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PROV-MESH: Prophylactic Ovarian Cancer MESH (PROV-MESH)
A Multicenter Randomized Clinical Trial Comparing Prophylactic Mesh Placement Versus Primary Closure, With or Without Negative Pressure Wound Therapy, in Patients Undergoing Primary or Interval Cytoreductive Surgery for Ovarian Cancer
Incisional hernia is a common complication after midline laparotomy and may significantly impact quality of life, morbidity, and healthcare costs. Patients undergoing cytoreductive surgery for ovarian cancer are considered at increased risk due to extensive surgical procedures, nutritional status, and exposure to systemic treatments.
This prospective randomized clinical trial aims to evaluate whether prophylactic mesh placement during abdominal wall closure reduces the incidence of incisional hernia compared with conventional fascial closure in women undergoing cytoreductive surgery for ovarian cancer through a midline laparotomy. To control for the potential effect of negative pressure wound therapy (NPWT) on surgical site infection, participants will also be randomized to receive NPWT or standard wound dressing, resulting in four treatment arms.
Studie Overzicht
Toestand
Conditie
Studietype
Inschrijving (Geschat)
Fase
- Niet toepasbaar
Contacten en locaties
Studiecontact
- Naam: Jose Luis Sánchez Iglesias, MD PhD
- Telefoonnummer: 3217 +34 932746000
- E-mail: jlsanig@yahoo.es
Studie Locaties
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Barcelona
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Barcelona, Barcelona, Spanje, 08035
- Werving
- Hospital Universitario Vall d'Hebron
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Contact:
- Jose Luis Sánchez Iglesias, MD PhD
- Telefoonnummer: 3217 +34 932746000
- E-mail: jlsanig@yahoo.es
-
-
Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Volwassen
- Oudere volwassene
Accepteert gezonde vrijwilligers
Beschrijving
Inclusion Criteria:
- Female patients diagnosed with ovarian carcinoma.
- Undergoing primary cytoreductive surgery, interval cytoreductive surgery, or delayed cytoreductive surgery after six cycles of chemotherapy.
- Surgical procedure performed through a midline laparotomy.
- Ability and willingness to provide written informed consent.
Exclusion Criteria:
- Surgery for recurrent ovarian cancer (secondary, tertiary, or subsequent cytoreductions).
- Minimally invasive surgical approach.
- Planned secondary cytoreductive surgery during the 24-month follow-up period.
- Inability or unwillingness to comply with follow-up requirements.
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Preventie
- Toewijzing: Gerandomiseerd
- Interventioneel model: Faculteitstoewijzing
- Masker: Geen (open label)
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
|
Experimenteel: Prophylactic Mesh + Negative Pressure Wound Therapy
Participants will undergo standard fascial closure reinforced with a prophylactic supra-aponeurotic non-absorbable mesh and postoperative negative pressure wound therapy using a PICO dressing for 7 days.
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Placement of a non-absorbable polypropylene or polyester mesh in a supra-aponeurotic position at the time of abdominal wall closure following cytoreductive surgery.
Application of a PICO negative pressure dressing after skin closure, maintained for 7 days postoperatively.
|
|
Experimenteel: Prophylactic Mesh without Negative Pressure Wound Therapy
Participants will undergo standard fascial closure reinforced with a prophylactic supra-aponeurotic non-absorbable mesh and standard postoperative wound dressing.
|
Placement of a non-absorbable polypropylene or polyester mesh in a supra-aponeurotic position at the time of abdominal wall closure following cytoreductive surgery.
|
|
Actieve vergelijker: Conventional Closure + Negative Pressure Wound Therapy
Participants will undergo standard fascial closure without mesh reinforcement and postoperative negative pressure wound therapy using a PICO dressing for 7 days.
|
Application of a PICO negative pressure dressing after skin closure, maintained for 7 days postoperatively.
Continuous closure of the abdominal fascia using slowly absorbable monofilament suture (PDS 2-0), single-layer closure without peritoneal closure, maintaining a suture-to-wound length ratio greater than 4:1 and employing the small-bites technique.
|
|
Experimenteel: Conventional Closure without Negative Pressure Wound Therapy
Participants will undergo standard fascial closure without mesh reinforcement and standard postoperative wound dressing.
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Continuous closure of the abdominal fascia using slowly absorbable monofilament suture (PDS 2-0), single-layer closure without peritoneal closure, maintaining a suture-to-wound length ratio greater than 4:1 and employing the small-bites technique.
|
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Incidence of Incisional Hernia
Tijdsspanne: 24 months after surgery
|
Presence of an abdominal wall incisional hernia confirmed by computed tomography (CT scan) or by imaging performed after clinical suspicion during follow-up.
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24 months after surgery
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Incidence of Surgical Site Infection
Tijdsspanne: Within 30 days after surgery
|
Surgical site infection according to CDC criteria.
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Within 30 days after surgery
|
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Incidence of Incisional Hernia at Intermediate Time Points
Tijdsspanne: 3, 6, and 12 months after surgery
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Radiologically confirmed incisional hernia detected during routine follow-up imaging.
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3, 6, and 12 months after surgery
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Risk Factors Associated With Incisional Hernia Development
Tijdsspanne: Up to 24 months
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Identification of demographic, clinical, oncological, and surgical variables associated with incisional hernia occurrence.
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Up to 24 months
|
Medewerkers en onderzoekers
Studie record data
Bestudeer belangrijke data
Studie start (Werkelijk)
Primaire voltooiing (Geschat)
Studie voltooiing (Geschat)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Aanvullende relevante MeSH-voorwaarden
- Urogenitale ziekten
- Genitale ziekten
- Endocriene systeemziekten
- Urogenitale neoplasmata
- Neoplasmata per site
- Neoplasmata
- Vrouwelijke urogenitale ziekten
- Vrouwelijke urogenitale ziekten en zwangerschapscomplicaties
- Genitale ziekten, vrouw
- Endocriene klierneoplasmata
- Ovariële ziekten
- Adnexale ziekten
- Genitale neoplasmata, vrouwelijk
- Gonadale aandoeningen
- Ovariumneoplasmata
- Therapeutica
- Chirurgische procedures, operatief
- Afwatering
- Wondsluitingstechnieken
- Negatieve drukwondtherapie
Andere studie-ID-nummers
- PI-24-055
Plan Individuele Deelnemersgegevens (IPD)
Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?
IPD delen Ondersteunend informatietype
- LEERPROTOCOOL
- SAP
- ICF
- MVO
Informatie over medicijnen en apparaten, studiedocumenten
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product vervaardigd in en geëxporteerd uit de V.S.
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