Swedish National Parotidectomy Study (SNaPs): Drainless Versus Standard Surgery (SNaPs)
A Prospective, Randomized, Multicenter Non-Inferiority Trial Evaluating the Safety of Parotidectomy Without Active Surgical Drainage (Svenska Nationella Parotisstudien)
The purpose of this study The purpose of this study is to find out if it is safe to perform surgery on the parotid gland (the large salivary gland in front of the ear) without using a wound drain. A wound drain is a small plastic tube used to remove excess fluid from the surgical site after the operation. Currently, using a drain is the standard practice in Sweden, which often means patients must stay in hospital overnight. Researchers want to see if skipping the drain is just as safe and if it could allow more patients to return home on the same day as their surgery.
What happens during the study
Participants in this study will be randomly assigned to one of two groups during their surgery:
Group 1: Will receive the standard treatment with a wound drain.
Group 2: Will have the surgery performed without a wound drain.
Apart from the use of a drain, all participants will receive the same surgical care. After the operation, researchers will monitor the healing process. Participants will be asked to fill out questionnaires about their health and any symptoms at one week and six months after their surgery.
The goal of the study The main goal is to compare the safety of the two methods. Researchers will look at whether there is any difference in the number of complications, such as fluid build-up (seroma), bleeding, or infections, between those who had a drain and those who did not. The study also aims to evaluate if avoiding a drain improves the patient's quality of life and if it is a more cost-effective approach for the healthcare system.
調査の概要
状態
研究の種類
入学 (推定)
段階
- 適用できない
連絡先と場所
研究連絡先
- 名前:Karl Sandström, MD, PhD
- 電話番号:+46 76 113 29 52
- メール:karl.sandstrom@akademiska.se
研究場所
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Stockholm、スウェーデン
- 募集
- Karolinska University Hospital
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Trollhättan、スウェーデン
- 募集
- NÄL
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Uppsala、スウェーデン
- 募集
- Uppsala University Hospital, Department of Otorhinolaryngology
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コンタクト:
- Karl Sandström, MD, PhD
- 電話番号:+46 76 113 29 52
- メール:karl.sandstrom@akademiska.se
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参加基準
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 Criteria:
- Patients scheduled to undergo partial or superficial parotidectomy without concurrent soft tissue surgery, in cases where a wound drain is traditionally used (extirpation of single adjacent lymph nodes is acceptable).
- ASA physical status class 1-3.
- Aged 18 years or older.
- The patient understands the participant information and is able to make an informed choice.
Exclusion Criteria:
- Previous parotid surgery on the same side
- Tumour with parapharyngeal extension.
- Ongoing or planned perioperative treatment with tranexamic acid.
- Ongoing treatment with dual antiplatelet therapy (single agent therapy, such as Aspirin or Clopidogrel, is not an exclusion criterion).
- Ongoing treatment with anticoagulants (NOAC, Warfarin) at the time of surgery. NOAC must be discontinued at least 24 hours before surgery.
- Ongoing treatment with low molecular weight heparin in doses higher than: Fragmin 5000 IU/day, Clexane 40 mg/day, or Innohep 4500 IU/day.Ongoing treatment for malignancy.Known coagulation disorder.
- Platelet count <150 x 10⁹
- PK-INR >1.2.
- Hb <120 g/L.
- APTT >42s.
- Preoperative impaired facial nerve function on the affected side (Sunnybrook Facial Grading System score <90).
- Supplementary postoperative treatment such as radiotherapy or extended 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:ヘルスサービス研究
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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実験的:Drainless Group (Intervention)
Participants in this group will undergo partial or superficial parotidectomy without the placement of a postoperative active wound drain.
The surgical site is closed according to the standard technique, but the suction drain is omitted.
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The surgical procedure is performed without the insertion of an active suction drain.
All other aspects of the surgical care and postoperative monitoring follow standard protocols.
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アクティブコンパレータ:Standard Drain Group (Control)
Participants in this group will undergo partial or superficial parotidectomy with the placement of a postoperative active wound drain, according to current standard clinical routine in Sweden.
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An active suction drain is placed in the surgical bed before wound closure, which is the current established clinical practice for parotidectomy in Sweden.
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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
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Cumulative incidence of early postoperative complications requiring intervention
時間枠:From the day of surgery up to 7 weeks postoperatively.
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The primary outcome is the number of participants experiencing at least one early complication, defined as a salivary fistula, haematoma, seroma/sialocele, or surgical site infection that requires invasive or medical treatment (e.g., aspiration, re-operation, or antibiotics).
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From the day of surgery up to 7 weeks postoperatively.
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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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Requirement for inpatient hospital care after the day of surgery.
時間枠:From the first postoperative day up to 6 months
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Evaluation of the number of participants requiring unplanned hospital admission or prolonged stay related to the surgical procedure.
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From the first postoperative day up to 6 months
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Postoperative facial nerve function.
時間枠:Baseline (preoperative), at discharge, at 7 weeks, and at 6 months
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Assessment of facial nerve function using the Sunnybrook Facial Grading System (SFGS).
The SFGS is a clinical evaluation scale that ranges from 0 to 100.
A score of 0 indicates complete facial paralysis, while a score of 100 represents normal facial function.
Higher scores indicate a better outcome (better facial nerve function).
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Baseline (preoperative), at discharge, at 7 weeks, and at 6 months
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Incidence of Frey's syndrome
時間枠:6 months postoperatively.
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Subjective and objective assessment of gustatory sweating (Frey's syndrome).
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6 months postoperatively.
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Health-related quality of life (EQ-5D-5L)
時間枠:7 weeks, and 6 months postoperatively
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Evaluated using the EQ-5D-5L descriptive system, which comprises 5 dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression).
Each dimension is scored from 1 (no problems) to 5 (extreme problems).
The digits are combined into a 5-digit health state profile, which is then converted into a single index value.
Index values range from less than 0 (where 0 is a state equivalent to death and negative values are states worse than death) to 1.0 (perfect health).
Higher scores indicate a better quality of life outcome.
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7 weeks, and 6 months postoperatively
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Postoperative length of stay
時間枠:Through initial hospital discharge, an average of 1.5 days, assessed up to 7 weeks.
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Total number of days spent in hospital following the surgical procedure.
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Through initial hospital discharge, an average of 1.5 days, assessed up to 7 weeks.
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Symptom-specific outcomes (SwPOI-8)
時間枠:7 weeks and 6 months postoperatively
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Measured using the Swedish Parotidectomy Outcome Inventory 8 (SwPOI-8), a disease-specific instrument assessing subjective symptoms after parotid surgery (e.g., pain, sensory disturbances, scarring, facial palsy, sweating, dry mouth).
Each of the 8 items is scored on a Likert scale from 0 to 3, with a total score ranging from 0 to 24.
Higher scores indicate a greater symptom burden and a worse outcome.
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7 weeks and 6 months postoperatively
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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 (実際)
一次修了 (推定)
研究の完了 (推定)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
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
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
- 2025-07555-01
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
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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Omission of active wound drainの臨床試験
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Royal Brompton & Harefield NHS Foundation TrustNational Institute for Health Research, United Kingdom完了