ORASIS in Breast Reconstruction
ORASIS and Microsurgical Anastomosis Outcomes in DIEP Flap Breast Reconstruction: A Crossover Randomized Controlled Trial
調査の概要
状態
状態
条件
条件
介入・治療
介入・治療
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:Joey Liang
- 電話番号:4252097705
- メール:joey.liang@duke.edu
研究連絡先のバックアップ
- 名前:Ash Patel, MB ChB
- メール:ash.patel@duke.edu
研究場所
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North Carolina
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Durham、North Carolina、アメリカ、27710
- Duke University Medical Center
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コンタクト:
- Joey Liang
- 電話番号:425-209-7705
- メール:joey.liang@duke.edu
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Raleigh、North Carolina、アメリカ、27609
- Duke Raleigh Hospital
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コンタクト:
- Joey Liang
- 電話番号:425-209-7705
- メール:joey.liang@duke.edu
-
-
参加基準
適格基準
適格基準
就学可能な年齢
- 大人
- 高齢者
健康ボランティアの受け入れ
説明
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
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:クロスオーバー割り当て
- 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 |
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介入なし: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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実験的: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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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 |
|---|---|---|
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Mean anastomosis time (minutes)
時間枠: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)
時間枠: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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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 |
|---|---|---|
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Mean number of interruptions per procedure
時間枠: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
時間枠: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
時間枠: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
時間枠: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
時間枠: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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その他の成果指標
その他の成果指標
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Number of surgeons per case
時間枠: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)
時間枠: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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協力者と研究者
研究記録日
主要日程の研究
研究開始 (推定)
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
その他の研究ID番号
その他の研究ID番号
- Pro00118006
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?
IPD プランの説明
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.
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
米国で製造され、米国から輸出された製品。
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。