ORASIS in Breast Reconstruction
ORASIS and Microsurgical Anastomosis Outcomes in DIEP Flap Breast Reconstruction: A Crossover Randomized Controlled Trial
Descripción general del estudio
Estado
Estado
Condiciones
Condiciones
Intervención / Tratamiento
Intervención / Tratamiento
Tipo de estudio
Tipo de estudio
Inscripción (Estimado)
Inscripción
Fase
Fase
- No aplica
Contactos y Ubicaciones
Estudio Contacto
Estudio Contacto
- Nombre: Joey Liang
- Número de teléfono: 4252097705
- Correo electrónico: joey.liang@duke.edu
Copia de seguridad de contactos de estudio
- Nombre: Ash Patel, MB ChB
- Correo electrónico: ash.patel@duke.edu
Ubicaciones de estudio
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North Carolina
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Durham, North Carolina, Estados Unidos, 27710
- Duke University Medical Center
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Contacto:
- Joey Liang
- Número de teléfono: 425-209-7705
- Correo electrónico: joey.liang@duke.edu
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Raleigh, North Carolina, Estados Unidos, 27609
- Duke Raleigh Hospital
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Contacto:
- Joey Liang
- Número de teléfono: 425-209-7705
- Correo electrónico: joey.liang@duke.edu
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Criterios de participación
Criterio de elegibilidad
Criterio de elegibilidad
Edades elegibles para estudiar
- Adulto
- Adulto Mayor
Acepta Voluntarios Saludables
Descripción
Inclusion:
- Female Deep Inferior Epigastric Perforator (DIEP) flap breast reconstruction patients who have received a prior mastectomy (either unilateral or bilateral) on the breast undergoing reconstruction
- Patients who received mastectomies for oncologic or prophylactic indications
- Patients receiving either immediate or delayed DIEP flap breast reconstruction
- Age 18 or older at the time of patient consent and DIEP flap surgery
Exclusion:
- History of any prior tissue expander placement or breast reconstruction on the breast undergoing DIEP flap reconstruction
- Patients receiving DIEP flap breast reconstruction for indications other than oncologic or prophylactic post-mastectomy breast reconstruction
- Under the age of 18 at the time of patient consent or DIEP flap surgery
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Tratamiento
- Asignación: Aleatorizado
- Modelo Intervencionista: Asignación cruzada
- Enmascaramiento: Único
Número de brazos
Armas e Intervenciones
Grupo de participantes/brazoGrupo de participantes/brazo |
Intervención / TratamientoIntervención / Tratamiento |
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Sin intervención: Control Arm
In the control arm, surgeons will perform two microsurgical anastomoses without the use of ORASIS in either bilateral or unilateral Deep Inferior Epigastric Perforator (DIEP) flap reconstruction.
If bilateral DIEP flap reconstruction is performed in the control arm, only the first microsurgical anastomosis for each bilateral DIEP flap reconstruction will be assessed.
In both study arms, surgeons will perform end-to-end anastomosis using current standard-of-care techniques.
This will include the formation of anastomoses between the deep inferior epigastric artery (DIEA) perforators and internal mammary artery (IMA) in the antegrade direction of blood flow using 8-0 nylon sutures, as well as the deep inferior epigastric vein (DIEV) perforators and internal mammary vein (IMV).
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Experimental: ORASIS Arm
In the ORASIS arm, surgeons will perform two microsurgical anastomoses with the use of ORASIS in either bilateral or unilateral Deep Inferior Epigastric Perforator (DIEP) flap reconstruction.
If bilateral DIEP flap reconstruction is performed in the treatment arm, ORASIS will only be used in the first microsurgical anastomosis performed in each bilateral DIEP flap reconstruction; only the breast reconstructed with the use of ORASIS will be assessed.
In both study arms, surgeons will perform end-to-end anastomosis using current standard-of-care techniques.
This will include the formation of anastomoses between the deep inferior epigastric artery (DIEA) and internal mammary artery (IMA) in the antegrade direction of blood flow using 8-0 nylon sutures, as well as the deep inferior epigastric vein (DIEV) perforators and internal mammary vein (IMV).
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The study intervention is the use of the ORASIS device during Deep Inferior Epigastric Perforator (DIEP) flap breast reconstruction.
ORASIS is a dual irrigation and suction device that can be placed in the surgical field during the formation of microsurgical anastomoses.
The device was previously registered with the Food and Drug Administration (FDA) under registration number 878.4200; the device is currently not registered with the FDA as it is pending renewal.
The device is manufactured by a partner company (Spectroplast/Ricoh UK) with compliance to international quality standards.
The manufacturer has successfully implemented the ISO 9001 Quality Management System across operational areas following a comprehensive audit process that supports compliance with FDA Current Good Manufacturing Practice (cGMP) requirements (21 CFR Part 820) for Class I medical devices.
Spectroplast/Ricoh UK is certified under FDA ISO 10993 standards for biological evaluation of medical devices.
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¿Qué mide el estudio?
Medidas de resultado primarias
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
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Mean anastomosis time (minutes)
Periodo de tiempo: From first suture placement to anastomosis completion
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Total anastomosis time will be defined as the number of minutes from first suture placement to anastomosis completion.
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From first suture placement to anastomosis completion
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Mean ischemia time (minutes)
Periodo de tiempo: From pedicle transection to anastomosis completion
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Total ischemia time will be defined as the number of minutes from flap division to flap reperfusion.
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From pedicle transection to anastomosis completion
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Medidas de resultado secundarias
Medidas de resultado secundarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
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Mean number of interruptions per procedure
Periodo de tiempo: From beginning of microsurgical anastomosis to end of microsurgical anastomosis
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Interruptions will be defined as instances where the surgeon pauses for suction/irrigation in the control arm vs. automatic suction/irrigation in the ORASIS arm.
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From beginning of microsurgical anastomosis to end of microsurgical anastomosis
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Surgeon Survey
Periodo de tiempo: Within 1 month after conclusion of DIEP flap surgery procedure
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A post-procedure survey (Likert scale) will be administered after each procedure assessing ease of use, surgeon perception of precision, and overall satisfaction with the ORASIS device.
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Within 1 month after conclusion of DIEP flap surgery procedure
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Incidence of postoperative complications 0-48 hours after procedure
Periodo de tiempo: Within 48 hours after DIEP flap surgery
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Notable complications include flap failure, re-operation/take-back and wound dehiscence, seroma, hematoma, and surgical site infection.
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Within 48 hours after DIEP flap surgery
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Mean NASA-TLX (Task Load Index) score
Periodo de tiempo: From beginning of microsurgical anastomosis to end of microsurgical anastomosis
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The NASA Task Load Index (NASA-TLX) is a validated tool to measure cognitive and physical workload for surgeons, reported as a score between 0 to 100.
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From beginning of microsurgical anastomosis to end of microsurgical anastomosis
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Mean Surgical Assessment Metric Scale (SAMS) overall scores
Periodo de tiempo: From beginning of microsurgical anastomosis to end of microsurgical anastomosis
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The Surgical Assessment Metric Scale (SAMS) is a validated tool that assesses proficiency across key technical metrics such as suture placement, knot quality, and overall flow of the procedure on a scale of 1-5.
Performed anastomoses will be recorded by the digital microscope, and the quality and precision of the anastomosis will be assessed by a blinded rater using the previously validated SAMS score checklist.
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From beginning of microsurgical anastomosis to end of microsurgical anastomosis
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Otras medidas de resultado
Otras medidas de resultado
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
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Number of surgeons per case
Periodo de tiempo: During the entirety of the DIEP flap procedure
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Number of surgeons per case, stratified by level of training (i.e. 1 vs 2 microsurgeons required +/- residents).
For example, allowing a microsurgeon to perform the anastomosis alone as opposed to a co-surgeon case would reduce operative costs.
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During the entirety of the DIEP flap procedure
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Estimated cost difference per case (economic impact metrics)
Periodo de tiempo: During the entirety of the DIEP flap procedure
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Based on average operating room (OR) time cost for plastic surgery procedures at Duke (dollars per minute).
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During the entirety of the DIEP flap procedure
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Colaboradores e Investigadores
Patrocinador
Patrocinador
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio (Estimado)
Inicio del estudio
Finalización primaria (Estimado)
Finalización primaria
Finalización del estudio (Estimado)
Finalización del estudio
Fechas de registro del estudio
Enviado por primera vez
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Actual)
Publicado por primera vez
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
Última actualización publicada
Última actualización enviada que cumplió con los criterios de control de calidad
Última actualización enviada que cumplió con los criterios de control de calidad
Última verificación
Última verificación
Más información
Términos relacionados con este estudio
Palabras clave
Términos MeSH relevantes adicionales
Otros números de identificación del estudio
Otros números de identificación del estudio
- Pro00118006
Plan de datos de participantes individuales (IPD)
¿Planea compartir datos de participantes individuales (IPD)?
Descripción del plan IPD
Confidentiality of subject data will be ensured by de-identification of subject data. During data collection, subject identifiers and relevant data elements will be recorded in the database. Then, study-specific identification numbers will be assigned to each subject. Prior to dissemination of any information in this database beyond the DUMC's secure servers or firewall, all identifiers will be stripped from the database and data will only be referenced by the study-specific identification numbers.
The adequacy of the Duke Research Data Lifecycle will be evaluated and approved by the Surgery CRU and IT personnel prior to study conduct. Any publications or presentations that result from this research will not identify any subjects individually and will present data in aggregate form only. Data collected as part of this study will not be submitted to the FDA; data collected will only be used for publication as part of an assessment of device efficacy.
Información sobre medicamentos y dispositivos, documentos del estudio
Estudia un producto farmacéutico regulado por la FDA de EE. UU.
Estudia un producto de dispositivo regulado por la FDA de EE. UU.
producto fabricado y exportado desde los EE. UU.
Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .