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ENVELOP: Sårpleje efter pilonidal bihuleoperation (ENVELOP)

21. september 2026 opdateret af: Royal College of Surgeons, Ireland

Excision og negativt tryk sårterapi versus excision og efterladelse åben med standard sårpleje til behandling af kronisk pilonidal sinus sygdom - et randomiseret kontrolleret forsøg

This is a single-blinded, multicentre, prospective randomised controlled trial (RCT) comparing post-operative and patient-reported outcomes for patients undergoing application of negative-pressure wound therapy (NPWT) after sinus tract excision as compared to excision and standard open wound care in chronic pilonidal sinus disease (PSD).

Studieoversigt

Status

Rekruttering

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Pilonidal sinus disease (PSD) is a chronic inflammatory condition of the skin and subcutaneous tissues arising from hair follicles in the natal cleft. The definitive aetiology of the condition is unknown, however, it is theorised that it is the result of either the obstruction and subsequent inflammation of hair follicles or secondary to hair penetrating through the skin into the subcutaneous tissue. This results in infection, abscess formation, chronic discharge and pain. PSD is a common condition affecting 26 per 10,000 population, with the prevalence reaching 1.1% in young adult males.

PSD causes a significant burden on healthcare services due to high rates of recurrence and readmission following surgery, together with negative impacts on patients' quality of life and self-image. An effective management strategy for the disease is necessary to ensure that post-operative outcomes are optimised and patient-reported outcomes are satisfactory in those whose PSD requires surgery.

The objective of this multicentre, national RCT is to prospectively investigate the effect of negative pressure wound therapy compared to leaving open with standard wound care on time to wound healing following surgical excision of chronic PSD.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

200

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Undersøgelse Kontakt Backup

Studiesteder

      • Castlebar, Irland
        • Rekruttering
        • Mayo University Hospital
        • Kontakt:
          • Kevin Barry
      • Dublin, Irland
        • Rekruttering
        • Tallaght University Hospital
        • Kontakt:
          • Dara Kavanagh
      • Dublin, Irland, D09V2N0
        • Rekruttering
        • Beaumont Hospital
        • Kontakt:
          • John Burke
      • Dublin, Irland
        • Rekruttering
        • St James's Hospital
        • Kontakt:
          • Michael Kelly
      • Dublin, Irland
        • Rekruttering
        • St Michael's Hospital, Dún Laoghaire
        • Kontakt:
          • Helen Heneghan
      • Dublin, Irland
        • Rekruttering
        • St Vincent's Univeristy Hospital
        • Kontakt:
          • Eanna Ryan
      • Kilkenny, Irland
        • Rekruttering
        • St. Luke's Hospital
        • Kontakt:
          • Cathy Cronin
      • Limerick, Irland
        • Rekruttering
        • University Hospital Limerick
        • Kontakt:
          • Colin Peirce
      • Tullamore, Irland
        • Rekruttering
        • Midlands University Hospital
        • Kontakt:
          • Sean Johnston
      • Waterford, Irland
        • Rekruttering
        • University Hospital Waterford
        • Kontakt:
          • Peter Neary

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

i) They are aged 18 years or older

ii) They are undergoing elective pilonidal sinus excision without primary closure

Exclusion Criteria:

i) They are unable to adhere to protocol requirements e.g. questionnaire completion

ii) They are undergoing emergency drainage for a pilonidal abscess

iii) They are undergoing surgery for pilonidal sinus disease in locations other than the natal cleft

iv) They have underlying osteomyelitis

v) They have underlying fistulating disease e.g. Crohn's

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Enkelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Negative Pressure Wound Therapy

The wound is dressed using negative pressure wound therapy.

Following elective excision of chronic pilonidal sinus disease with the wound left open, NPWT is applied in theatre using a polyurethane foam-based system (e.g. VAC, Renasys-GO, Prevena or equivalent) cut to fit the wound cavity, sealed with an adhesive drape and connected to a portable pump at -125 mmHg continuous pressure. Dressings are changed every 48-72 hours in clinic until granulation reaches skin level, followed by standard dressings until epithelialisation.

Aktiv komparator: Standard wound care (SWC)

Following excision, the wound is left open (no primary closure) and managed with standard dressings according to local protocol, with wound healing by secondary intention.

Standard wound care

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Time to complete wound healing
Tidsramme: Up to 6 months post surgery

Number of days to complete epithelialisation or closure of the wound without any discharge, drainage, scab, and/or the requirement for further dressing.

Up to 6 months post surgery

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Measure of post operative pain
Tidsramme: Day of surgery, 28 days post surgery & 3 months post surgery

Pain measured by visual analogue pain scale (0 = no pain, 10 = worst pain) at rest, on walking and on sitting

Day of surgery, 28 days post surgery & 3 months post surgery
Measure of post operative complications
Tidsramme: 6 months post surgery

Post-operative complications, including surgical site infection (CDC criteria), seroma, abscess, readmission and return to theatre.

6 months post surgery
To compare recurrence rates
Tidsramme: 6 months post surgery

To compare the 6-month recurrence rates (recurrence being defined as the development of a new sinus or abscess within the natal cleft occurring after wound healing had been achieved) between the NPWT and SWC Groups

6 months post surgery
Cost-effectiveness
Tidsramme: 6 months post surgery

Within-trial cost-utility analysis from health-system and patient perspectives, expressed as incremental cost per QALY gained (QALYs from EQ-5D-5L, area under the curve). Resource use includes hospital and community contacts, dressing changes, complications, readmissions and returns to theatre, valued at Irish unit costs; patient costs and productivity losses via CoPaQ.

6 months post surgery
Health-related quality of life with the EuroQol-5 dimensions five level index questionnaire (EQ-5D-5L)
Tidsramme: Baseline, 1 month, 3 months & 6 months

The questionnaire covers five dimensions of health: mobility, self-care, usual activities, pain or discomfort, and anxiety or depression. Each dimension has 5 levels: no problems (1), slight problems (2), moderate problems (3), severe problems (4) and extreme problems (5). The patient is asked to indicate his/her health state by ticking the box next to the most appropriate statement in each of the five dimensions. Index values derived using the EQ-5D-5L value set specified in the Statistical Analysis Plan (Irish value set where available).

Baseline, 1 month, 3 months & 6 months
Scar assessment - using the Patient and Observer Scar Assessment Scale (POSAS)
Tidsramme: 28 days, 3 months, 6 months

The POSAS is made up of two scales: the patient and observer scales each comprise six items scored 1 to 10; each scale is summed (6 = normal, 60 = worst) and reported separately.

28 days, 3 months, 6 months
Health-related out-of- Pocket Costs assessed using the Costs for Patients Questionnaire (CoPaQ)
Tidsramme: 28 days, 3 months, 6 months

The CoPaQ measures patient and caregivers out-of-pocket expenses (direct and indirect) associated with a health condition

28 days, 3 months, 6 months

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Efterforskere

  • Ledende efterforsker: Sean T Martin, St. James's Hospital, Ireland

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

1. oktober 2024

Primær færdiggørelse (Anslået)

1. december 2026

Studieafslutning (Anslået)

1. juni 2027

Datoer for studieregistrering

Først indsendt

28. november 2023

Først indsendt, der opfyldte QC-kriterier

16. oktober 2024

Først opslået (Faktiske)

17. oktober 2024

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

24. september 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

21. september 2026

Sidst verificeret

1. juli 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • RCSI-ENVELOP

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

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