ENVELOP: 毛巣洞手術後の創傷ケア (ENVELOP)
慢性ピロニダル副鼻腔疾患の管理のための、切除および陰圧創傷治療と標準的な創傷ケアによる切除および開いたままにすることの比較 - ランダム化比較試験
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).
調査の概要
状態
状態
条件
条件
介入・治療
介入・治療
詳細な説明
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.
研究の種類
研究の種類
入学 (推定)
入学
段階
段階
- 適用できない
連絡先と場所
研究連絡先
研究連絡先
- 名前:Sean T Martin
- 電話番号:(01) 261 4037
- メール:seanmartin@rcsi.ie
研究連絡先のバックアップ
- 名前:Eanna Ryan
- 電話番号:(01) 261 4037
- メール:eannaryan@rcsi.com
研究場所
-
-
-
Castlebar、アイルランド
- 募集
- Mayo University Hospital
-
コンタクト:
- Kevin Barry
-
Dublin、アイルランド
- 募集
- Tallaght University Hospital
-
コンタクト:
- Dara Kavanagh
-
Dublin、アイルランド、D09V2N0
- 募集
- Beaumont Hospital
-
コンタクト:
- John Burke
-
Dublin、アイルランド
- 募集
- St James's Hospital
-
コンタクト:
- Michael Kelly
-
Dublin、アイルランド
- 募集
- St Michael's Hospital, Dún Laoghaire
-
コンタクト:
- Helen Heneghan
-
Dublin、アイルランド
- 募集
- St Vincent's Univeristy Hospital
-
コンタクト:
- Eanna Ryan
-
Kilkenny、アイルランド
- 募集
- St. Luke's Hospital
-
コンタクト:
- Cathy Cronin
-
Limerick、アイルランド
- 募集
- University Hospital Limerick
-
コンタクト:
- Colin Peirce
-
Tullamore、アイルランド
- 募集
- Midlands University Hospital
-
コンタクト:
- Sean Johnston
-
Waterford、アイルランド
- 募集
- University Hospital Waterford
-
コンタクト:
- Peter Neary
-
-
参加基準
適格基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
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
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:独身
アーム数
武器と介入
参加者グループ / アーム参加者グループ / アーム |
介入・治療介入・治療 |
|---|---|
|
実験的: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. |
|
アクティブコンパレータ: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 |
この研究は何を測定していますか?
主要な結果の測定
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Time to complete wound healing
時間枠: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
|
二次結果の測定
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Measure of post operative pain
時間枠: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
時間枠: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
時間枠: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
時間枠: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)
時間枠: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)
時間枠: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)
時間枠: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
|
協力者と研究者
捜査官
捜査官
- 主任研究者:Sean T Martin、St. James's Hospital, Ireland
研究記録日
主要日程の研究
研究開始 (実際)
研究開始
一次修了 (推定)
一次修了
研究の完了 (推定)
研究の完了
試験登録日
最初に提出
最初に提出
QC基準を満たした最初の提出物
QC基準を満たした最初の提出物
最初の投稿 (実際)
最初の投稿
学習記録の更新
投稿された最後の更新 (実際)
投稿された最後の更新
QC基準を満たした最後の更新が送信されました
QC基準を満たした最後の更新が送信されました
最終確認日
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
その他の研究ID番号
その他の研究ID番号
- RCSI-ENVELOP
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
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