Prophylactic Subcutaneous Drainage After Gynecologic Oncology Midline Laparotomy (SCDRAIN-GO)
Effect of Prophylactic Subcutaneous Drainage on Wound Complications in Patients With Thick Subcutaneous Tissue Undergoing Midline Laparotomy for Gynecologic Oncology Surgery: A Randomized Controlled Trial
The goal of this clinical trial is to learn whether placing a small drain under the skin can help prevent wound problems after gynecologic oncology surgery in adult women with a thick layer of tissue under the skin.
The main question it aims to answer is:
Does a small drain placed under the skin lower the number of wound complications within 30 days after surgery?
Researchers will compare two groups:
Participants in one group will have a small closed-suction drain placed under the skin before the skin is closed.
Participants in the other group will not have a drain placed under the skin.
All participants will have midline abdominal surgery. During surgery, the surgeon will measure the thickness of the tissue under the skin. Participants with a thickness of 2.5 cm or more will be randomly assigned to one of the two groups.
In both groups, the tissue under the skin will be closed in a standard way using separate 2/0 Vicryl stitches. Participants in the drain group will have the drain removed when the amount of fluid collected in 24 hours is less than 30 mL, unless the surgeon decides that earlier or later removal is needed.
Participants will be followed for 30 days after surgery to check for wound problems such as infection, wound separation, fluid collection, blood collection, or the need for extra wound care or another procedure.
Studienübersicht
Status
Status
Bedingungen
Bedingungen
Intervention / Behandlung
Intervention / Behandlung
Detaillierte Beschreibung
Wound complications after gynecologic oncology surgery are clinically important because they may increase postoperative morbidity, delay recovery, prolong hospital stay, and postpone planned adjuvant treatment. Increased subcutaneous tissue thickness is a recognized surgical risk factor for wound-related problems after abdominal surgery. However, the benefit of routinely placing a prophylactic drain in the subcutaneous tissue remains uncertain, and practice varies among surgeons.
This study will evaluate a standardized approach to prophylactic subcutaneous drainage in participants undergoing gynecologic oncology surgery through a midline laparotomy. The study is designed as a single-center, prospective, randomized, open-label, parallel-group clinical trial. Because the intervention is a surgical procedure that is visible to the operating team and to postoperative care providers, masking will not be used.
Written informed consent will be obtained before surgery from potentially eligible participants. The final eligibility for randomization will be confirmed during surgery by measuring the subcutaneous tissue thickness with a sterile ruler at the thickest part of the incision. Participants who meet the intraoperative thickness requirement will be assigned to one of the study groups using a pre-generated randomization sequence and sequentially numbered, opaque, sealed envelopes.
The study compares two standard surgical approaches used in routine clinical practice: placement of a closed-suction drain in the subcutaneous tissue versus no subcutaneous drain. No investigational drug, biological product, or experimental medical device will be used. In both groups, subcutaneous tissue approximation will be standardized with interrupted 2/0 Vicryl sutures. In the drainage group, the subcutaneous drain will be managed according to a predefined removal criterion based on the 24-hour drainage volume, unless clinical circumstances require a different decision.
Postoperative care will otherwise follow the usual clinical practice of the gynecologic oncology surgery service. Wound-related findings and postoperative clinical data will be collected during hospitalization, at discharge, and during the postoperative follow-up period. Hospital records, outpatient assessments, readmission records, and telephone follow-up may be used to complete follow-up information when needed.
The primary analysis will follow the intention-to-treat principle, with participants analyzed according to their randomized group. A supportive per-protocol analysis will also be performed to assess the effect of protocol adherence. The main treatment effect will be expressed using absolute risk difference with 95% confidence intervals, with relative effect estimates reported as additional measures. The results are expected to clarify whether routine prophylactic subcutaneous drainage provides clinically meaningful benefit in patients with thick subcutaneous tissue undergoing gynecologic oncology midline laparotomy.
Prespecified exploratory analyses will examine the association between baseline and intraoperative variables (body mass index, diabetes mellitus, preoperative hemoglobin, preoperative serum albumin, operative duration, bowel intervention, and subcutaneous tissue thickness) and 30-day composite wound complication using multivariable logistic regression. These analyses are exploratory and are not registered as outcome measures.
Studientyp
Studientyp
Einschreibung (Geschätzt)
Einschreibung
Phase
Phase
- Unzutreffend
Kontakte und Standorte
Studienkontakt
Studienkontakt
- Name: MAHMUT yassa, MD
- Telefonnummer: +905396635484
- E-Mail: mahmut_yassa@hotmail.com
Studieren Sie die Kontaktsicherung
- Name: Bora Taşpınar, MD
- Telefonnummer: +905053946331
- E-Mail: borataspinar@gmail.com
Studienorte
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-
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Istanbul, Türkei (türkiye)
- Rekrutierung
- Başakşehir Çam and Sakura City Hospital
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Kontakt:
- mahmut yassa
- Telefonnummer: +905396635484
- E-Mail: mahmut_yassa@hotmail.com
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Teilnahmekriterien
Zulassungskriterien
Zulassungskriterien
Studienberechtigtes Alter
- Erwachsene
- Älterer Erwachsener
Akzeptiert gesunde Freiwillige
Beschreibung
Inclusion Criteria:
- Female participants aged 18 years or older
- Undergoing midline laparotomy for gynecologic oncology surgery
- Intraoperative subcutaneous tissue thickness of 2.5 cm or greater, measured at the thickest part of the incision
- Able and willing to provide written informed consent before surgery
Exclusion Criteria:
- Emergency surgery
- Active infection before surgery
- Severe immunosuppression
- Refusal to provide written informed consent
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Verhütung
- Zuteilung: Zufällig
- Interventionsmodell: Parallele Zuordnung
- Maskierung: Keine (Offenes Etikett)
Anzahl der Arme
Waffen und Interventionen
Teilnehmergruppe / ArmTeilnehmergruppe / Arm |
Intervention / BehandlungIntervention / Behandlung |
|---|---|
|
Experimental: Subcutaneous Drain
Participants allocated to this arm will receive prophylactic closed-suction subcutaneous drainage after midline laparotomy and before skin closure.
Subcutaneous tissue approximation will be performed with interrupted 2/0 Vicryl sutures.
The drain will be removed when the 24-hour drainage volume is less than 30 mL, unless earlier or later removal is clinically indicated.
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Placement of a closed-suction drain in the subcutaneous tissue before skin closure in patients with intraoperative subcutaneous tissue thickness of 2.5 cm or greater.
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Aktiver Komparator: No Subcutaneous Drain
Participants allocated to this arm will undergo standard surgical closure without prophylactic subcutaneous drainage.
Subcutaneous tissue approximation will be performed with interrupted 2/0 Vicryl sutures.
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Standardized subcutaneous tissue approximation and skin closure without placement of a prophylactic subcutaneous drain.
|
Was misst die Studie?
Primäre Ergebnismessungen
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Composite wound complication within 30 postoperative days
Zeitfenster: Up to 30 days after surgery
|
The primary outcome is the incidence of composite wound complication within 30 postoperative days. Composite wound complication is defined as the occurrence of at least one of the following: surgical site infection, wound dehiscence, clinically significant subcutaneous seroma, clinically significant subcutaneous hematoma, or wound-related intervention. Clinically significant subcutaneous seroma or hematoma is defined as a seroma or hematoma requiring any additional wound care beyond routine postoperative care, unscheduled clinical assessment, imaging, antibiotic treatment, aspiration, drainage, readmission, or surgical intervention. Wound-related intervention is defined as any wound-directed procedure (aspiration, drainage, re-suturing, surgical revision, or operative wound debridement) performed because of a postoperative wound complication, in either an inpatient or outpatient setting. |
Up to 30 days after surgery
|
Sekundäre Ergebnismessungen
Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Surgical site infection within 30 postoperative days
Zeitfenster: Up to 30 days after surgery
|
Incidence of surgical site infection within 30 postoperative days, including superficial or deep incisional surgical site infection as clinically diagnosed and recorded during postoperative follow-up.
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Up to 30 days after surgery
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Wound dehiscence within 30 postoperative days
Zeitfenster: Up to 30 days after surgery
|
Incidence of wound dehiscence within 30 postoperative days, including superficial or deep wound separation documented during postoperative follow-up.
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Up to 30 days after surgery
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Clinically significant subcutaneous seroma within 30 postoperative days
Zeitfenster: Up to 30 days after surgery
|
Incidence of clinically significant subcutaneous seroma within 30 postoperative days.
Clinically significant seroma is defined as a seroma requiring additional wound care beyond routine postoperative care, unscheduled clinical assessment, imaging, antibiotic treatment, aspiration, drainage, readmission, or surgical intervention.
|
Up to 30 days after surgery
|
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Clinically significant subcutaneous hematoma within 30 postoperative days
Zeitfenster: Up to 30 days after surgery
|
Incidence of clinically significant subcutaneous hematoma within 30 postoperative days.
Clinically significant hematoma is defined as a hematoma requiring additional wound care beyond routine postoperative care, unscheduled clinical assessment, imaging, antibiotic treatment, aspiration, drainage, readmission, or surgical intervention.
|
Up to 30 days after surgery
|
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Wound-related intervention within 30 postoperative days
Zeitfenster: Up to 30 days after surgery
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Incidence of wound-related intervention within 30 postoperative days.
Wound-related intervention is defined as any wound-directed procedure performed because of a postoperative wound complication, including aspiration, drainage, re-suturing, surgical revision, or operative wound debridement, regardless of whether the procedure is performed in an inpatient or outpatient setting.
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Up to 30 days after surgery
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Wound-related readmission within 30 postoperative days
Zeitfenster: Up to 30 days after surgery
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Incidence of hospital readmission within 30 postoperative days due to a wound-related complication.
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Up to 30 days after surgery
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Postoperative length of hospital stay
Zeitfenster: From the date of surgery to hospital discharge, assessed up to 30 days after surgery
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Length of postoperative hospital stay, defined as the number of days from surgery to hospital discharge.
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From the date of surgery to hospital discharge, assessed up to 30 days after surgery
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Subcutaneous tissue thickness in participants with and without 30-day composite wound complication
Zeitfenster: Up to 30 days after surgery
|
Subcutaneous tissue thickness, measured in centimeters intraoperatively with a sterile ruler at the thickest part of the midline incision, reported separately for participants with and without composite wound complication within 30 postoperative days.
|
Up to 30 days after surgery
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Mitarbeiter und Ermittler
Sponsor
Sponsor
Ermittler
Ermittler
- Hauptermittler: MAHMUT YASSA, MD, Başakşehir Çam & Sakura City Hospital
- Studienleiter: Bora Taşpınar, MD, Başakşehir Çam & Sakura City Hospital
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn (Tatsächlich)
Studienbeginn
Primärer Abschluss (Geschätzt)
Primärer Abschluss
Studienabschluss (Geschätzt)
Studienabschluss
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Tatsächlich)
Zuerst gepostet
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Tatsächlich)
Letztes Update gepostet
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Schlüsselwörter
Zusätzliche relevante MeSH-Bedingungen
Andere Studien-ID-Nummern
Andere Studien-ID-Nummern
- SCDRAIN-GO-RCT-2026
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