyses suggest that ciNPWT reduces the risk of SSI in abdominal surgery. However, based on the available randomized controlled trials (RCT), the evidence for the effect of ciNPWT on SSI in abdominal surgery is insufficient.
Rationale:
Considering the frequent occurrence of SSI in abdominal surgery, associated worse outcomes, and insufficient evidence, an adequately powered, robust RCT investigating the effect of ciNPWT on SSI in elective and emergency abdominal surgery is warranted. Provided that ciNPWT significantly reduces the incidence of SSI, this adjunct to surgical therapy has the potential to fundamentally improve patient outcomes in abdominal surgery.
Aim of the trial:
To investigate the effect of ciNPWT on superficial and deep SSI in patients undergoing elective or emergency abdominal surgery by laparotomy.
Methodology:
Multicenter, open-label, two arm, parallel group RCT. Patients undergoing elective or emergency laparotomy will be enrolled. During surgery, participants will be randomized in a 1:1 ratio to the ciNPWT (treatment) or standard dressing (control) group. After the completion of abdominal surgery and standardized skin closure with staples, either ciNPWT or standard dry dressings will be applied. Other than the study procedure, participants in both groups will be treated the same according to the current standard of care at the participating centers. Data collection will be carried out during the subsequent hospital stay and at 30 (+/- 7) days postoperatively.
Hypothesis:
The investigators hypothesize that ciNPWT will significantly reduce the incidence of superficial and deep SSI in patients undergoing laparotomy.
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Tobias Haltmeier, MD
- Phone Number: +41 31 664 03 04
- Email: tobias.haltmeier@insel.ch
Study Locations
-
-
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Bern, Switzerland, 3010
- Inselspital, Bern University Hospital
-
Contact:
- Tobias Haltmeier, MD
- Phone Number: +41 31 664 03 04
- Email: tobias.haltmeier@insel.ch
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Elective or emergency laparotomy, or laparoscopy converted to laparotomy, including surgery for complications after elective operations
- Incision length ≥ 10 cm
- Centers for Disease Control and Prevention (CDC) wound class 1 and 2 (clean, clean-contaminated)
- Abdominal closure with or without mesh implantation
- Primary abdominal closure or closure after open abdomen treatment
- Age over 18 years
- Written informed consent
Exclusion Criteria:
- Age ≤ 18 years
- CDC wound class 4 (dirty/infected wound)
- Organ transplantation
- Sensitivity or allergy to silver
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Closed incision negative pressure wound therapy
At the completion of the surgical procedure, the skin will be closed with staples at a distance of two centimeters from each other.
After skin closure, ciNPWT will be applied, using a commercially available device.
The device will be left in place for 7 days.
|
After the completion of abdominal surgery and standardised skin closure with staples, ciNPWT will be applied, using a commercially available device.
|
Active Comparator: Standard dressing
At the completion of the surgical procedure, the skin will be closed with staples at a distance of two centimeters from each other.
After skin closure, conventional dry dressings will be applied.
Conventional dressings will be changed according to clinical practice in the participating study centers.
|
After the completion of abdominal surgery and standardised skin closure with staples, standard dressings will be applied.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Composite incidence of superficial and deep surgical site infections
Time Frame: 30 (+/- 7) days
|
Number of participants with a superficial or deep surgical site infections at 30 (+/- 7) days postoperatively.
|
30 (+/- 7) days
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
30-day mortality
Time Frame: 30 days
|
30 days
|
|
Overall surgical site infections (superficial, deep, and organ space)
Time Frame: 30 (+/- 7) days
|
Number of participants with a superficial or deep or organ space surgical site infections at 30 (+/- 7) days postoperatively.
|
30 (+/- 7) days
|
Superficial, deep, and organ space surgical site infections as separate outcomes
Time Frame: 30 (+/- 7) days
|
Number of participants with a superficial surgical site infections at 30 (+/- 7) days postoperatively. Number of participants with a deep surgical site infections at 30 (+/- 7) days postoperatively. Number of participants with an organ space surgical site infections at 30 (+/- 7) days postoperatively. |
30 (+/- 7) days
|
Other wound complications (wound dehiscence, seroma, hematoma)
Time Frame: 30 (+/- 7) days
|
Number of participants with another wound complication at 30 (+/- 7) days postoperatively.
|
30 (+/- 7) days
|
Postoperative hospital length of stay
Time Frame: Usually between 1 and 14 days
|
Usually between 1 and 14 days
|
|
Duration of closed incision negative pressure wound therapy
Time Frame: 7 days
|
7 days
|
|
Number of outpatient visits
Time Frame: 30 days
|
30 days
|
|
Postoperative health-related quality of life (SF-36 Health Survey)
Time Frame: 30 (+/- 7) days
|
Range from 0 (worst) to 100 (best).
|
30 (+/- 7) days
|
Costs for inpatient treatment
Time Frame: Usually between 1 and 14 days
|
Usually between 1 and 14 days
|
|
In-hospital mortality
Time Frame: Usually between 1 and 14 days
|
Usually between 1 and 14 days
|
Collaborators and Investigators
Collaborators
Investigators
- Principal Investigator: Tobias Haltmeier, MD, Inselspital, Bern University Hospital
Study record dates
Study Major Dates
Study Start (Estimated)
Primary Completion (Estimated)
Study Completion (Estimated)
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
- CISSI
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.
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